Theoretically based treatment for sentence comprehension deficits in aphasia

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DESCRIPTION (provided by applicant): One goal of the Healthy People 2010 program is to reduce health disparities across different segments of the population. Diagnosis and treatment of sentence comprehension deficits in patients with aphasia is one area where disparities continue to exist even though this topic is of great theoretical importance. The current research on this topic, however, lacks specific recommendations on how to train sentence comprehension skills in patients with aphasia and to what extent generalization of comprehension skills occurs across sentences of similar syntactic structure and across different comprehension tasks. The goal of the project is to develop an effective, theoretically sound, treatment for sentence comprehension deficits in patients with aphasia following stroke. Our approach to developing effective therapies for these deficits will be guided by results in linguistics, psycholinguistics, and aphasiology. This project consists of two distinct phases: Phase 1: Specific Plans and Milestones for R21 (Year 1) In the first (R21) phase of the project, which will last one year, we will develop two effective therapies for syntactic comprehension deficits - one based on picture matching and one based on object enactment. Milestones will be measures of the effectiveness of these therapies. In this year, we will also develop the optimal treatment prescription (frequency and duration of therapy sessions) and the stimuli to be utilized for training and generalization. Phase 2: R33 (Years 2-5) in the second (R33) phase of the project, we will investigate the wider clinical utility of the treatment developed in Phase 1. We will address the critical issues of rate of acquisition of treated items, generalization to untrained items, maintenance of performance after termination of treatment, transfer to everyday comprehension tasks, and optimal patient selection for training. The expected outcome of this phase is a novel treatment approach whose clinical utility is well characterized and that can be used by clinicians with appropriate patients with aphasia.