Papers by Jennifer Mozeiko
The Handbook of Language and Speech Disorders
Frontiers in Rehabilitation Sciences, 2021
This systematic review aimed to determine how aerobic exercise affects cognition after stroke, wi... more This systematic review aimed to determine how aerobic exercise affects cognition after stroke, with particular focus on aphasia and language improvement. Methodological quality was assessed with the PEDro+ scale with half of the 27 included studies rated as high quality. Data extraction focused on cognitive effects of aerobic exercise post-stroke, intervention characteristics, outcome measures, and participant characteristics. Whereas attention, memory, and executive functioning measures were common across the included studies, no study included a language-specific, performance-based measure. Seventeen studies reported positive cognitive effects, most frequently in the domains of attention, memory and executive functioning. Variability in outcome measures, intervention characteristics, and participant characteristics made it difficult to identify similarities among studies reporting positive cognitive effects of exercise or among those studies reporting null outcomes. Only three stu...
Journal of Communication Disorders, 2020
The behavioral effects of lexical priming are well studied in the cognitive sciences. Clinical us... more The behavioral effects of lexical priming are well studied in the cognitive sciences. Clinical use of the term and widespread implementation of priming based behavioral interventions has remained limited. This is despite the fact that response-contingent cueing, a behavioral intervention technique used during many cognitive-linguistic interventions, is grounded in theories of priming research. The aim of this manuscript is to connect behavioral performance changes observed following priming with those noted following cueing, providing a theoretical rationale for the therapeutic use of both priming and cueing in language and cognitive interventions. In this review, we establish a conceptual basis for how both primes and cues serve to pre-engage the neural system by triggering the retrieval of linked conceptual knowledge, resulting in faster and more accurate responses. Differences between the two (primes and cues) have been linked to timing and conscious intentional engagement, though these distinctions are often task dependent. Additionally, this paper will provide evidence of the clinical utility of priming. Studies of priming in adults with acquired brain injuries are discussed and clinical interventions based on theories of priming are examined. Furthermore, the present work will briefly detail the inhibitory effects of priming to aid clinicians and researchers in deciding how to pair primes and cues with intended retrieval targets. In summation, the present work is intended to bridge two related fields providing both theoretical and clinical insight with respect to the use of primes and cues.
Aphasiology, 2019
Background: Massed practice has become a widely used method of treatment administration in the st... more Background: Massed practice has become a widely used method of treatment administration in the study of aphasia. It is often shown to be as or more effective than treatment provided in a distributed fashion. Some studies report changes beyond the targeted treatment materials, and durability of effects tends to be positive. Feasibility of this specific dosage for Sound Production Training (SPT) for apraxia of speech has yet to be tested. Aims: This case study investigates the effects of a massed practice administration of SPT for a patient with severe and chronic apraxia of speech. Responsiveness was monitored for target treatment items at the level of the word and the manner of articulation. In addition, we assessed for changes in general aphasia severity, patient perception of communicative effectiveness, and ability to self-correct errors. Methods & Procedures: SPT was administered for 3 h per weekday over 2 weeks. All sessions were audiotaped and analyzed independently by two raters. Initial responses were coded as correct or incorrect and then re-analyzed for each manner of articulation within each word. The total number of correct and incorrect self-corrections were also recorded. Multiple baselines across behaviors was used to track progress on trained materials. Outcomes & Results: Improvements were observed on the accuracy of trained repeated productions, untrained equivalent exemplars, increased self-corrections, and also in reduced aphasia severity. There was no observed benefit to increased repetitions of a specific manner of articulation. Conclusions: Massed practice is a viable way to administer SPT and may also positively impact non-targeted treatment items and objectives. Self-correction attempts precede or coincide with production accuracy and may be worth training in patients who do not spontaneously self-correct. Since increased repetitions did not improve a specific manner of speech, we speculate that the use of functional words versus those targeting specific phonemes may be as effective at eliciting desired speech outcomes.
Frontiers in Human Neuroscience, 2017
The ASHA Leader, 2011
... Disorders Following TBI. by Karen Lê, Jennifer Mozeiko & Carl Coelho. ... Szekeres, 1989)... more ... Disorders Following TBI. by Karen Lê, Jennifer Mozeiko & Carl Coelho. ... Szekeres, 1989). More than any other cognitive process, executive function skills are linked to the success of community reintegration (Sohlberg & Mateer, 2001). Aspects ...
