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  • Purpose: Clinical supervisors play a fundamental role inenabling students to transform knowledge into clinicalskills. The 2020 changes to Speech-Language PathologyCertification Standards will require speech-languagepathologists, who want to serve as clinical supervisorsof applicants for certification, to complete a minimum of9 months of practice experience postcertification and 2 hrof professional development in the professional practicedomain of supervision postcertification prior to overseeinga student in a clinical supervisor capacity. Conclusion: This article describes a framework for clinicalsupervisors of graduate students to use, based on thepremise that supervision should be an intentional reflectiveactivity. The authors describe how to plan for clinicaleducation across practice settings, provide appropriatefeedback, and use questions effectively.
    Data Types:
    • Video
  • This presentation video is from the Research Symposium at the 2018 annual convention of the American Speech-Language-Hearing Association held in Boston, MA. The abstract for the accompanying article is below. This article is part of the JSLHR Forum: Advances in Neuroplasticity Research on Language Recovery in Aphasia. Purpose: Despite a tremendous amount of research in this topic, the precise neural mechanisms underlying language recovery remain unclear. Much of the evidence suggests that activation of remaining left-hemisphere tissue, including perilesional areas, is linked to the best treatment outcomes, yet recruitment of the right hemisphere for various language tasks has also been linked to favorable behavioral outcomes. In this review article, we propose a framework of language recovery that incorporates a network-based view of the brain regions involved in recovery.Method: We review evidence from the extant literature and work from our own laboratory to identify findings consistent with our proposed framework and identify gaps in our current knowledge.Results: Expanding on Heiss and Thiel’s (2006) hierarchy of language recovery, we identify 4 emerging themes: (a) Several bilateral regions constitute a network engaged in language recovery; (b) spared left-hemisphere regions are important components of the network engaged in language recovery; (c) as damage increases in the left hemisphere, activation expands to the right hemisphere and domain-general regions; and (d) patients with efficient, control-like network topology show greater improvement than paients with abnormal topology. We propose a mechanistic model of language recovery that accounts for individual differences in behavior, network topology, and treatment responsiveness.Conclusion: Continued work in this topic will lead us to a better understanding of the mechanisms underlying language recovery, biomarkers that influence recovery, and, consequently, more personalized treatment options for individual patients. Kiran, S., Meier, E. L., & Johnson, J. P. (2019). Neuroplasticity in aphasia: A proposed framework of language recovery. Journal of Speech, Language, and Hearing Research, 62(11), 3973–3985. https://doi.org/10.1044/2019_JSLHR-L-RSNP-19-0054
    Data Types:
    • Video
  • This presentation video is from the Research Symposium at the 2018 annual convention of the American Speech-Language-Hearing Association held in Boston, MA. The abstract for the accompanying article is below. This article is part of the JSLHR Forum: Advances in Neuroplasticity Research on Language Recovery in Aphasia. Purpose: The brain-derived neurotrophic factor (BDNF) gene has been shown to be important for synaptic plasticity in animal models. Human research has suggested that BDNF genotype may influence stroke recovery. Some studies have suggested a genotype-specific motor-related brain activation in stroke recovery. However, recovery from aphasia in relation to BDNF genotype and language-related brain activation has received limited attention. We aimed to explore functional brain activation by BDNF genotype in individuals with chronic aphasia. Consistent with findings in healthy individuals and individuals with poststroke motor impairment, we hypothesized that, among individuals with aphasia, the presence of the Met allele of the BDNF gene is associated with reduced functional brain activation compared to noncarriers of the Met allele.Method: Eighty-seven individuals with chronic stroke-induced aphasia performed a naming task during functional magnetic resonance imaging scanning and submitted blood or saliva samples for BDNF