The evaluation o f written language performance for the patients with severe aphasia is presented in Table 2.17 (cases BM, MC, and ES) and Table 2.19 (cases SK and DS) and their errors in tables 2.18 & 2.20 respectively. The aphasia profiles and the details o f written language evaluation are presented in Appendix A.2.
Patients BM and ES had produced a small proportion o f written output - less than 25% in the writing to dictation task and less than 45% in the naming task. In the writing to dictation task, BM produced more words after therapy, and demonstrated side difference as he produced more words and had a better success rate with the right
therapy, but the performance o f the right hand was worse than the left hand. However, ES demonstrated a totally opposite pattern o f improvement. In writing to dictation, ES did not produce more words after therapy. However, in the naming task after therapy, he produced less words with the left hand and more words with the right hand. Also while, BM produced only upper case letter on all occasions, ES was able to produce lower case letters with his right hand in the naming task after therapy. In these two patients we were unable to calculate the correlations between the word/non word length and their responses as they produced a small proportion o f written output.
In contrast to BM and ES, patients DS, MC and SK produced almost all the words - more than 90% in both tasks. DS produced almost all the words but a very small proportion was correct. D S’ written output was characterised with overproduction o f letters, which was evident only in the writing to dictation task and not in the naming task. In both tasks before therapy, he used a mixture o f upper and lower case letters. After therapy he tended to use more upper case than lower case letters. Before therapy, in the writing to dictation task, he was able to produce words containing up to ten letters, the same as the target words. However, instead o f clusters o f graphemes, he produced alphabet sequences such as “acbew” for “fish” and “abcB” for “week” or mainly perseverations o f letter sequences between words. In the naming task, unlike his performance in the writing to dictation task, he produced words containing up to eight letters when the target words contained up to ten letters. Following therapy, in the writing to dictation task, with both hands, he was able to produce words containing up to nine letters while the target was words containing up to ten letters. In contrast to pre-therapy assessment, his written output did not contain strings o f
produced clusters o f the target graphemes usually perseverating between words. After therapy, in the naming task, with his left hand, he produced words containing up to ten letters which was the same length as the target words, but with his right hand he produced words containing up to six letters.
MC, like DS, was able to produce almost all o f the words, however, his success rate was higher that DS and he produced more lower case letters than upper case letters. M C ’s written output was characterised by overproduction o f letters only during the dictation o f non-words before therapy. After therapy, the overproduction o f letters was evident during dictation o f both non-words and words with the left hand and only non-words with the right hand. However, in the naming task, overproduction o f letters was evident in the words produced with the right hand and only after therapy. Before therapy, in the dictation task, while the target real words in this task, had up to ten letters, he produced words o f only up to eight letters. During the production o f non words, he produced words up to six letters, similar to the num ber o f letters contained in the target words. In the naming task, before therapy, he initiated each word with the article “a”, for example when the target was “bed” he produced “a bed”. In this task, he produced words containing up to ten letters, as required by the target words. After therapy, in the writing to dictation task, while the target words in this task, had up to ten letters, he produced words o f only up to nine letters with the right hand, but up to thirteen letters with the left hand. During the production o f non-words, he produced words up to six letters with the left hand, similar to the number o f letters contained in the target words, and up to eight letters with the right hand. In the naming task after therapy, he produced words containing up to ten letters with his left hand as required
TABLE 2.17:
BM MC ES
Time o f Assessment BT(L)' A T (L f AT(R)^ BT(L)' A T {L f AT(R)^ BT(L)‘ AT(L)^ AT(R)^
Dictation (words =35, letters = 155)
Words initiated 1(2.8%) 5 (14.3%) 9(25.7%) 32(91.4%) 35(100%) 30(85.7%) 4(11.4%) 4(11.4%) 4(11.4%) Word correct 1(2.8%) 3(8.5%) 4(11.4%) 1(2.9%) 3(8.6%) 2(5.7%) 1(2.9%) 1(2.9%) 3(8.5%) No o f letters produced 4 (2.5%) 12(7.7%) 24(15.5%) 164(106%) 188(121.3%) 158(102%) 9(5.8%) 11(7.1%) 15(9.7%) No o f correct letters 4 (2.5%) 12(7.7%) 21(13.5%) 34(21.9%) 46(29.6%) 49(31.3%) 9(5.8%) 10(6.5%) 15(9.7%) No o f correct letters in correct position 4 (2.5%) 12(7.7%) 21(13.5%) 16(10.3%) 11(7.1%) 23(14.8%) 7(4.5%) 9(5.8%) 14(9%) Upper case letters produced 4(100%) 12(100%) 24(100%) 39(23.7%) 27(14.3%) 23(14.5%) 9(100%) 11(100%) 15(100%) Lower case letters produced 0 0 0 124(76.3%) 161(85.7%) 135(85.5%) 0 0 0
Naming (words =30, letters = 169)
Words initiated 7(23.3%) 14(46.6%) 3(10%) 29(96.6%) 30(100%) 30(100%) 4(13.3%) 3(10%) 7(23.3%) Word correct 4 (13.3%) 5(16.6%) 0 7(23.3%) 5(16.6%) 6(20%) 1(3.3%) 2(6.6%) 3(10%) No o f letters produced 20(11.8%) 34(20.1%) 10(5.9%) 153(90.5%) 156(92.3%) 182(107.7%) 16(9.5%) 8(4.7%) 28(16.5%) No o f correct letters 19(11.2%) 32(18.9%) 7(4.1%) 66(39.1%) 61(36.1%) 81(47.9%) 15(8.9%) 8(4.7%) 26(15.4%) No o f correct letters in correct position 17(10%) 27(16%) 5(2.9%) 26(15.4%) 24(14.2%) 47(27.8%) 10(5.9%) 8(4.7%) 21(12.4%) Upper case letters produced 7 (100%) 34(100%) 10(100%) 4 (2.6%) 19(12.2%) 16(8.8%) 16(100%) 8(100%) 26(92.9%) Lower case letters produced 0 0 0 149(97.4%) 137(87.8%) 166(91.2%) 0 0 2(7.1%)
TABLE 2.18: Errors produced by the moderately aphasie patients (BM, MC, ES).
BM MC ES
Time o f Assessment BT(L)’ AT(L)^ AT(R)^ BT(L)‘ AT(L)" AT(R)^ BT(L)‘ AT(L)^ AT(R)^
D ictation (Total) 0 2 7 101 82 75 12 8 3
1. Letter level errors 0 2 7 101 75 74 12 8 3
Spelling Errors 0 2 7 40 35 40 12 8 3
Perseverative Errors 0 0 0 57 36 32 0 0 0
Phonological errors 0 0 0 4 1 0 0 0 0
Other 0 0 0 0 4 2 0 0 0