This is a language progress note and treatment material for a patient I worked with at Salinas Valley Health. Although there is some overlap between cognitive-communicative and language aspects, this treatment utilized Semantic Feature Analysis (SFA) to target this individual's expressive language deficits. Previously, this patient's expressive language deficits limited her participation in a cognitive evaluation. These expressive language deficits warranted further intervention. SFA aims to improve word retrieval by strengthening semantic networks and has been shown to improve confrontational naming and word retrieval in discourse (Boyle, 2001; Boyle & Coelho, 1995; Rider et al., 2008). SFA promotes circumlocution and self-cueing to aid in functional communication (Antonucci & MacWilliam, 2015). From this experience, I learned the importance of treatment adaptation through various stages of recovery.  

Click the buttons below to view resources

Click the button below to view the articles 

Antonucci, S. M., & MacWilliam, C. (2015). Verbal Description of Concrete Objects: A Method for Assessing Semantic Circumlocution in Persons With Aphasia. American Journal of Speech-language Pathology, 24(4). https://doi.org/10.1044/2015_ajslp-14-0154

Boyle, M. (2001). Semantic Feature Analysis: The Evidence for Treating Lexical Impairments in Aphasia. Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, 11(2), 23–28. https://doi.org/10.1044/nnsld11.2.23 

Boyle, M., & Coelho, C. A. (1995). Application of Semantic Feature Analysis as a Treatment for Aphasic Dysnomia. American Journal of Speech-language Pathology, 4(4), 94–98. https://doi.org/10.1044/1058-0360.0404.94

Rider, J. D., Wright, H. H., Marshall, R. C., & Page, J. L. (2008). Using Semantic Feature Analysis to Improve Contextual Discourse in Adults With Aphasia. American Journal of Speech-Language Pathology, 17(2), 161–172. https://doi.org/10.1044/1058-0360(2008/016)

This is a progress report and treatment material for my first adult client, whom I worked with at the Adult Language Clinic. The client's initial and progress reports are featured in the 612 clinical experiences page. This patient had moderate Broca's aphasia and was known to the clinic as having expressive language deficits in word-finding. One language goal I created for this client focused on using agent-object pairs in sentences. Verb Network Strengthening Treatment (VNeST) was used to train agent-object pairs at the sentence level to support generalization and functional communication (Edmonds & Babb, 2011). Another goal I created for this client focused on content elaboration by answering WH questions with phrases. Response Elaboration Training (RET) was used to promote independent and spontaneous content production (Bunker et al., 2019). These approaches were effective in supporting the patient's expressive language deficits. At baseline he completed VNeST tasks with ~50% accuracy and increased his performance to ~80% accuracy. At baseline he completed RET tasks with ~50% accuracy and increased his performance to ~90% accuracy. This experience aided in my learning of treatment adaptation as I found visual supports were beneficial to his performance. 

My time with this individual revealed additional difficulties with reading, writing, and spelling, which greatly impacted his reading comprehension and written expression. I suggested that the next clinician utilize the Anagram, Copy, and Recall Treatment (ACRT) to support his written expression and strengthen his graphemic representation and spelling skills (Beeson, 1999). I also suggested further evaluation with considerations for phonological treatment to support phonology skills and grammatical accuracy (Beeson et al., 2019). This client greatly contributed to my learning in aphasia treatment and highlighted the importance of ongoing intervention post-stroke.  

Click the buttons below to view resources

Click the button below to view the articles 

Beeson, P. M. (1999). Treating acquired writing impairment: strengthening graphemic representations. Aphasiology, 13(9–11), 767–785. https://doi.org/10.1080/026870399401867 

Beeson, P. M., Rising, K., DeMarco, A. T., Foley, T. H., & Rapcsak, S. Z. (2018). The nature and treatment of phonological text agraphia. Neuropsychological rehabilitation, 28(4), 568–588. https://doi.org/10.1080/09602011.2016.1199387

Bunker, L. D., Nessler, C., & Wambaugh, J. L. (2019). Effect Size Benchmarks for Response Elaboration Training: A Meta-Analysis. American Journal of Speech-language Pathology, 28(1S), 247–258. https://doi.org/10.1044/2018_ajslp-17-0152

Edmonds, L. A., & Babb, M. (2011). Effect of Verb Network Strengthening Treatment in Moderate-to-Severe Aphasia. American Journal of Speech-language Pathology, 20(2), 131–145. https://doi.org/10.1044/1058-0360(2011/10-0036) 

This is a case study presentation I created in collaboration with Patricia Padilla in my Autism Spectrum Disorder (ASD) course for a simulated child with ASD and language impairments. It contains an assessment plan, proposed goals, a treatment plan, and a language sample that calculates the child's mean length of utterance. The assessment plan includes a parent interview, play observation, language sample, and administration of the Preschool Language Scales Fifth Edition (PLS-5) (Zimmerman et al., 2011). The proposed goals target answering WH questions and following instructions for spatial concepts. The treatment plan incorporates direct instruction (Cadette et al., 2016), prompting, and modeling in play-based therapy (Kool & Lawver, 2010). The lesson promotes language and literacy with a book about the child's preferred interest through the shared reading intervention RECALL (reading to engage children with Autism in language learning) (Whalon et al., 2015; Whalon et al., 2013). This assignment was beneficial to my learning in receptive-expressive language assessment and treatment for early intervention. It highlighted the importance of play-based treatment, parent involvement, and child buy-in to target goals. From this project, I gained skills in clinical play observation, language sample analysis, and creative treatment planning for children.  

Click the buttons below to visit AFIRM's resources

Click the button below to view the articles 

Cadette, J. N., Wilson, C. L., Brady, M. P., Dukes, C., & Bennett, K. D. (2016). The Effectiveness of Direct Instruction in Teaching Students with Autism Spectrum Disorder to Answer “Wh-” Questions. Journal of Autism and Developmental Disorders, 46(9), 2968–2978. https://doi.org/10.1007/s10803-016-2825-2

Kool, R., & Lawver, T. (2010). Play therapy: considerations and applications for the practitioner. Psychiatry (Edgmont (Pa.: Township)), 7(10), 19–24.

Whalon, K., Delano, M., & Hanline, M. F. (2013). A Rationale and Strategy for Adapting Dialogic Reading for Children With Autism Spectrum Disorder: RECALL. Preventing School Failure, 57(2), 93–101. https://doi.org/10.1080/1045988X.2012.672347

Whalon, K., Martinez, J. R., Shannon, D., Butcher, C., & Hanline, M. F. (2015). The Impact of Reading to Engage Children With Autism in Language and Learning (RECALL). Topics in Early Childhood Special Education, 35(2), 102–115. https://doi.org/10.1177/0271121414565515