The Complexity Hypothesis: Research and ideas for aphasia treatment

The Complexity Hypothesis:
Research and ideas for
aphasia treatment
Aura Kagan (Aphasia Institute)
Nina Simmons-Mackie (Southeastern Louisiana University)
Mary Boyle (Montclair State University)
Roberta Elman (Aphasia Center of California)
Ellyn Riley (Northwestern University)
Cynthia Thompson (Northwestern University)
© Aphasia Institute 2011
ASHA 2011
San Diego
AGENDA
• Introduction and background – Aura Kagan
• Panelists:
– Phonology – Ellyn Riley
– Word-finding – Mary Boyle
– Syntax – Cynthia Thompson
– Conversation – Roberta Elman
• Wrap-up and discussion – Nina Simmons-Mackie
© Aphasia Institute 2011
The problem with complexity
is that it is complex
• ‘Complicatedness’
– Difficult to understand regardless of level of
complexity
• Complexity
– A system characteristic
– Implies many densely connected parts
– Multiple levels of ‘embeddedness’ and
entanglement
© Aphasia Institute 2011
Baby-steps may not be ‘the way’
• Work of several people in our field lends
support to this counter-intuitive notion
• Starting at a more complex level results in
generalization cascading down to simpler
levels but the opposite is not necessarily
true
© Aphasia Institute 2011
Paradigm Shifting Idea
• Our training based on a ‘common-sense’
idea
– E.g., You need to walk before you can run
• But does this hold in the light of recent
research?
© Aphasia Institute 2011
Evidence from other disciplines
What can we learn from the work on:
– Neuroplasticity and translational research?
– Second-language learning?
– Literacy and whole language?
– Computational modeling and language?
– OT, PT and Education?
– Linguistics?
© Aphasia Institute 2011
What can we learn from the
work on neuroplasticity and
translational research?
Translational research
(animal research with implications for human functioning)
“greater functional outcomes and enhancement of
neuroplastic changes are more likely when
rehabilitation incorporates complex tasks and/or
environments” Raymer et. al., (2008)
© Aphasia Institute 2011
Vygotsky and Luria
• Vygotsky
– e.g., child development within a context or
situation is the smallest unit that we should
study
• Luria
– e.g., views language in terms of complex
functional systems rather than a more
reductionist approach
© Aphasia Institute 2011
What can we learn from the
work in second-language
learning?
e.g., The ‘interaction hypothesis’ (Long,
1996)
• Emphasizes the role of the linguistic
environment on second-language learning
• Social context is critical for the acquisition
process
© Aphasia Institute 2011
Literacy and Whole Language
• Current work in literacy (e.g. Damico,
2011) supports a meaning-based
approach
• Whole language approaches to child
language learning and intervention (e.g.
Norris & Damico, 1990)
© Aphasia Institute 2011
What can we learn from work
in computational modeling
and language?
• Work related to our field – mostly at the level of
trying to account for aphasia symptomatology at
the level of linguistic elements
• Challenge: moving from this to natural language
usage (similar to idea that difficult to get
generalization ‘upwards’)
© Aphasia Institute 2011
What can we learn from OT,
PT and Education?
• Current thinking: Best functional outcomes
obtained when target behaviour is embedded in
a complex and meaningful context e.g.
education’s focus on part/whole task practice
• Complexity does not automatically mean
‘personally relevant communicative intent’
Acknowledgement: Leslie Gonzalez-Rothi (personal communication)
© Aphasia Institute 2011
What can we learn from the
field of linguistics?
• E.g., Reading
– For children, approaches of teachers and slp’s
markedly different (noted nearly 25 years ago)
• Teachers: sense-making
• Slp’s: reductionist approach
– Both have a place
• In aphasia, we should think about this at a metalevel (inter-domain) and more micro-level (intradomain)
© Aphasia Institute 2011
Other fun examples
• Orff music approach
• Specialized journals on complexity and
education
• A William Gaddis quote for those of us
who love ‘order’
© Aphasia Institute 2011
Complicity: An International Journal
of Complexity and Education
Complicity is an open access
(free to all readers), peerreviewed journal that publishes
original articles on all aspects of
education that are informed by
the idea of complexity (in its
technical, applied, philosophical,
theoretical, or narrative
manifestations). The journal
strives to serve as a forum for
both theoretical and practical
contributions and to facilitate the
exchange of diverse ideas and
points of view related to
complexity in education.
© Aphasia Institute 2011
Artwork: Jackson Pollock Number 8, 1949 (detail) ©
2008 Pollock-Krasner Foundation / Artists Rights
Society (ARS), New York
Order and Chaos 
Before we go any further here, has it ever occurred to any of you that all this
is simply one grand misunderstanding? Since you’re not here to learn
anything, but to be taught so you can pass these tests, knowledge has to be
organized so it can be taught, and it has to be reduced to information so it
can be organized do you follow that? In other words this leads you to
assume that organization is an inherent property of the knowledge itself,
and that disorder and chaos are simply irrelevant forces that threaten it from
outside. In fact it’s exactly the opposite. Order is simply a thin, perilous
condition we try to impose on the basic reality of chaos...
William Gaddis (1975)
© Aphasia Institute 2011
MOVING ON…
Panelists
• Phonology – Ellyn Riley
• Word-finding – Mary Boyle
• Syntax – Cynthia Thompson
• Conversation – Roberta Elman
© Aphasia Institute 2011
© Aphasia Institute 2011