Theoretically based treatment for sentence comprehension deficits in aphasia

描述（由申请人提供）：2010年健康人群方案的目标之一是减少不同人群之间的健康差距。失语患者句子理解缺陷的诊断和治疗虽然具有重要的理论意义，但仍存在差异。然而，对于如何训练失语症患者的句子理解能力，以及在语法结构相似的句子和不同的理解任务之间，理解能力的泛化在多大程度上发生，目前的研究还缺乏具体的建议。该项目的目标是开发一种有效的、理论上合理的治疗中风后失语症患者的句子理解缺陷的方法。我们开发有效治疗这些缺陷的方法将以语言学、心理语言学和失语症学的结果为指导。该项目包括两个不同的阶段：第一阶段：R21的具体计划和里程碑（第一年）在项目的第一阶段（R21），将持续一年，我们将开发两种有效的治疗句法理解缺陷的方法-一种基于图片匹配，另一种基于对象设定。里程碑将是这些疗法有效性的衡量标准。在这一年中，我们还将制定最佳治疗处方（治疗次数和持续时间）以及用于训练和推广的刺激。第二阶段：R33（2-5年）在项目的第二阶段（R33），我们将研究第一阶段开发的治疗方法的更广泛的临床应用。我们将讨论一些关键问题，如已治疗项目的获取率，对未训练项目的推广，治疗结束后的表现维持，转移到日常理解任务，以及训练的最佳患者选择。这一阶段的预期结果是一种新的治疗方法，其临床效用被很好地表征，可以被临床医生用于适当的失语症患者。

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. PUBLIC HEALTH RELEVANCE: This project is relevant because it will address the important issue of language recovery following a theoretically based sentence comprehension treatment for patients with aphasia. The ability to understand sentences is often affected in aphasia and impairs comprehension of sentences in which syntax determines aspects of meaning such as thematic roles. We will first develop two new methods of treatment and, in the second phase of the research, determine how successfully training one structure generalizes to others, how it leads to savings in further treatments, how it affects passage comprehension, and how long it lasts. The result is expected to be an effective and efficient training protocol that can be used to treat deficits in syntactically based comprehension people with aphasia.