Learning Paradigms in Aphasia Rehabilitation

描述（由申请人提供）：本研究项目的长期目标是提高我们设计有效治疗失语症症状的治疗策略的能力。该项目研究了一个特定的设计变量，该变量适用于多种认知康复计划-患者在训练期间试图产生正确反应时犯错误的程度。它侧重于一个特定的认知缺陷，命名障碍，在试图研究的相对有效性的无错与有错的学习语言缺陷的康复。失名症是一种词汇提取障碍，是左半球中风最常见的缺陷。这种缺陷可能会对一个人有效沟通的能力产生严重影响，并可能干扰工作，社会功能和日常生活。该项目的一个目标是测试一个假设，即与保证产生错误的常用疗法相比，在训练过程中允许很少或没有错误的治疗后，失名症患者更有可能提高他们检索单词的能力。第二个目的是检查外显记忆和注意力/执行控制缺陷对错误/错误变量的影响。这些假设来自于无错与有错学习的文献，这些文献已应用于记忆缺陷患者。失名症患者将参加一个治疗计划，其中在不同的条件下训练两组不同的单词。在错误条件下，患者首先尝试在没有任何外部提示的情况下命名图片。如果产生了不正确的反应，则提供最小的刺激线索。如果又给出了一个不正确的反应，就会加上一个更有力的提示，等等，直到病人说出正确的词。在无错误的情况下，病人看到一张图片，并被告知它的名字，并被要求重复它，然后一点一点地删除单词的片段，病人在删除每个连续的片段后命名该项目。条件进行比较，在主题内，差异的时间来学习的话和程度的保留的话后一个月和六个月。这些结果将与外显和内隐记忆以及注意力的测试结果相关。总体结果将为未来的研究提供基础的无错/完整的变量在语言缺陷的认知康复设计的重要性，和潜在的价值的测试外显记忆在预测治疗成功。

DESCRIPTION (provided by applicant): The long-term objective of this research project is to improve our ability to design effective treatment strategies for the remediation of aphasic symptoms. The project examines a specific design variable that has application to many kinds of cognitive rehabilitation programs - the extent to which the patient makes errors when attempting to produce the correct response during training. It focuses on one particular cognitive deficit, anomia, in attempting to study the relative efficacy of errorless vs. errorful learning in the rehabilitation of language deficits. Anomia, an impairment in the retrieval of words, is the most common deficit resulting from a left hemisphere stroke. This deficit can have grave consequences upon one's ability to communicate effectively and can interfere with work, social function, and everyday life. One goal of the project is to test the hypothesis that patients with anomia are more likely to improve their ability to retrieve words following a therapy that allows for few or no errors during training compared with a commonly used therapy that guarantees that errors are produced. A second aim is to examine the effects of deficits in explicit memory and in attention/executive control on the errodess/ful variable. These hypotheses derive from the literature on errorless vs. errorful learning that has been applied to patients with memory deficits. Patients with anomia will participate in a therapy program in which two different sets of words are trained under different conditions. In the errorful condition, the patient first attempts to name a picture without any external cues. If an incorrect response is produced, a minimal stimulus cue is provided. If another incorrect response is given, a more powerful cue is added, etc. until the patient produces the correct word. In the errorless condition, the patient views a picture and is given its name and asked to repeat it. Pieces of the word are then removed bit by bit, and the patient names the item after each successive piece is removed. The conditions are compared, within-subject, for differences in time to learn the words and degree of retention of the words after one month and six months. These results will be correlated with the results of tests of explicit and implicit memory, and attention. The overall results will provide the basis for future studies of the importance of the errorless/ful variable in the design of cognitive rehabilitation of language deficits, and the potential value of tests of explicit memory in predicting therapy success.