The Repository @ St. Cloud State

Open Access Knowledge and Scholarship

Date of Award


Culminating Project Type


Degree Name

Communication Sciences and Disorders: M.S.


Communication Sciences and Disorders


School of Health and Human Services

First Advisor

G. N. Rangamani

Second Advisor

Rebecca Crowell

Third Advisor

Phyllis Greenberg

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Keywords and Subject Headings

Aphasia, Constraint-Induced Auditory Therapy, Lexical retrieval



Traditional cognitive-linguistic therapy has demonstrated success in strengthening the semantic-lexical retrieval system through direct mapping of semantic features in persons with aphasia (PWA) (David & Thompson, 2005; Edmonds, 2014; Edmonds & Swathi, 2009). Within these treatments, auditory processing is implicitly addressed, as most practice tasks involve an auditory-verbal modality. However, evidence of explicit training of auditory processing and its effects on lexical processing is very limited. Constraint Induced Auditory Therapy (CIAT) has demonstrated the ability to strengthen the auditory input processing in some patients with aphasia; however evidence is scanty (Hurley & Davis, 2011). Also, until now there are no known studies that illustrate the combined effects of cognitive-linguistic treatment (such as Verb Network Strengthening Treatment (VNeST)) and explicit training of auditory processing (such as CIAT) on lexical retrieval and overall language ability. Therefore, the following study was undertaken with the objective of determining the differences in treatment and functional communication outcomes in a PWA with and without CIAT in combination with VNeST in an individual with moderate aphasia.


A single-subject research design was used to determine the effects of explicit auditory training using CIAT and cognitive-linguistic therapy (VNeST) on overall language expression, comprehension, and functional communication. The subject was a 73 year-old female stroke survivor with moderate degree of aphasia. Standardized and criterion-reference assessments were administered prior to and following each of three blocks of treatment. All treatment outcomes were analyzed using non-parametric statistics and subjective analyses. Non-parametric analyses included logistical regressions and Chi-square calculations. Subjective analyses included effect size changes, visual inspections using a two-standard deviation method and discourse analyses using the measures described by Nicholas and Brookshire (1993).


The use of VNeST in isolation demonstrated a greater impact on cognitive-linguistic processing and language outcomes, whereas VNeST in combination with CIAT appeared to improve mainly the language modality of repetition and attentional tasks. Therefore, the use of CIAT in combination with VNeST may depend on the specific PWAs skills prior to and during treatment. More research is necessary in order to establish an understanding the method and condition for which to introduce explicit auditory training into cognitive-linguistic therapy. This is necessary in order to ensure that explicit auditory training enhances, rather than hinders the advancement of skills.


I would like to thank Dr. Rangamani for her unweaving commitment to this project and to my success as a graduate student. Without her support, this project would not have been possible. I would also like to thank my family for their encouragement throughout this process. Last, I would like to thank Dr. Rebecca Crowell and Dr. Phyllis Greenberg for their guidance and input. Their contributions were invaluable in making this project a success.