Communication Outcomes for Naming Treatments in Aphasia

描述（由申请人提供）：每年有成千上万的人患有影响左脑半球的中风，并发展为失语症，这是一种获得性语言障碍。失语症最常见的症状之一是单词提取障碍，它甚至会破坏表达基本想法和需求的能力。已经描述了几种行为治疗方法对单词检索能力有积极影响，主要是在约束图片命名任务中。治疗成果的真正影响也需要在会话词检索期间，即在交流活动/参与的层面上加以认识（世卫组织，2001年）。很少有证据表明，最有效的治疗方法可以在话语层面的沟通中产生积极的结果。此外，单词检索治疗研究通常表明，在轻度至中度单词检索障碍患者中，治疗效果最大，通常以词汇音韵学阶段的单词检索失败为特征，而在严重的基于语义的单词检索障碍患者中，治疗效果更有限。也就是说，那些最需要交流的人，如果只使用单个单词，对单词检索治疗的反应最差。本项目的目的是研究两种词语检索处理方法的改进版本，即无差错命名处理和言语+手势处理，它们不仅对图片命名的影响，而且对交流活动/参与的衡量也有影响。此外，我们将检查语音和语义单词检索障碍个体的治疗结果。由于我们的治疗方法仍处于探索发展阶段，我们计划测试16名参与者，每个治疗方案8名，使用单参与者多基线实验设计，在单词集和参与者之间复制。接受每种治疗的参与者中有一半会有基于语义的障碍。我们将在图片命名和话语样本中检查我们的治疗对单词检索和手势产生的影响，以及在治疗完成和一个月随访时测量的交流评级量表。最后，我们将比较每日使用图片命名探针与治疗前后使用图片命名探针的结果，以确定这种错误研究设计对无错误训练的任何影响。公共卫生相关性：成千上万的人生活在中风的后果中，包括失语症，这是一种通过单词和句子理解和表达自己的能力受损。本项目旨在寻找更有效的语言治疗方法，以帮助中风和失语症患者最大限度地提高他们在日常生活活动中表达想法和基本需求的能力。

DESCRIPTION (provided by applicant): Thousands of individuals each year suffer a stroke affecting the left hemisphere of the brain and develop aphasia, an acquired language disability. One of the most common symptoms of aphasia is word retrieval impairment, which can disrupt the ability to express even basic thoughts and needs. Several behavioral treatment methods have been described that have positive impact on word retrieval abilities, largely in constrained picture naming tasks. The true impact of treatment gains need to be appreciated as well during conversational word retrieval, that is, at the level of communication activities/participation (WHO, 2001). Much less evidence is available about the most effective treatments leading to positive outcomes in discourse level- communication. Further, word retrieval treatment studies have often shown largest treatment effects in individuals with mild-to-moderate impairments, often characterized by failure in lexical phonologic stages of word retrieval, and more limited effects in individuals with severe semantically-based word retrieval impairments. That is, those with the greatest needs to communicate, if only with single words, have the poorest response to word retrieval treatment. The purpose of this project is to investigate modified versions of two word retrieval treatment approaches, errorless naming treatment and verbal+gestural treatment, for their effects not only for picture naming, but also for measures of communication activities/participation. Further, we will examine treatment outcomes in individuals with phonologic and semantic word retrieval impairments. Because our treatments are still in exploratory stages of development, we plan to test 16 participants, 8 in each treatment protocol, using single participant multiple baseline experimental designs replicated across word sets and participants. Half of the participants receiving each treatment will have semantically-based impairments. We will examine the effects of our treatments for word retrieval and gesture production in picture naming and discourse samples, as well as in communication rating scales measured at treatment completion and at one month follow up. Finally, we will compare outcomes for picture naming probes administered daily versus those administered at pre- and post- treatment to determine any impact of this errorful research design for errorless training. PUBLIC HEALTH RELEVANCE: Hundreds of thousands of individuals are living with the consequences of stroke, including aphasia, an impairment in the ability to understand and express oneself through words and sentences. This project aims to identify more effective methods of speech therapy to assist individuals who are recovering from stroke and aphasia to maximize their ability to express ideas and basic needs during daily life activities.