American Journal of Speech-Language Pathology, 2018
Purpose The Story Goodness Index (SGI) is a hybrid analysis of narrative discourse combining 2 ma... more Purpose The Story Goodness Index (SGI) is a hybrid analysis of narrative discourse combining 2 macrostructural measures: story grammar and story completeness. Initially proposed by Lê and colleagues ( Lê, Coelho, Mozeiko, & Grafman, 2011 ), the SGI is intended to characterize the discourse performance of individuals with cognitive–communication disorders. In this study, the SGI was utilized to examine the discourse of 2 groups, one with closed head injuries and another with non–brain injured (NBI) peers. The intent of this study was to ascertain whether the SGI could differentiate the discourse performance of the 2 groups, as was previously reported for individuals with penetrating traumatic brain injury and an NBI comparison group ( Lê, Coelho, Mozeiko, Krueger, & Grafman, 2012 ). Because of the retrospective nature of this study, the wordless visual narrative used to elicit discourse was different from the narrative used by Lê and colleagues (2012) . Method A retrospective analysi...
Journal of Speech, Language, and Hearing Research, 2018
Purpose This study investigated changes in oral–verbal expressive language associated with improv... more Purpose This study investigated changes in oral–verbal expressive language associated with improvements following 2 treatment periods of constraint-induced language therapy in 4 participants with stroke-induced chronic aphasia. Generalization of treatment to untrained materials and to discourse production was also analyzed, as was the durability of the treatment effect. Method Participants with aphasia were assessed using standardized measures and discourse tasks at 3 to 4 time points to document behavioral changes throughout each of two 30-hr treatment periods of constraint-induced language therapy. Daily probes of trained and untrained materials were also administered. Results Despite participant heterogeneity, behavioral results for each person with aphasia indicated a positive response to treatment following each treatment period indicated by performance on standardized tests, trained materials, or both. Treatment effects generalized to some degree to untrained stimuli and to di...
Neuropsychologia, 2018
Changes in discourse structure over time following traumatic brain injury, Neuropsychologia,
Aphasiology, 2018
Background: Reading difficulties often present as a consequence of aphasia. The specific nature o... more Background: Reading difficulties often present as a consequence of aphasia. The specific nature of reading deficits varies widely in manifestation, and the cause of these deficits may be the result of a phonological, lexical semantic, or cognitive impairment. Several treatments have been developed to address a range of impairments underlying reading difficulty. Aims: The purpose of this review is to describe the current research on reading comprehension treatments for persons with aphasia, assess the quality of the research, and summarize treatment outcomes. Methods & Procedures: A systematic review of the literature was conducted based on a set of a priori questions, inclusion/exclusion criteria, and predetermined search parameters. Results were summarized according to treatment type, methodologic rigor, and outcomes. Outcomes & Results: Fifteen studies meeting criteria were identified. A variety of reading comprehension treatments was implemented including: oral reading, strategy-based, cognitive treatment, and hierarchical reading treatments. Quality ratings were highly variable, ranging from 3 to 9 (on a 12-point scale). Overall, 14 of the 18 individuals for whom individual data were provided demonstrated some degree of improvement (oral reading 4/5 participants, strategy based 4/6, and cognitive treatment 6/7). Gains were also evident for hierarchical reading treatment administered to participant groups via computer; however, the degree to which improvement reached statistical significance varied among studies. Conclusions: Reading comprehension treatments have the potential to improve reading comprehension ability in persons with aphasia; however, outcomes were variable within and among treatment methods. We suggest focusing future research on factors such as participant candidacy and treatment intensity using increased methodological rigor.
Archives of Physical Medicine and Rehabilitation, 2018
Conclusions: Patient reported severity of bodily injuries is not consistent with AIS severity sco... more Conclusions: Patient reported severity of bodily injuries is not consistent with AIS severity score derived from medical record review and cannot be used for a valid diagnosis of injury severity following poly-trauma.
Aphasiology, 2015
Background: Studies of intensive aphasia treatments vary widely in terms of treatment focus, in p... more Background: Studies of intensive aphasia treatments vary widely in terms of treatment focus, in patient population and, in particular, in definition of what is considered "intensive". Variability makes it difficult to compare among studies and to definitively determine whether more treatment is actually better. Constraint-induced language therapy (CILT) is one treatment that has been successfully replicated at approximately the same dosage with generally positive results. Aims: The current study used a modified multiple baseline design across participants to investigate the administration of CILT at the standard intensive dosage of 30 hours over 2 weeks (CILT-I) compared to a more distributed dosage of 30 hours over 10 weeks (CILT-D). Methods & Procedures: Eight participants with chronic aphasia participated in either CILT-I or CILT-D. Standardised and discourse measures were taken pre-and posttreatment and also 4 weeks after the completion of treatment. Discourse probes were administered after every 6 hours of treatment to assess change in productivity and efficiency over time. Outcomes & Results: All of the participants who received CILT-I and CILT-D showed either an increased effect size on a discourse measure, a clinically significant change on a standardised battery or both. Gains were maintained in nearly all cases. Conclusions: CILT administered in both intensive and distributed dosages resulted in positive changes in aphasia severity and discourse. This study adds evidence to the still inconclusive role of intensity to CILT.
