Translation and Clinical Implementation of a Test of Language and Short-term Memory (STM) in Aphasia

失语症是一种后天性语言能力障碍，其原因是左脑受损。 中风、头部创伤或其他神经疾病。它可以影响口语和/或书面语的任何方面 从轻微到严重不等。由于语言为我们提供了一种独特的交流形式， 失语症可能会对一个人的生活质量产生深远的不利影响。虽然失语症在老年人中更常见 失语症可能发生在任何年龄段，许多失语症患者想要找到恢复疾病前状态的方法。 生活方式，包括积极的职业，只要这是可能的。显然，有必要进行有效的临床治疗。 诊断和治疗失语症的工具，但第三个因素使满足这一需求的可能性成为现实：更多 30多年的康复研究提供了强有力的证据，即使在失语症的慢性阶段， 行为干预可改善语言功能和大脑皮层神经活动 以支持语言而闻名。该项目旨在将理论驱动和经验支持的诊断 失语症(TALSA)语言和短期记忆的TIMPLE评估 可用于语言障碍筛查或深度测量的可行测试组。重要的是 TALSA基于一种语言的理论模型，该模型包含了言语短期记忆的作用 (STM)在语言处理中。语言和言语STM障碍通常在失语症中并存，而这 共同出现的模型属性是对支持访问和检索的进程的常见损害 词汇：在词汇过程中弱激活和/或不能保持语言表征的激活 正在处理。需要这种水平的诊断来指导基于损伤的治疗方法，直接 刺激访问和检索过程。TALSA的独特之处在于它包括语言测试，这些测试增加了 内存负荷和处理时间，这些变量对这些处理损伤很敏感。 TALSA的研究版本是在计算机上实施的，但它很长，在临床上不实用 布景。我们的目标是开发一种用于临床的计算机化自适应测试版本。此项目将使用 基于里程碑的方法来开发这一创新的临床工具。在头两年，我们将开发临床 使用焦点小组和项目反应理论来确定临床上使用的最佳项目和子测试 此测试的版本(里程碑1)。达到里程碑2的目标将包括(1)对参与的临床医生的评估 对失语症康复的当前和最佳做法的看法和(2)培训参与的临床医生 TALSA背后的概念，以及关于其管理和解释的具体情况。里程碑3将 包括在临床环境中实施临床版本，以及评估临床医生对 与原始版本相关的临床版本的有用性和有效性。传播的计划 TALSA的最终临床版本将包括开发一个安全的网站，使其能够访问 初版(在第3-5年)和在第5年出版最后版本的安排。

Aphasia is an acquired impairment of language abilities resulting from damage to the left hemisphere from stroke, head trauma or other neurological conditions. It can affect any aspect of spoken and/or written language processing and can range from mild to severe. As language provides us with a unique form of communication, aphasia can have profound adverse effects on one's quality of life. Although aphasia is more common in older populations, it can occur at any age, and many people with aphasia want to find ways to return to their premorbid lifestyles, including active careers, to the extent that this is possible. Clearly, there is a need for effective clinical tools to diagnose and treat aphasia, but a third factor makes the possibility of meeting this need a reality: More than 30 years of rehabilitation research provides strong evidence that even in chronic stages of aphasia, behavioral interventions lead to improved language function and changes in neural activity of cortical areas known to support language. This project aims to translate a theory-driven and empirically supported diagnostic battery for aphasia (Temple Assessment of Language and Short-term memory in Aphasia, TALSA) to a clinically feasible test battery that can be used for screening or in-depth measures of a language impairment. Importantly, the TALSA is based on a theoretical model of language that incorporates a role of verbal short-term memory (STM) in language processing. Language and verbal STM impairments commonly co-occur in aphasia, and this model attributes that co-occurrence to a common impairment of processes that support access and retrieval of words: weak activation and/or the inability to maintain activation of linguistic representations during word processing. This level of diagnosis is needed to guide impairment-based treatment approaches that directly stimulate access and retrieval processes. The TALSA is unique in that it includes language tests that add memory load and processing time, variables which are sensitive to these processing impairments. The research version of the TALSA is administered on a computer but is lengthy and not practical in a clinical setting. Our aim is to develop a computerized adaptive test version for clinical use. This project will use a Milestone based approach to develop this innovative clinical tool. In the first two years, we will develop the clinical version using focus groups and item response theory to identify the best items and subtests to use in the clinical version of this test (Milestone 1). Goals to meet Milestone 2 will include (1) assessment of participating clinicians' views of current and best practices in aphasia rehabilitation and (2) training participating clinicians on the concepts behind the TALSA, as well as specifics about its administration and interpretation. Milestone 3 will involve implementation of the clinical version in the clinical settings and assessment of clinicians' responses to its usefulness and validation of the clinical version, in relation to the original version. Plans for dissemination of the final clinical version of the TALSA will include development of a secured website enabling access to the preliminary version (in Years 3-5) and arrangements for publication of the final version in Year 5.