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      Exploring the efficacy of melodic intonation therapy with Broca’s aphasia in Arabic

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          Abstract

          Background

          Even though the efficacy of melodic intonation therapy (MIT) with persons with aphasia (PWA) has been explored in different languages, the efficacy of MIT with Arabic-speaking PWA has never been explored.

          Aims

          To explore the efficacy of MIT, adapted to Arabic, in promoting the expressive abilities of a 70-year-old Jordanian Arabic-speaking male subject with severe Broca’s aphasia 3 months post-onset.

          Methods

          An 8-week MIT therapy programme with tapping (1.5 h daily, 6 days a week) was used in a multiple baseline design across two types of trained phrases (i.e. automatic and self-generated phrases). Outcome measures included accuracy of production of trained (at the end of each session) and untrained phrases (at the end of each week). Pre- and post-treatment measures used, were the bilingual aphasia test, the American Speech-Language Hearing Association Functional Assessment of Communicative Skills, the communicative effectiveness index and the American Speech and Hearing Association Quality of Communication Life Scale. Accuracy of production for the trained and untrained phrases was also measured 2 weeks and 4 weeks after the treatment programme was finished.

          Results

          The patient, (MK), improved his expressive productions post-treatment in automatic and self-generated phrases. Automatic phrases exceeded the established 75% accuracy criterion, whereas the self-generated phrases reached criterion and remained constant at follow-up. Moreover, MK gradually started improving on the generalisation stimuli, once the treatment on the self-generated phrases started and maintained the gains 2 weeks and 4 weeks post-treatment.

          Conclusion

          MIT appears to be a viable treatment option for Jordanian Arabic-speaking persons with Broca’s aphasia. However, more research is needed with larger groups of Jordanian Arabic-speaking persons with Broca’s aphasia to provide more support to the present findings. Moreover, future studies might focus on the efficacy of MIT with persons with Broca’s aphasia from different Arab countries and from countries where Arabic is part of the multicultural structure like South Africa and other countries on the African continent.

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          Most cited references31

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          Update on the Global Burden of Ischemic and Hemorrhagic Stroke in 1990-2013: The GBD 2013 Study

          Background: Global stroke epidemiology is changing rapidly. Although age-standardized rates of stroke mortality have decreased worldwide in the past 2 decades, the absolute numbers of people who have a stroke every year, and live with the consequences of stroke or die from their stroke, are increasing. Regular updates on the current level of stroke burden are important for advancing our knowledge on stroke epidemiology and facilitate organization and planning of evidence-based stroke care. Objectives: This study aims to estimate incidence, prevalence, mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs) and their trends for ischemic stroke (IS) and hemorrhagic stroke (HS) for 188 countries from 1990 to 2013. Methodology: Stroke incidence, prevalence, mortality, DALYs and YLDs were estimated using all available data on mortality and stroke incidence, prevalence and excess mortality. Statistical models and country-level covariate data were employed, and all rates were age-standardized to a global population. All estimates were produced with 95% uncertainty intervals (UIs). Results: In 2013, there were globally almost 25.7 million stroke survivors (71% with IS), 6.5 million deaths from stroke (51% died from IS), 113 million DALYs due to stroke (58% due to IS) and 10.3 million new strokes (67% IS). Over the 1990-2013 period, there was a significant increase in the absolute number of DALYs due to IS, and of deaths from IS and HS, survivors and incident events for both IS and HS. The preponderance of the burden of stroke continued to reside in developing countries, comprising 75.2% of deaths from stroke and 81.0% of stroke-related DALYs. Globally, the proportional contribution of stroke-related DALYs and deaths due to stroke compared to all diseases increased from 1990 (3.54% (95% UI 3.11-4.00) and 9.66% (95% UI 8.47-10.70), respectively) to 2013 (4.62% (95% UI 4.01-5.30) and 11.75% (95% UI 10.45-13.31), respectively), but there was a diverging trend in developed and developing countries with a significant increase in DALYs and deaths in developing countries, and no measurable change in the proportional contribution of DALYs and deaths from stroke in developed countries. Conclusion: Global stroke burden continues to increase globally. More efficient stroke prevention and management strategies are urgently needed to halt and eventually reverse the stroke pandemic, while universal access to organized stroke services should be a priority.
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            Children's Brain Development Benefits from Longer Gestation