Narrative discourse performance of two groups with penetrating head injuries, left-and right-hemi... more Narrative discourse performance of two groups with penetrating head injuries, left-and right-hemisphere damaged, was examined and compared to that of a non-injured control group. Discourse deficits were then associated with lesion size and brain regions (Brodmann areas) included within lesion boundaries. Findings indicated that discourse impairments involving the organization of language and maintenance of a narrative theme result from large or relatively small lesions to either hemisphere. Although specific frontal and temporal regions within both hemispheres were most commonly implicated, parietal and limbic areas also appear to play a role in the production of narrative discourse.
Poster presented at the …, 2008
In the present study an additional measure of story narrative performance, story completeness, is... more In the present study an additional measure of story narrative performance, story completeness, is evaluated. The completeness measure involves a tally of the critical story components mentioned by a storyteller. It was hypothesized that by combining organizational (story grammar) and completeness measures, story "goodness" could be quantified. Data from 46 normal adults indicated that this analysis was relatively sensitive in that it classified the story narratives of the group into four distinct categories of story "goodness". This analysis should prove useful for the study of narrative discourse of brain-injured populations.
Neuropsychologia, 2012
Individuals with damage to the prefrontal cortex, and the dorsolateral prefrontal cortex (DLPFC) ... more Individuals with damage to the prefrontal cortex, and the dorsolateral prefrontal cortex (DLPFC) in particular, often demonstrate difficulties with the formulation of complex language not attributable to aphasia. The present study employed a discourse analysis procedure to characterize the language of individuals with left (L) or right (R) DLPFC lesions. All participants were 30-35 years post-onset of injury and presented with persistent discourse impairments. The discourse performance of the R DLPFC group was not significantly different from either the L DLPFC group or the non-injured comparison group. Individuals from the L DLPFC group demonstrated specific difficulties with narrative coherence and inclusion of critical story components. Both measures were significantly different from the comparison group. The discourse ability of the DLPFC groups was significantly correlated with measures of working memory. Findings support the use of discourse analysis for examining language impairments in individuals with PFC lesions.
Journal of Speech, Language, and Hearing Research, 2011
Purpose The purpose of this article was to evaluate a new measure of story narrative performance:... more Purpose The purpose of this article was to evaluate a new measure of story narrative performance: story completeness. It was hypothesized that by combining organizational (story grammar) and completeness measures, story “goodness” could be quantified. Method Discourse samples from 46 typically developing adults were compared with those from 24 adults with acquired brain injuries. Story retellings were elicited and analyzed for episode structure (story grammar). Each story was also evaluated for the presence of 5 key components, yielding the story completeness score. Story goodness was quantified by combining the story grammar and completeness measures using a 2-coordinate grid system. A multivariate analysis of variance was performed as well as correlational analyses between the story grammar and story completeness scores. Results There were significant group differences on both story grammar and story completeness. Moderate correlations were noted between the 2 measures, suggesting...
Aphasiology, 2005
Background: In a previous study, discriminant function analyses (DFA) were employed to determine ... more Background: In a previous study, discriminant function analyses (DFA) were employed to determine the accuracy of various story narrative and conversational discourse measures in classifying non-brain-injured (NBI) and closed-head-injured (CHI) adults (Coelho, Youse, Le, & Feinn, 2003). The DFAs correctly predicted group membership with 70±81% accuracy. Aims: The present study reexamined the performance of the CHI and NBI participants who were incorrectly classified in an effort to determine what aspects of their discourse performance contributed to the misclassifications. It was hypothesised that the misclassifications were due to the relatively broad range in performance on the discourse measures, resulting in considerable overlap between the NBI and CHI participants. Methods & Procedures: Scores for the story narrative and conversational discourse measures that made the largest contribution to the correct classification of the two participant groups were reexamined for the CHI and NBI participants who were misclassified by the DFA in the previous study (Coelho et al., 2003). Outcomes & Results: Results indicated that there was considerable overlap in the discourse performance of the two participant groups for several of the story narrative and conversational discourse measures. Conclusions: The performance overlaps occurred on many of the same discourse measures that were noted to be fairly good discriminators of CHI versus NBI discourse performance in the original study. Consequently, recommendations regarding elimination of certain measures to streamline the discourse analysis procedure could not be made. Other factors such as sampling discourse acontextually and specific participant characteristics undoubtedly influenced these findings as well. In addition, the DFA procedure utilised in the original study did not take into account the heterogeneity of discourse data. Nonparametric procedures such as classification and regression trees (CART) (Breiman, Friedman, Olshen, & Stone, 1984; Johnson & Wichern, 2002) may be better suited for the classification of nonhomogeneous populations such as individuals with CHI.
Aphasiology, 2011
Background: Story grammar is a super-structural measure of discourse performance that has shown t... more Background: Story grammar is a super-structural measure of discourse performance that has shown to be sensitive to the deficits seen following traumatic brain injury (TBI). Narrative organisation and identification of logical relationships between events and characters are key components of story grammar. Reports of significant correlations for measures of story grammar and scores from various tests of executive functioning for
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Papers by Jennifer Mozeiko