genotyping. The mean number of activated voxels was compared between groups, and group-based activation maps were directly compared. Neuropsychological testing was conducted to compare language impairment between BDNF genotype groups. The Western Aphasia Battery Aphasia Quotient (Kertesz, 2007) was included as a covariate in all analyses.Results: While lesion size was comparable between groups, the amount of activation, quantified as the number of activated voxels, was significantly greater in noncarriers of the Met allele (whole brain: 98,500 vs. 28,630, p < .001; left hemisphere only: 37,209 vs. 7,000, p < .001; right hemisphere only: 74,830 vs. 30,630, p < .001). This difference was most strongly expressed in the right hemisphere posterior temporal area, pre- and postcentral gyrus, and frontal lobe, extending into the white matter. Correspondingly, the atypical BDNF genotype group was found to have significantly less severe aphasia (Western Aphasia Battery Aphasia Quotient of 64.2 vs. 54.3, p = .033) and performed better on a naming task (Philadelphia Naming Test [Roach, Schwartz, Martin, Grewal, & Brecher, 1996] score of 74.7 vs. 52.8, p = .047). A region of interest analysis of intensity of activation revealed no group differences, and a direct comparison of average activation maps across groups similarly yielded null results.Conclusion: BDNF genotype mediates cortical brain activation in individuals with chronic aphasia. Correspondingly, individuals carrying the Met allele present with more severe aphasia compared to noncarriers. These findings warrant further study into the effects of BDNF genotype in aphasia. Kristinsson, S., Yourganov, G., Xiao, F., Bonilha, L., Stark, B. C., Rorden, C., Basilakos, A., & Fridriksson, J. (2019). Brain-derived neurotrophic factor genotype–specific differences in cortical activation in chronic aphasia. Journal of Speech, Language, and Hearing Research, 62(11), 3923–3936. https://doi.org/10.1044/2019_JSLHR-L-RSNP-19-0021
    Data Types:
    • Video
  • This presentation video is from the Research Symposium at the 2018 annual convention of the American Speech-Language-Hearing Association held in Boston, MA. The abstract for the accompanying article is below. This article is part of the JSLHR Forum: Advances in Neuroplasticity Research on Language Recovery in Aphasia. Purpose: Despite a tremendous amount of research in this topic, the precise neural mechanisms underlying language recovery remain unclear. Much of the evidence suggests that activation of remaining left-hemisphere tissue, including perilesional areas, is linked to the best treatment outcomes, yet recruitment of the right hemisphere for various language tasks has also been linked to favorable behavioral outcomes. In this review article, we propose a framework of language recovery that incorporates a network-based view of the brain regions involved in recovery.Method: We review evidence from the extant literature and work from our own laboratory to identify findings consistent with our proposed framework and identify gaps in our current knowledge.Results: Expanding on Heiss and Thiel’s (2006) hierarchy of language recovery, we identify 4 emerging themes: (a) Several bilateral regions constitute a network engaged in language recovery; (b) spared left-hemisphere regions are important components of the network engaged in language recovery; (c) as damage increases in the left hemisphere, activation expands to the right hemisphere and domain-general regions; and (d) patients with efficient, control-like network topology show greater improvement than paients with abnormal topology. We propose a mechanistic model of language recovery that accounts for individual differences in behavior, network topology, and treatment responsiveness.Conclusion: Continued work in this topic will lead us to a better understanding of the mechanisms underlying language recovery, biomarkers that influence recovery, and, consequently, more personalized treatment options for individual patients. Kiran, S., Meier, E. L., & Johnson, J. P. (2019). Neuroplasticity in aphasia: A proposed framework of language recovery. Journal of Speech, Language, and Hearing Research, 62(11), 3973–3985. https://doi.org/10.1044/2019_JSLHR-L-RSNP-19-0054
    Data Types:
    • Video
