What's new for semantic feature analysis? Revisiting a classic therapy technique 2012 Adult Language Group NSW Speech Pathology Evidence Based Practice Network Linda Jones, Julia Murphy and Claire Layfield (Group Co-Leaders) Lyndsey Nickels - Academic Member Presented by Claire Layfield

Semantic Feature Analysis Aphasia is frequently associated with semantic breakdown Semantic feature analysis is a technique that underpins the general philosophy behind many treatments for semantic impairments

Object, picture or idea Semantics Semantic word retrieval impairment purrs fur barks 4-legs pet scales Phonological Lexicon robin cat dog rabbit fish house The idea behind sematic feature analysis is that the client is guided to produce words that are semantically associated to a target word, enhancing target retrieval. So we can see here that as we increase the number of semantic links it the object we restrict the number of retrieval options but it isn’t until we include barks as a feature that we end up with a unique set of semantic features which gives us the target exclusively. Phonological Buffer/ Phonemes k d æ o g t Slide modified with thanks to Lyndsey Nickels

Semantic Feature Analysis GROUP ACTION PROPERTIES ASSOCIATION (Boyle, 2001; Boyle, 2004; Coelho, McHugh, & Boyle, 2004; Kiran, & Johnson,2008; Kiran, 2008; Rider, Wright, Marshall & Page, 2008) PWA is provided with a picture, asked to name it, and then encouraged to describe the semantic features of a target.

Semantic Feature Analysis Semantic feature analysis therapy is provided at word level BUT our treatment goals are discourse based Clinical Question: For people with aphasia, in what circumstances does SFA improve Naming of treated items Naming of untreated items Generalisation to spontaneous speech As a group, despite many of using this technique clinically, few of us knew the efficacy for it. Also because it is considered a word based therapy technique and generally we want our therapy goasl to be discourse based if possible we were interested in knowing whether naming therapy such as semantic feature analysis transferred to spontaneous speech. So the clinical question we came up with was…

Semantic Feature Analysis: CAPS Initial searching by the group found 23 articles From these 16 were CAPPED The others were excluded because Treatment data was not available (e.g. expert commentary) Treatment was not applicable (e.g. neuroimaging) The participants had speech and language impairments in addition to aphasia PWA is provided with a picture, asked to name it, and then encouraged to describe the semantic features of a target.

The Evidence: Research Design Single case experimental design Case series Low level of evidence on NHMRC evidence hierarchy. BUT well designed single case and case series, can be more powerful in terms of clinical applicability.

The Evidence: Participants No correlation between treatment efficacy and Type of aphasia Severity of aphasia Time post onset Aetiology Representative of the group caseload High variability was reported for Type of aphasia: range of fluent and non fluent and where neuroimaging was reported there was wide ranging patterns in neural correlates. The range of severity (mild-severe). There was also a case series report of bilingual aphasia looking at transfer of naming skills in the untrained language which was quite clinically relevant for a lot of us and so little evidence for bilingual aphasiacs on treatment but most of have bilingual aphasics on our caseload. Time PO: ranged from 4months – 65 months

The Evidence : Intervention Variability noted in Treatment schedules Therapy duration Individual vs group based Variability noted in therapy administration Cueing hierarchies, prompts, responses to errors Added components of discourse (put word into phrase) Initially when we decided on this topic, we all had an idea of what SFA was and how to use it therapeutically and to tweak to fit the individual needs of our clients. What we didn’t expect was for there to be so much variability in the research.

The Evidence: Measurement Measures included confrontational naming (typically treated and untreated items) Standardised measures Generalisation measures typically discourse based (CIU, words and error production rates) Participation measures: Social validity questionnaire

The Evidence: Outcomes Treated items increased and maintained Untreated items Similar trends but reduced in magnitude Standardised assessments Small improvements to overall scores Generalisation At best “modest” improvements in discourse based measurements maintained over time

Applying these results to clinical practice Semantic feature analysis Appears to be clinically feasible Increases naming, reduces perseveration, and this transfers to conversation in the short term What remains in question is Is this technique more beneficial than other therapy techniques and Is there a way of combining this technique with a second level of phrase/sentence level therapy which may generate and maintain functional communication improvements

Future Research Research investigating Semantic feature analysis vs other techniques which is controlled for therapy dosage Semantic feature analysis in group vs individual settings Systematic investigation of enhancing maintenance and generalisation Outcomes from acute and chronic phases of therapy would all be helpful to determine the extent and nature of the therapy benefits reported in the literature to date

Questions??? Best Friend Target = Ruby Digs holes in new lawn Barks in the middle of the night Best Friend Jumps to get clean clothes off the line Steals shoes and chews them

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