            Disruptions to brain development associated with shortened gestation place individuals at risk for the development of behavioral and psychological dysfunction throughout the lifespan. The purpose of the present study was to determine if the benefit for brain development conferred by increased gestational length exists on a continuum across the gestational age spectrum among healthy children with a stable neonatal course. Neurodevelopment was evaluated with structural magnetic resonance imaging in 100 healthy right-handed 6- to 10-year-old children born between 28 and 41 gestational weeks with a stable neonatal course. Data indicate that a longer gestational period confers an advantage for neurodevelopment. Longer duration of gestation was associated with region-specific increases in gray matter density. Further, the benefit of longer gestation for brain development was present even when only children born full term were considered. These findings demonstrate that even modest decreases in the duration of gestation can exert profound and lasting effects on neurodevelopment for both term and preterm infants and may contribute to long-term risk for health and disease.
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              Dopaminergic foundations of schizotypy as measured by the German version of the Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE)—a suitable endophenotype of schizophrenia

              The concept of schizotypy or “psychosis proneness” captures individual differences in perceptual, cognitive, and affective experiences that may relate to a range of psychotic disorders. The concept is an important way to assess the contribution of pre-existing psychological and genetically based biological features to the development of illnesses such as schizophrenia (so called endophenotypes). The Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE) is a widely used multi-dimensional measure of the construct and consists of four scales which mirror several groups of psychotic symptoms: Unusual Experiences (UnEx; positive symptoms), Cognitive Disorganization (CogDis; cognitive symptoms), Introvertive Anhedonia (IntAn; negative symptoms), and Impulsive Nonconformity (ImpNon; impulsive and antisocial symptoms). For the purpose of evaluating the suitability of schizotypy as an endophenotype of schizophrenia the current version of the O-LIFE was translated into German: its psychometric properties (including re-test reliability and construct validity) were examined in a large sample (n > 1200) and compared to those of the English original. The German version was both highly reliable and consistent with the original. The study aimed to show that schizotypy as measured by the O-LIFE can indeed be regarded as an endophenotype of schizophrenia in terms of genetic associations regarding relevant dopamine-related candidate polymorphisms of schizotypy [i.e., Val158Met-polymorphism of the COMT gene, uVNTR of the MAOA gene, Taq1A-polymorphism of the DRD2 gene, VNTR of the SLC6A3 (DAT) gene]. We also wanted to compare the genetic associations of the O-LIFE to those published using other operationalizations of schizotypy. Our results show a large number of significant associations and borderline-significant trends between the O-LIFE sub-scales and a range of genes, thereby supporting using the O-LIFE in the search for endophenotypic markers.
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                Author and article information

                Journal
                S Afr J Commun Disord
                S Afr J Commun Disord
                SAJCD
                The South African Journal of Communication Disorders
                AOSIS
                0379-8046
                2225-4765
                31 May 2018
                2018
                : 65
                : 1
                : 567
                Affiliations
                [1 ]Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Jordan
                [2 ]Amman Center for Speech-Language and Swallowing, Amman, Jordan
                Author notes
                Corresponding author: Khalid Al-Shdifat, kgalshdifat@ 123456just.edu.jo
                Article
                SAJCD-65-567
                10.4102/sajcd.v65i1.567
                6018128
                29943587
                cf1672a4-e92d-46fd-99ef-5a08336de374
                © 2018. The Authors

                Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.

                History
                : 06 June 2017
                : 07 March 2018
                Categories
                Original Research

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