  • This presentation video is from the Research Symposium at the 2018 annual convention of the American Speech-Language-Hearing Association held in Boston, MA. The abstract for the accompanying article is below. This article is part of the JSLHR Forum: Advances in Neuroplasticity Research on Language Recovery in Aphasia. Purpose: The brain-derived neurotrophic factor (BDNF) gene has been shown to be important for synaptic plasticity in animal models. Human research has suggested that BDNF genotype may influence stroke recovery. Some studies have suggested a genotype-specific motor-related brain activation in stroke recovery. However, recovery from aphasia in relation to BDNF genotype and language-related brain activation has received limited attention. We aimed to explore functional brain activation by BDNF genotype in individuals with chronic aphasia. Consistent with findings in healthy individuals and individuals with poststroke motor impairment, we hypothesized that, among individuals with aphasia, the presence of the Met allele of the BDNF gene is associated with reduced functional brain activation compared to noncarriers of the Met allele.Method: Eighty-seven individuals with chronic stroke-induced aphasia performed a naming task during functional magnetic resonance imaging scanning and submitted blood or saliva samples for BDNF genotyping. The mean number of activated voxels was compared between groups, and group-based activation maps were directly compared. Neuropsychological testing was conducted to compare language impairment between BDNF genotype groups. The Western Aphasia Battery Aphasia Quotient (Kertesz, 2007) was included as a covariate in all analyses.Results: While lesion size was comparable between groups, the amount of activation, quantified as the number of activated voxels, was significantly greater in noncarriers of the Met allele (whole brain: 98,500 vs. 28,630, p < .001; left hemisphere only: 37,209 vs. 7,000, p < .001; right hemisphere only: 74,830 vs. 30,630, p < .001). This difference was most strongly expressed in the right hemisphere posterior temporal area, pre- and postcentral gyrus, and frontal lobe, extending into the white matter. Correspondingly, the atypical BDNF genotype group was found to have significantly less severe aphasia (Western Aphasia Battery Aphasia Quotient of 64.2 vs. 54.3, p = .033) and performed better on a naming task (Philadelphia Naming Test [Roach, Schwartz, Martin, Grewal, & Brecher, 1996] score of 74.7 vs. 52.8, p = .047). A region of interest analysis of intensity of activation revealed no group differences, and a direct comparison of average activation maps across groups similarly yielded null results.Conclusion: BDNF genotype mediates cortical brain activation in individuals with chronic aphasia. Correspondingly, individuals carrying the Met allele present with more severe aphasia compared to noncarriers. These findings warrant further study into the effects of BDNF genotype in aphasia. Kristinsson, S., Yourganov, G., Xiao, F., Bonilha, L., Stark, B. C., Rorden, C., Basilakos, A., & Fridriksson, J. (2019). Brain-derived neurotrophic factor genotype–specific differences in cortical activation in chronic aphasia. Journal of Speech, Language, and Hearing Research, 62(11), 3923–3936. https://doi.org/10.1044/2019_JSLHR-L-RSNP-19-0021
    Data Types:
    • Video
  • This presentation video is from the Research Symposium at the 2018 annual convention of the American Speech-Language-Hearing Association held in Boston, MA. The abstract for the accompanying article is below. This article is part of the JSLHR Forum: Advances in Neuroplasticity Research on Language Recovery in Aphasia. Purpose: Recovery from aphasia is thought to depend on neural plasticity, that is, functional reorganization of surviving brain regions such that they take on new or expanded roles in language processing. To make progress in characterizing the nature of this process, we need feasible, reliable, and valid methods for identifying language regions of the brain in individuals with aphasia. This article reviews 3 recent studies from our lab in which we have developed and validated several novel functional magnetic resonance imaging paradigms for language mapping in aphasia.Method: In the 1st study, we investigated the reliability and validity of 4 language mapping paradigms in neurologically normal older adults. In the 2nd study, we developed a novel adaptive semantic matching paradigm and assessed its feasibility, reliability, and validity in individuals with and without aphasia. In the 3rd study, we developed and evaluated 2 additional adaptive paradigms—rhyme judgment and syllable counting—for mapping phonological encoding regions.Results: We found that the adaptive semantic matching paradigm could be performed by most individuals with aphasia and yielded reliable and valid maps of core