Retrieval Practice Principles: A Theory of Learning for Aphasia Rehabilitation

今天有超过100万患者，失语症是左半球中风后的一种普遍损害， 影响口语、书面语或手势语的产生或理解。我们和其他人一样认为， 有效地优先考虑和优化现有的失语症治疗方法需要一个 了解受损系统如何响应不同类型的学习经验，即，一个理论 学习。本建议致力于进一步发展失语症的学习理论 基于从基础心理学研究中得出的强大学习原则的康复（即，检索 RP原则（principles）。我们先前的研究为RP学习理论提供了实证基础 通过证明其与治疗命名障碍的相关性，命名障碍是一种普遍存在的症状， 失语症（PWA）患者，难以可靠地命名常见的日常物品。在我们之前的工作中， 我们表明，提供“检索练习”（练习从长- 术语记忆）比不起名字的流行形式的命名治疗具有更大的持续益处 包括检索练习（无错学习）。在确认一个相关的“间隔”原则时，我们还发现 当一个项目的重复训练试验随着时间的推移而间隔时， 聚集在一起。在这项基础工作中，我们研究了一组相对均匀的PWA， 命名是唯一或主要受影响的领域。在目前的提案中，我们采取了重要的后续步骤， 更广泛的临床和理论意义的学习理论，通过研究如何RP原则 更普遍地影响失语症的命名障碍（研究1）;检查原则的相关性， 治疗单词理解缺陷（即，可靠地获取熟悉单词的含义的问题）， 失语症（研究1和2），并通过发展一个理论帐户的RP原则如何影响字 生产中的检索过程（研究3-5）。研究1将研究RP原则如何影响命名 损害和转移的好处，从命名处理，以文字理解的表现， 非均匀且充分表征PWA样品。在个体差异分析中，我们将研究 作为文字处理主要组成部分故障的函数， 和认知，从而为如何最好地优先考虑不同的学习经验提供基准 鉴于PWA的认知语言缺陷的概况进行了检查。研究2也关注理解， RP原则是否影响重度PWA接受治疗形式的疗效 理解缺陷研究3考察了失败的提取实践带来益处的条件。 研究4探讨了解释为什么努力会增强成功提取的益处的潜在机制 实践最后，研究5将正式RP理论在计算框架，将促进 整合现有的词汇学习和使用模式。

With over 1 million sufferers today, aphasia is a prevalent impairment after left-hemisphere stroke that affects the production or comprehension of spoken, written, or gestured speech. We contend, as have others, that effective prioritization and optimization of available treatment methods for aphasia requires an understanding of how the damaged system responds to different kinds of learning experiences, i.e., a theory of learning. This proposal is dedicated to furthering development of a theory of learning for aphasia rehabilitation based on powerful learning principles derived from basic psychological research (i.e., retrieval practice or RP principles). Our prior research provided an empirical foundation for the RP theory of learning by demonstrating its relevance for the treatment of naming impairment, a ubiquitous symptom experienced by people with aphasia (PWA) involving difficulty reliably naming common, everyday objects. In our prior work, we showed that treatment that provides `retrieval practice' (practice retrieving names for objects from long- term memory) conferred greater persistent benefit than a popular form of naming treatment that does not involve retrieval practice (errorless learning). In confirmation of a relate `spacing' principle, we also found treatment benefits were enhanced when repeated training trials for an item were spaced over time, as opposed to massed together. In this foundational work, we studied a relatively homogeneous group of PWA in that naming was the sole or primary area affected. In the current proposal we take important next steps to articulate the broader clinical and theoretical significance of our learning theory by studying how the RP principles impact naming impairment in aphasia more generally (Study 1); examining the principles' relevance for treating word comprehension deficits (i.e., problems reliably accessing the meanings of familiar words) in aphasia (Studies 1 & 2); and, by developing a theoretical account of how the RP principles impact word retrieval processes in production (Studies 3-5). Study 1 will examine how the RP principles impact naming impairment and the transfer of benefit from naming treatment to word comprehension performance in a heterogeneous and well-characterized sample of PWA. In individual differences analyses, we will examine variability in response to the principles as a function of breakdown in primary components of word processing and cognition, thereby providing benchmarks for how best to prioritize the different learning experiences examined given a PWA's profile of cognitive-linguistic deficits. Study 2 also focuses on comprehension, asking whether the RP principles influence the efficacy of receptive forms of treatment in PWA with severe word comprehension deficits. Study 3 examines conditions under which failed retrieval practice confers benefit. Study 4 investigates potential mechanisms to explain why effort enhances the benefits from successful retrieval practice. Finally, Study 5 will formalize the RP theory in a computational framework that will promote integration of existing models of lexical learning and use.