Comparing the effectiveness of orthographic and phonological cues in the treatment of anomia. Lyndsey Nickels 1, Antje Lorenz 1,2, 1 Macquarie Centre for Cognitive Science (MACCS), Macquarie University 2 Institut für Linguistik, Potsdam University

Introduction: phonological cues Phonological cues have strong effects on spoken word retrieval (e.g. Pease & Goodglass, 1978) early studies: phonological cues produce only short- lasting effects on naming success - Patterson et al., 1983 (NO effects: 25 min. later) - Howard et al., 1985a (NO effects: 10 min. later) more recent studies: phonological cues may produce long-lasting effects e.g. Best et al., 2002 (effects still present: 10 min. later), Barry & McHattie, 1991 (20 min.)

Introduction: orthographic cues relatively little research on the effects of written cues on spoken word retrieval orthographic cues may have strong effects (e.g. Howard & Harding, 1998: single-case study) orthographic cue-effects might be long-lasting (Best et al., 2002: 10 min. Later)

Introduction: phonological vs. orthographic cues - little research looking at phonological vs. orthographic cues in the same participants - both phonological and orthographic cues may have similar effects on word retrieval in anomic aphasia (Best et al., 2002) - orthographic cues may produce longer lasting effects than phonological cues / tasks in language-unimpaired subjects and aphasic people (e.g. Basso et al., 2001)

AIM of this study...to compare the effects of phonological and orthographic cues with a specific focus on: 1. duration of effects (immediate vs. delayed effects: 20 min. vs. 24 h ) 2. predictability of cueing-effects from underlying functional deficits 3. underlying mechanism of effectiveness of phonological vs. orthographic cues

Material: Black & white line drawings of objects (N=224) Phonological cues (N=56)Orthographic cues (N=56) UNCUED SETS (N=112) CUED SETS (N=112) seen (N=56) (presented for uncued naming in all sessions) unseen (N=56) (only in pre- and post- assessments)

Material: Black & white line drawings of objects (N=224) MATCHING - matching of sets for each participant individually: for naming-accuracy in the pre-assessment (N=224) further factors: word frequency (comb. spoken + written, log.); word-length (nb. phonemes); articulatory complexity (consonant clusters); animacy; OPC-regularity

pre-assessments Design Phase 1: 24 hr post- assessment PHASE 1 PICTURE NAMING sound cues letter cues no cues (n=28 each set) 3 sessions  pseudorandomized order of pictures within each set  order of presentation of different sets counterbalanced across different sessions Phase 2: 24 hr post- assessment PHASE 2 PICTURE NAMING sound cues letter cues no cues (n=28 each set) 3 sessions

Preparation of experiments Prestimulation-paradigm: SOUNDS (wav-files) initial sound break: 300 ms target picture (time-out: 6 sec.) break: 200 ms LETTERS (bmp-files) initial letter: 600 ms break: 300 ms target picture break: 200 ms NO CUES after 300 ms: target picture break: 200 ms (Universal Data Acquisition Program, UDAP, Zierdt, 2002) 20 minutes later all pictures are named again with NO CUES

Participants - no (severe) apraxia of speech - auditory discrimination of single sounds unimpaired (or mildly impaired) - unimpaired in object decision task (BORB, Riddoch & Humphreys, 1993) - impaired word retrieval in conversation and spoken naming - predominantly post-semantic anomia in all participants Initial s Gender Age (years ) Time post onset (years; months) Aetiology Speech output Auditory discrimination: single sounds % correct (n=50) Spoken naming % correct (n=224) DRSF565;11L CVAFluent JUEF334;9L CVANonfluent MCBF633;2L CVAFluent KCCM666;0L CVANonFluent9233.5

Cue effects in first session: immediate effects * p <.05, McNemar-test (2-tailed): pre-assessment vs. naming immediately after cue * * n.s.

* * Cue effects in first session * p <.05, McNemar-test (2-tailed): pre-assessment vs. naming after cue Immediate 20 mins later

* * n.s. Cue effects in first session * p <.05, McNemar-test (2-tailed): pre-assessment vs. naming after cue * * * * Immediate 20 mins later

third session Cue effects in third session: cumulative effects * p <.05, McNemar-test (2-tailed): pre-assessment vs. naming after cue * Immediate * * * * * 3 rd session: 20 mins after cue * ** * * * *

* p <.05, McNemar-test (2-tailed): pre-assessment vs. naming after cue 3 rd session: 20 mins after cue * ** * * * * Post-test: 1 day after 3 rd session

* p <.05, McNemar-test (2-tailed): pre-assessment vs. naming after cue * Immediate 3 rd session: 20 mins after cue * * * * ** ** * * * * Post-test: 1 day after 3 rd session * * * * * *

Summary of results: JUE & KCC did not improve with seen or unseen control pictures graphemic cue effective stable effect (20 min., 24 hours later) How do letter cues help SPOKEN naming?

phonological output lexicon phonological output buffer semantic system speech target picture How might letter cues work? tomato /t/ /ə/ /m/ /a:/ /t/ /ə ʊ / “tomato”

phonological output lexicon phonological output buffer semantic system speech target picture How might letter cues work? tomato

phonological output lexicon phonological output buffer semantic system speech target picture How might letter cues work? tomato /t/ “tomato” orthographic- phonological conversion T initial grapheme cue tomato /t/ /ə/ /m/ /a:/ /t/ /ə ʊ / Nonword reading route

JUE & KCC: Reading aloud Nonword reading impaired - is there another mechanism by which cues might be effective?

phonological output lexicon phonological output buffer semantic system speech target picture How might letter cues work? Direct lexical theory tomato orthographic- phonological conversion T initial grapheme cue orthographic input lexicon

phonological output lexicon phonological output buffer semantic system speech target picture How might letter cues work? Direct lexical theory tomato “tomato” orthographic- phonological conversion T initial grapheme cue tomato /t/ /ə/ /m/ /a:/ /t/ /ə ʊ / orthographic input lexicon [tomato][toy] [tent] [tea]

Summary of results: JUE & KCC did not improve with seen or unseen control pictures graphemic cue effective stable effect (20 min., 24 hours later) Poor nonword reading – but some ability – is it enough? Further investigation with words with irregular initial letters (e.g. Knife) will determine whether this is the cueing mechanism Good (concrete) word reading – means a direct lexical mechanism may be a possibility (cf Best et al.)

Summary of results: DRS DRS –improved with seen control pictures (no cues, help, feedback) –unseen control pictures remained stable ie trying to name pictures (with no feedback) helps naming on a subsequent occasion

Conclusions Orthographic cues can be effective in improving naming -BUT NOT for all individuals -further investigation required to determine the mechanism -Orthographic cues may be effective via a direct- lexical route in some people. Trying to name the same set of pictures in different sessions without help or feedback can result in an improved naming of those pictures for some individuals

Thank you!