perisylvian language regions in each individual participant. The psychometric properties of this paradigm were superior to those of other commonly used paradigms such as narrative comprehension and picture naming. The adaptive rhyme judgment paradigm was capable of identifying fronto-parietal phonological encoding regions in individual participants.Conclusion: Adaptive language mapping paradigms offer a promising approach for future research on the neural basis of recovery from aphasia. Wilson, S. M., Eriksson, D. K., Yen, M., Demarco, A. T., Schneck, S. M., & Lucanie, J. M. (2019). Language mapping in aphasia. Journal of Speech, Language, and Hearing Research, 62(11), 3937–3946. https://doi.org/10.1044/2019_JSLHR-L-RSNP-19-0031
    Data Types:
    • Video
  • This presentation video is from the Research Symposium at the 2018 annual convention of the American Speech-Language-Hearing Association held in Boston, MA. The abstract for the forum introduction is below. This introduction is part of the JSLHR Forum: Advances in Neuroplasticity Research on Language Recovery in Aphasia. Purpose: The purpose of this introduction is to provide an overview of the articles contained within this forum of Journal of Speech, Language, and Hearing Research (JSLHR). Each of these articles is based upon presentations from the Research Symposium at the 2018 annual convention of the American Speech-Language-Hearing Association held in Boston, MA. Kiran, S. (2019). Introduction to the 2018 research symposium forum. Journal of Speech, Language, and Hearing Research, 62(11), 3905–3906. https://doi.org/10.1044/2019_JSLHR-19-00297
    Data Types:
    • Video
  • This presentation video is from the Research Symposium at the 2018 annual convention of the American Speech-Language-Hearing Association held in Boston, MA. The abstract for the accompanying article is below. This article is part of the JSLHR Forum: Advances in Neuroplasticity Research on Language Recovery in Aphasia. Purpose: Reorganization of language networks in aphasia takes advantage of the facts that (a) the brain is an organ of plasticity, with neuronal changes occurring throughout the life span, including following brain damage; (b) plasticity is highly experience dependent; and (c) as with any learning system, language reorganization involves a synergistic interplay between organism-intrinsic (i.e., cognitive and brain) and organism-extrinsic (i.e., environmental) variables. A major goal for clinical treatment of aphasia is to be able to prescribe treatment and predict its outcome based on the neurocognitive deficit profiles of individual patients. This review article summarizes the results of research examining the neurocognitive effects of psycholinguistically based treatment (i.e., Treatment of Underlying Forms; Thompson & Shapiro, 2005) for sentence processing impairments in individuals with chronic agrammatic aphasia resulting from stroke and primary progressive aphasia and addresses both behavioral and brain variables related to successful treatment outcomes. The influences of lesion volume and location, perfusion (blood flow), and resting-state neural activity on language recovery are also discussed as related to recovery of agrammatism and other language impairments. Based on these and other data, principles for promoting neuroplasticity of language networks are presented.Conclusions: Sentence processing treatment results in improved comprehension and production of complex syntactic structures in chronic agrammatism and generalization to less complex, linguistically related structures in chronic agrammatism. Patients also show treatment-induced shifts toward normal-like online sentence processing routines (based on eye movement data) and changes in neural recruitment patterns (based on functional neuroimaging), with posttreatment activation of regions overlapping with those within sentence processing and dorsal attention networks engaged by neurotypical adults performing the same task. These findings provide compelling evidence that treatment focused on principles of neuroplasticity promotes neurocognitive recovery in chronic agrammatic aphasia. Thompson, C. K. (2019). Neurocognitive recovery of sentence processing in aphasia. Journal of Speech, Language, and Hearing Research, 62(11), 3947–3972. https://doi.org/10.1044/2019_JSLHR-L-RSNP-19-0219
    Data Types:
    • Video
