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Retrieval Practice Principles: A Theory of Learning for Aphasia Rehabilitaion

检索实践原则：失语症康复的学习理论

基本信息

批准号：
10736376
负责人：
Erica Lee Middleton
金额：
$ 62.37万
依托单位：
THOMAS JEFFERSON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-04-01 至 2028-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10736376
关键词：
Address Affect Aftercare American Anatomy Aphasia Brain imaging Categories Chronic Comprehension Dedications Development Disease Dose Drops Elements Feedback Future Gestures Goals Grouping Guidelines Home Impairment Individual Differences Language Learning Left Measures Memory Methods Names National Institute on Deafness and Other Communication Disorders Outcome Participant Pathologist Persons Phase Preparation Production Protocols documentation Randomized, Controlled Trials Regimen Research Research Design Retrieval Schedule Semantics Speech Stroke Symptoms System Techniques Training Vocabulary Word Processing Work Writing aphasia rehabilitation clinical application clinically relevant comprehension deficit design dosage experience feasibility trial improved improved outcome individualized medicine programs psychologic theories treatment response trend

项目摘要

Aphasia is an impairment that affects the production or comprehension of spoken, written, or gestured speech. Effective prioritization and optimization of available treatment methods for people with aphasia (PWA) requires an understanding of how the damaged system responds to different kinds of learning experiences, i.e., a theory of learning. This proposal continues development of a theory of learning for aphasia rehabilitation based on retrieval practice (RP) principles, powerful learning principles derived from basic psychological research. This renewal submission builds on the following findings concerning the treatment of the debilitating and pervasive word retrieval deficit in aphasia: (a) retrieval practice-based naming treatment, in which the PWA attempts to name an object followed by feedback, confers greater benefit to later naming of the same items compared to errorless learning, in which the name is provided for the object and repeated by the PWA; (b) correct retrievals during retrieval practice confer greater improvement compared to failed retrievals; (c) greater spacing between an item’s trials confers greater improvement. Products of a basic phase of research, these observations were derived from study designs involving the administration of a fixed number of trials per item, regardless of the mastery achieved during training. This renewal submission takes important next steps to broaden the clinical relevance of the RP theory by examining a retrieval practice-based naming treatment termed criterion learning. In criterion learning, each item’s assigned criterion level dictates the number of times that item is correctly retrieved before it is dropped from further training within a session. Criterion learning optimally incorporates the most potent elements of the RP theory thus far—spaced retrieval practice with emphasis on correct retrievals during training. By examining scheduling and dosing parameters, and feasibility of at-home delivery, the present studies will provide critical observations for optimizing criterion learning for treating word processing deficits in people with aphasia. Study 1 will identify the optimal combination of criterion level and number of training sessions for efficiently attaining naming mastery of functional, personally-relevant vocabulary for PWA with word retrieval deficit. Using a multiple-case, within- participant, multiple baseline design, Study 2 will measure early efficacy and use of the optimal dosage- schedule combination for mastery of functional vocabulary identified in Study 1. The two modules of treatment in Study 2 will involve in-lab practice and unsupervised at-home practice. Brain imaging acquisition will permit individual differences explorations in response to treatment. Study 3 will examine whether practicing items in semantically related groups enhances naming treatment benefit in a multiple-session training regimen using criterion learning. Study 4 will investigate whether naming treatment involving criterion learning confers a benefit to word comprehension in PWA, and if it does so more robustly and durably than errorless learning.

失语症是一种影响口语、书面语或手势语的产生或理解的障碍。有效地优先考虑和优化失语症（PWA）患者的可用治疗方法需要了解受损系统如何对不同类型的学习经验作出反应，即，学习理论这个建议继续发展失语症康复的学习理论基于检索实践（RP）原则，强大的学习原则，从基本的心理学 research.这一更新申请是基于以下关于治疗衰弱的研究结果和失语症中普遍存在的单词检索缺陷：（a）基于检索实践的命名治疗，其中， PWA尝试命名一个对象，然后进行反馈，为以后命名该对象提供更大的好处。与无错误学习相比的项目，其中为对象提供名称并由PWA重复; (b)与回收失败相比，回收实践中的正确回收带来更大的改进;（c）项目试验之间的更大间隔赋予更大的改进。基础研究阶段的产物，这些观察结果来自于研究设计，涉及按照项目，无论在训练中取得的掌握。此更新提交将采取重要的后续步骤通过检查基于检索实践的命名治疗来拓宽RP理论的临床相关性称为标准学习。在标准学习中，每个项目的指定标准水平决定了在会话中从进一步训练中删除该项目之前正确检索该项目的次数。标准学习最佳地结合了RP理论的最有效的元素，从而远距离检索实践重点是训练期间的正确检索。通过检查时间安排和给药参数，的可行性，目前的研究将提供关键的意见，优化标准学习如何治疗失语症患者的文字处理缺陷。研究1将确定最佳标准水平和训练课程数量的组合，以有效地实现命名掌握功能，个人相关的词汇与词检索赤字PWA。使用多个案例，在- 受试者，多基线设计，研究2将测量早期疗效和最佳剂量的使用- 表的组合，掌握功能性词汇在研究1中确定。治疗的两个模块在研究2中，将涉及实验室实践和无人监督的家庭实践。脑成像采集将允许对治疗反应的个体差异进行探索。第三项研究将考察语义相关组中的项目增强了多次训练方案中的命名治疗益处使用标准学习。研究4将探讨命名治疗是否涉及标准学习在PWA中赋予单词理解的好处，如果它这样做比无错误更强大和持久，学习