Treatment of psychological distress following mastectomy: an initial report

A behavioural programme to treat psychological distress following mastectomy for breast cancer is described. The first 10 patients to be treated were randomly allocated to two treatment groups: Behavioural Programme Only or Behavioural Programme + Drugs (antidepressant medication). Both groups showed improvement over treatment, but the Behavioural Programme + Drugs group appeared to maintain their improvement better.     

Generalization of treatment effects in training public speakers

Three studies compared the efficacy of various treatments for public-speaking incompetence. These effects were evaluated for the target behavior as well as for generalization effects across situations (conversations), settings (different sizes and types of audiences) and time (6-month follow-up). The first study showed that Self-instructional Training, either alone or in combination with other procedures, produced little or no benefits. The second study demonstrated the superiority of a Skills Training program over flooding therapy, while the final study failed to detect any enhancement of treatment benefits for the addition of home-practice to the Skills Training. In the first two studies generalization occurred across the three dimensions (settings, situations and time), while in the final study it was shown that the program was effective for a clinical population as well as recruited volunteers.     

Measuring the activity of severely and profoundly mentally-handicapped adults in ordinary housing

Earlier work on the quality of care in settings for severely and profoundly mentally-handicapped adults raised the question whether any useful purpose is served by promoting the extensive use of simple recreational materials to occupy people. Data were collected by direct observation on the activity of 6 adults living in a staffed house organized to promote engagement in household activities. Observations were taken over 5 weekdays from 07.00 to 10.00 and 15.00 to 23.00hr. The results showed that Ss spent between 22 and 67% of available time in purposeful activity. Between 27 and 65% of purposeful activity was engagement in domestic or housework tasks. Even the most handicapped people spent more time engaged in housework than in leisure and recreational tasks. The implications of these data are commented on and measurement issues which arise in ordinary housing as opposed to institutional settings are discussed.     

Comprehension of directly and indirectly stated main ideas and details in discourse by brain-damaged and non-brain-damaged listeners

Aphasic, right-hemisphere-damaged, and non-brain-damaged subjects heard short narrative paragraphs. Each paragraph contained four main ideas and one or more details related to each main idea. After each paragraph was presented, subjects' comprehension and retention of main ideas and details from the paragraph were tested. Some of the test items directly restated information from paragraphs and others paraphrased information from paragraphs. All groups of subjects remembered main ideas better than they remembered details, and no group of subjects was significantly affected by whether test items directly or indirectly stated information from paragraphs. Disfluent aphasic and right-hemisphere-damaged subjects' overall paragraphs comprehension scores were not significantly poorer than those of non-brain-damaged subjects. Fluent and mixed aphasic subjects' overall paragraph comprehension scores were significantly worse than those of non-brain-damaged and right-hemisphere-damaged subjects. Token Test and Boston Diagnostic Aphasia Examination auditory comprehension scores did not predict aphasic subjects' paragraph comprehension scores. right-hemisphere-damaged subjects' overall paragraph comprehension scores were not significantly those of non-brain-damaged and right-hemisphere-damaged subjects. Token Test and Boston Diagnostic Aphasia Examination auditory comprehension scores did not predict aphasic subjects' paragraph comprehension scores.     

The processing of the sounds and meanings of ongoing speech by aphasic subjects

The ability of aphasic subjects to process the sounds and meanings of ongoing speech was tested. Subjects, 10 aphasic and 20 control, heard test sentences which contained one member of phonemically similar word pairs in one of three semantic contexts: congruent, neutral, and noncongruent. Immediately after hearing a sentence, subjects were to indicate which member of the word pair had been in the sentence. All subject groups had similar overall patterns of response to the different semantic contexts. The division of aphasic subjects into groups of high and low comprehenders revealed response differences. High comprehending aphasic subjects, like control subjects, demonstrated interactive processing of the sounds and meaning of speech while low comprehending aphasic subjects did not.     

Voice onset time in aphasia: Thai II. Production

The aim of this study was to investigate voice onset time (VOT) production in homorganic word-initial stops in Thai in order to explore the nature of speech production deficits across clinical varieties of aphasia. Thai exhibits a three-category distinction in bilabial (/b,p,ph/) and alveolar (/d,t,t,h/) stops, and a two-category distinction in velar (/k,kh/) stops. Subjects included three Broca asphasics, one transcortical motor asphasic, two global asphasics, one conduction aphasic, one Wernicke aphasic, one nonaphasic dysarthric patient, one right-brain-damaged patient, and five normal controls. Test stimuli consisted of eight monosyllabic real words. The results of VOT measurements indicated that Broca and global asphasics exhibited a more severe production disorder than Wernicke, conduction, or transcortical motor asphasics. The right-brain-damaged patient showed no impairment in VOT production. Comparisons are drawn to earlier studies of VOT production in aphasia in two-category languages. Issues concerning the underlying basis of the production deficit for nonfluent aphasics, fluent aphasics, and nonaphasic dysarthrics as well as the relation between perception and production of VOT are discussed.     

Comprehending homographs in aphasia

This study assessed 13 aphasic subjects' knowledge of the multiple meanings of homographs. The results indicated that the various meanings were less available to aphasic subjects than to normal subjects. In addition, specific meanings became less available as they became less typical although the number of meanings associated with a homograph did not influence performance. Aphasia type also did not influence performance. Performance on the experimental test was significantly correlated with auditory comprehension level and picture naming ability. The results were related to recent findings on semantic organization in aphasia.     

Comments on Hughes and Sussman''s time-sharing study of cerebral laterality in language-disordered and normal children

M. Hughes and H. M. Sussman (1983, Brain and Language, 19, 48-64) suggest that the time-sharing paradigm "does not serve as an adequate behavioral index for language lateralization in children." The merits of this conclusion are considered and general interpretative issues regarding manual interference in dual-task/time-sharing studies are discussed.     

Comprehension of main ideas and details in coherent and noncoherent discourse by aphasic and nonaphasic listeners

Aphasic and nonaphasic listeners' comprehension of main ideas and details within coherent and noncoherent narrative discourse was examined. Coherent paragraphs contained one topic to which all sentences in the paragraph related. Noncoherent paragraphs contained a change in topic with every third or fourth sentence. Each paragraph contained four main ideas and one or more details that related to each main idea. Listeners' responses to yes/no questions following each paragraph yielded the following results: (1) Nonaphasic listeners comprehended the paragraphs better than aphasic listeners. (2) Both aphasic and nonaphasic listeners comprehended main ideas better than they comprehended details. (3) Coherence did not affect comprehension of main ideas for either group. (4) Coherence did not affect comprehension of details by nonaphasic subjects. (5) Coherence affected comprehension of details by aphasic subjects, and their comprehension of details in coherent paragraphs was worse than their comprehension of details in noncoherent paragraphs. There was no significant correlation between Token Test scores and measures of paragraph comprehension.