  • This presentation video is from the Research Symposium at the 2018 annual convention of the American Speech-Language-Hearing Association held in Boston, MA. The abstract for the accompanying article is below. This article is part of the JSLHR Forum: Advances in Neuroplasticity Research on Language Recovery in Aphasia. Purpose: Understanding the brain basis of language and cognitive outcomes is a major goal of aphasia research. Prior studies have not often considered the many ways that brain features can relate to behavioral outcomes or the mechanisms underlying these relationships. The purpose of this review article is to provide a new framework for understanding the ways that brain features may relate to language and cognitive outcomes from stroke.Method: Brain–behavior relationships that may be important for aphasia outcomes are organized into a taxonomy, including features of the lesion and features of brain tissue spared by the lesion. Features of spared brain tissue are categorized into those that change after stroke and those that do not. Features that change are further subdivided, and multiple mechanisms of brain change after stroke are discussed.Results: Features of the stroke, including size, location, and white matter damage, relate to many behavioral outcomes and likely account for most of the variance in outcomes. Features of the spared brain tissue that are unchanged by stroke, such as prior ischemic disease in the white matter, contribute to outcomes. Many different neurobiological and behavioral mechanisms may drive changes in the brain after stroke in association with behavioral recovery. Changes primarily driven by neurobiology are likely to occur in brain regions with a systematic relationship to the stroke distribution. Changes primarily driven by behavior are likely to occur in brain networks related to the behavior driving the change.Conclusions: Organizing the various hypothesized brain–behavior relationships according to this framework and considering the mechanisms that drive these relationships may help investigators develop specific experimental designs and more complete statistical models to explain language and cognitive abilities after stroke. Eight main recommendations for future research are provided. Turkeltaub, P. E. (2019). A taxonomy of brain–behavior relationships after stroke. Journal of Speech, Language, and Hearing Research, 62(11), 3907–3922. https://doi.org/10.1044/2019_JSLHR-L-RSNP-19-0032
    Data Types:
    • Video
  • This presentation video is from the Research Symposium at the 2018 annual convention of the American Speech-Language-Hearing Association held in Boston, MA. The abstract for the accompanying article is below. This article is part of the JSLHR Forum: Advances in Neuroplasticity Research on Language Recovery in Aphasia. Purpose: Recovery from aphasia is thought to depend on neural plasticity, that is, functional reorganization of surviving brain regions such that they take on new or expanded roles in language processing. To make progress in characterizing the nature of this process, we need feasible, reliable, and valid methods for identifying language regions of the brain in individuals with aphasia. This article reviews 3 recent studies from our lab in which we have developed and validated several novel functional magnetic resonance imaging paradigms for language mapping in aphasia.Method: In the 1st study, we investigated the reliability and validity of 4 language mapping paradigms in neurologically normal older adults. In the 2nd study, we developed a novel adaptive semantic matching paradigm and assessed its feasibility, reliability, and validity in individuals with and without aphasia. In the 3rd study, we developed and evaluated 2 additional adaptive paradigms—rhyme judgment and syllable counting—for mapping phonological encoding regions.Results: We found that the adaptive semantic matching paradigm could be performed by most individuals with aphasia and yielded reliable and valid maps of core perisylvian language regions in each individual participant. The psychometric properties of this paradigm were superior to those of other commonly used paradigms such as narrative comprehension and picture naming. The adaptive rhyme judgment paradigm was capable of identifying fronto-parietal phonological encoding regions in individual participants.Conclusion: Adaptive language mapping paradigms offer a promising approach for future research on the neural basis of recovery from aphasia. Wilson, S. M., Eriksson, D. K., Yen, M., Demarco, A. T., Schneck, S. M., & Lucanie, J. M. (2019). Language mapping in aphasia. Journal of Speech, Language, and Hearing Research, 62(11), 3937–3946. https://doi.org/10.1044/2019_JSLHR-L-RSNP-19-0031
    Data Types:
    • Video