Incorporating Metacognitive Strategy Training Into Semantic Treatment Promotes Restitutive and Substitutive Gains in Naming: A Single-Subject Investigation.
Incorporating Metacognitive Strategy Training Into Semantic Treatment Promotes Restitutive and Substitutive Gains in Naming: A Single-Subject Investigation.
复制标题
将元认知策略训练纳入语义处理可促进命名中的恢复性和替代性收益：单受试者调查。
DOI：
10.1044/2023_ajslp-22-00230
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发表时间：
2023
影响因子：
2.6
通讯作者：
Vallila-Rohter,Sofia
中科院分区：
文献类型：
--
作者：
Tilton-Bolowsky,VictoriaE;Brock,Lauren;Nunn,Kristen;Evans,WilliamS;Vallila-Rohter,Sofia
本研究测试了一种结合元认知策略训练(MST)的改良语义特征分析(SFA)治疗方案的有效性。关于其恢复部分，SFA最可靠地改善了对已处理项目和未处理、语义相关项目的单词提取，但反应泛化的证据往往很少/不一致。关于其替代成分，SFA被认为通过习惯化SFA迂回策略来促进成功的沟通。然而，在没有直接MST的情况下反复实施SFA的战略，可能不会导致独立的战略使用和/或推广。此外，失语症患者在失调症时刻独立使用SFA策略的报道目前被低估了。为了解决这些局限性，我们将MST纳入SFA并直接测量替代结果。方法4名失语症患者参加了24次SFA+MST的治疗，采用A-B单一受试者实验设计，重复测量。我们测量了词提取的准确率、策略使用和外显策略知识。我们计算效应大小来衡量词汇提取准确率和策略使用的变化，并使用视觉检查来评估从处理前到处理后和保留过程中显性策略知识的增长。结果被试在词汇提取准确率上获得了轻微到中等的影响；未处理的，语义相关的；未处理的，语义无关的项目，以及独立策略使用的轻微的小到大的影响。结论在被试中，SFA+MST在词汇提取准确率和/或策略使用方面产生了积极的变化。单词提取准确率的积极变化与其他SFA研究类似。在战略使用方面的积极变化表明，初步证据表明，这种治疗有能力产生恢复性和替代性收益。总体而言，这项研究为SFA+MST的有效性提供了初步证据，并强调了直接衡量SFA替代结果的重要性，这表明失语症患者可以通过多种成功的方式对这种治疗做出反应--而不仅仅是改善目标词的产出。
PurposeThis study tested the effectiveness of a modified semantic feature analysis (SFA) treatment protocol that incorporated metacognitive strategy training (MST). Regarding its restitutive component, SFA most reliably results in improved word retrieval for treated items and untreated, semantically related items, but evidence of response generalization is often small/inconsistent. Regarding its substitutive component, SFA is thought to facilitate successful communication via habituation of the SFA circumlocution strategy. However, repeated practice with SFA's strategy in the absence of direct MST may not result in independent strategy use and/or generalization. Furthermore, people with aphasia's independent use of the SFA strategy in moments of anomia is presently underreported. To address these limitations, we incorporated MST into SFA and directly measured substitutive outcomes.MethodFour people with aphasia participated in 24 treatment sessions of SFA + MST in a single-subject, A-B experimental design with repeated measurements. We measured word retrieval accuracy, strategy use, and explicit strategy knowledge. We calculated effect sizes to measure changes in word retrieval accuracy and strategy use and used visual inspection to assess gains in explicit strategy knowledge from pre- to posttreatment and retention.ResultsParticipants achieved marginally small to medium effects in word retrieval accuracy for treated; untreated, semantically related; and untreated, semantically unrelated items and marginally small to large effects in independent strategy use. Explicit strategy knowledge was variable.ConclusionsAcross participants, SFA + MST yielded positive changes in word retrieval accuracy or strategy use, or both. Positive changes in word retrieval accuracy were comparable to other SFA studies. Positive changes in strategy use demonstrate preliminary evidence of this treatment's ability to yield restitutive and substitutive gains. Overall, this study offers preliminary evidence of SFA + MST's effectiveness and highlights the importance of directly measuring SFA's substitutive outcomes, which showed that people with aphasia can respond to this treatment in multiple successful ways—not just improved target word production.