Word Retrieval Treatment Using Collaborative Referencing

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Word Retrieval Treatment Using Collaborative
Referencing

• Author Cassie Shuemaker-Flack, B.S.
• Faculty Mentor Brenda Wilson, Ph.D.

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Collaborative Referencing Tasks

• Collaborative Referencing is the process through
  which people work together, using past knowledge
  and experiences, to establish a shared
  perspective (Clark and Wilkes-Gibbs, 1986).
• Collaborative Referencing tasks are barrier tasks
  that have been found to increase noun and verb
  retrieval in individuals with aphasia.

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Collaborative Referencing Tasks

• Partners sit across from each other separated by
  a barrier.
• Both have a numbered board and a matching set of
  pictures.
• The object is for the director to name or
  describe picture cards so that the matcher can
  place pictures in the same sequence.
• When Collaborative Referencing tasks are used for
  treatment, the object is for the individual with
  aphasia to improve naming skills while serving as
  the director.

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Phases

• During collaborative referencing tasks partners
  typically progress through 3 phases
• Initiation-first full phrase, includes detailed
  descriptions
• Refashioning- repairs, expansions, replacements
• Acceptance- both partners agree

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Collaborative Referencing Studies

• Clark and Wilkes-Gibbs (1986)
• Participants were 8 pairs of college students.
• Stimuli consisted of 12 Chinese Tangram figures.
• Number of words and conversational turns
  decreased across trials.
• Cards were placed with 98 accuracy.
• Separated by an opaque barrier.

• Hengst (2003) study
• Patterned after Clark and Wilkes-Gibbs (1986).
• Studied collaborative referencing of nouns
  between individuals with aphasia and routine
  communication partners.
• Separated by a partial barrier
• Resulted in accurate card placement,
  simplification of initiating descriptions, and a
  decrease in collaborative effort across trials
• Partners made references from shared knowledge
  and history

.
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Current Need

• Currently, there is a need to supplement
  traditional speech therapy to maximize
  effectiveness of techniques for treatment of word
  retrieval difficulties in individuals with
  aphasia.
• The use of collaborative referencing tasks in
  therapy settings is a possible solution.

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Research Questions

• The purpose of this study was to determine if
  collaborative referencing could be used to
  increase word retrieval in individuals with
  nonfluent aphasia.
• Can participants with aphasia improve naming
  skills through collaborative referencing?
• Which cueing strategies are most effective for a
  participant when targeting naming skills?
• Cueing strategies analyzed gesture, phonemic,
  sentence completion, description, question
• Is the learning pattern for naming consistent
  with the collaborative referencing model?

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Participants

• Participant 1
• 72 year old male
• Nine years post onset CVA
• Participant 2
• 84 year old female
• 6 years post onset CVA
• Both Participants
• Aphasia Diagnostic Profiles Indicated nonfluent
  aphasia and below average scores on Boston Naming
  Test
• Communicated at conversational level

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Research Design

• Multiple baseline across 2 subjects
• Independent Variables
• Collaborative Referencing Task and Cueing
  Strategies used by the partner
• Dependent Variables
• Number of correctly labeled verbs
• Responses to partners cues
• Adherence to the collaborative referencing model

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Procedures

• Collaborative Referencing Model patterned after
  Clark and Wilkes-Gibbs (1986) and Hengst (2003)
• Baseline was established at 30 accuracy for each
  card set.
• The routine communication partners were the
  participants spouses.
• Each session consisted of six trials.
• Correct responses included the targeted label and
  refashioned labels when the label had been
  accepted by the participant and the spouse.

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Procedures

• Picture sets were considered trained when the
  participant named 8 out of 10 labels correctly
  over 2 trials.
• After criterion was met, the next picture set was
  targeted.
• Participant 2 remained in baseline until
  Participant 1 reached criterion on his or her
  first card set.
• To assess carryover, each picture set was
  reintroduced and criterion reestablished.

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Setup
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Mean Number of Correct Responses

• Card Set 1

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Mean Number of Correct Responses

• Card Set 2

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Mean Number of Correct Responses

• Card Set 3

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Summary Mean Number of Correct Responses

• Criterion was met for all 3 verb picture sets.
• The number correct for each picture set increased
  across sessions.
• Across all picture sets for both participants,
  the number of correct verb labels on the first
  trial when a set was re-introduced was greater
  than the initial baseline for that picture set.

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Mean Number of Partner Cues and Mean Number of
Correct Responses to Cues Participant 1
Note r Spearman Correlation, psignificance
level, Standard Deviations in parenthesis
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Mean Number of Partner Cues and Mean Number of
Correct Responses to Cues Participant 2
Note r Spearman Correlation, psignificance
level, Standard Deviations in parenthesis
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Significance of Cueing Types

• Participants in this study benefited from all
  types of cueing provided.
• Data showed all types of cues were statistically
  beneficial for both participants.

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Adherence to the Collaborative Referencing Model

• Participants followed the Collaborative
  Referencing Model to come to an agreement on all
  Picture Card labels they did not initially agree
  on.
• Participant 1 followed the model for a total of 4
  pictures.
• Participant 2 followed the model for a total of 5
  pictures.

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Discussion

• The participants in this study made gains in verb
  retrieval across each session.
• Gains were shown to be maintained when picture
  sets were reintroduced, suggesting that the
  participants learned and remembered the verb
  labels in the context of the collaborative
  referencing task.
• In situations in which therapy sessions are
  limited, this model may be an important way to
  supplement services provided by the speech
  language pathologist.

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