Browsing by Author "Hintikka, Miamaria"

Background and aims. Aphasia and apraxia are neurological disorders most commonly caused by stroke. Aphasia manifests as varying degrees of difficulties in linguistic functions and apraxia as varying degrees of difficulties in producing voluntary body movements, such as speech movements and head nodding and shaking. Aphasia and apraxia often occur simultaneously. A severe apraxic-aphasic disorders manifests as diffi-culties in linguistic functions and the production of speech and head gestures, which can make communicating very challenging. In this case, answering yes/no questions can be a significant means of communication. There is only limited longitudinal follow-up research on recovery from apraxic-aphasic disorder. The aim of this thesis is to examine how the ability to respond intelligibly and correctly to yes/no questions changes in participants with a severe apraxic-aphasic disorder during a three-year follow-up period, beginning on the onset of the disorder. In addition, the aim is to examine whether the means used to respond intelligibly and correctly to yes/no questions change during the follow-up period, and how the changes in the amount and means of giving intelligible and correct yes/no responses compare across participants. Methods. The study included seven adults with a severe apraxic-aphasic disorder resulting from left hemisphere stroke. Participants were examined on five separate occasions during the three-year follow-up, apart from one participant, who was examined on four occasions. The examination sessions typically occurred within the first three months after the onset of the disorder, then six months, one year, two years and finally three years after the onset of the disorder. During the sessions participants were instructed to respond “yes” or “no” to 50 yes/no questions, composed by Sanna Lemmetyinen. The research data consisted of participants' responses to the questions, raw data consisted of video recordings of the sessions. The data was analyzed both qualitatively and quantitatively. Qualitative analysis consisted of evaluating the clarity and correctness of the participants’ responses, and of examining the means used to respond. Quantitative analysis consisted of scoring the responses based on their clarity and correctness. Results and conclusions. Participants' ability to respond intelligibly and correctly to yes/no questions during the three-year follow-up period varied. One participant’s ability clearly improved after the initial three months following disorder acquisition. Four participants’ performance profile was ascending during the follow-up period, two participant’s performance profile was descending, and one participant’s performance was the same after three years as it was in the first examination session. Some changes occurred in the means used to respond intelligibly and correctly. The amount of speech responses clearly increased in two participants. Apart from one, all participants appeared to have some characteristic means of responding. Participants were able to produce intelligible and correct yes/no responses using and combining several different means of responding.