Learning Paradigms in Aphasia Rehabilitation

描述（由申请人提供）：本研究项目的长期目标是提高我们设计有效的治疗策略来修复失语症状的能力。该项目考察了一个适用于多种认知康复项目的特定设计变量，即患者在训练过程中试图做出正确反应时犯错误的程度。本研究聚焦于一种特殊的认知缺陷，即失范，试图研究无误学习与错误学习在语言缺陷康复中的相对效果。失语症是一种词汇检索障碍，是左半球中风最常见的缺陷。这种缺陷会严重影响一个人有效沟通的能力，并会干扰工作、社交功能和日常生活。该项目的一个目标是验证这样一种假设，即在训练过程中接受一种允许很少或没有错误的治疗后，与一种保证会产生错误的常用治疗相比，失范症患者更有可能提高他们检索单词的能力。第二个目的是检查外显记忆和注意力/执行控制缺陷对腐蚀/满变量的影响。这些假设来源于应用于记忆缺陷患者的关于无误学习与错误学习的文献。失语症患者将参加一个治疗项目，在这个项目中，两组不同的单词在不同的条件下接受训练。在错误的情况下，患者首先尝试在没有任何外部提示的情况下说出一幅画的名字。如果产生错误的反应，则提供最小的刺激提示。如果给出了另一个错误的回答，就会增加一个更有力的提示，以此类推，直到病人说出正确的单词。在无差错的情况下，病人看到一张图片，被告知图片的名字，并被要求重复它。然后，这个单词的碎片被一点一点地移除，在每个连续的碎片被移除后，病人说出这个项目的名字。在主题内比较两个条件，分别在一个月和六个月后学习单词的时间和单词的保留程度的差异。这些结果将与外显记忆和内隐记忆以及注意力的测试结果相关联。研究结果将为进一步研究无错误/错误变量在语言障碍认知康复设计中的重要性，以及外显记忆测试在预测治疗成功方面的潜在价值提供基础。

DESCRIPTION (provided by applicant): The long-term objective of this research project is to improve our ability to design effective treatment strategies for the remediation of aphasic symptoms. The project examines a specific design variable that has application to many kinds of cognitive rehabilitation programs - the extent to which the patient makes errors when attempting to produce the correct response during training. It focuses on one particular cognitive deficit, anomia, in attempting to study the relative efficacy of errorless vs. errorful learning in the rehabilitation of language deficits. Anomia, an impairment in the retrieval of words, is the most common deficit resulting from a left hemisphere stroke. This deficit can have grave consequences upon one's ability to communicate effectively and can interfere with work, social function, and everyday life. One goal of the project is to test the hypothesis that patients with anomia are more likely to improve their ability to retrieve words following a therapy that allows for few or no errors during training compared with a commonly used therapy that guarantees that errors are produced. A second aim is to examine the effects of deficits in explicit memory and in attention/executive control on the errodess/ful variable. These hypotheses derive from the literature on errorless vs. errorful learning that has been applied to patients with memory deficits. Patients with anomia will participate in a therapy program in which two different sets of words are trained under different conditions. In the errorful condition, the patient first attempts to name a picture without any external cues. If an incorrect response is produced, a minimal stimulus cue is provided. If another incorrect response is given, a more powerful cue is added, etc. until the patient produces the correct word. In the errorless condition, the patient views a picture and is given its name and asked to repeat it. Pieces of the word are then removed bit by bit, and the patient names the item after each successive piece is removed. The conditions are compared, within-subject, for differences in time to learn the words and degree of retention of the words after one month and six months. These results will be correlated with the results of tests of explicit and implicit memory, and attention. The overall results will provide the basis for future studies of the importance of the errorless/ful variable in the design of cognitive rehabilitation of language deficits, and the potential value of tests of explicit memory in predicting therapy success.