Metaphor Training Program

描述（由申请人提供）：该项目解决了临床文献中的一个重要空白：缺乏与右大脑半球中风和创伤性脑损伤引起的脑损伤相关的沟通缺陷的补救工具。虽然通过标准失语症测试电池测量不是典型的失语症，但许多患有这些类型损伤的患者表现出一系列非文字语言的沟通障碍，这些障碍以负面的方式影响他们的生活。包括培训计划的任务的动机是隐喻理解缺陷和相关主题的神经心理学的理论分析。一种观点认为，右后区的损伤限制了患者处理单词之间内涵关联的能力。第二个概念是，右额叶和双侧前额叶区域的损伤会影响工作记忆和患者回顾信息并从一组中选择最相关替代方案的能力。训练是基于一个简单的模式，表示语义关系的话和叙述，思维地图，已被广泛用于儿童。思维导图明确列出了单词之间共享的语义特征或关联，这些特征或关联为隐喻提供了潜在的基础。思维导图将隐喻的成分以具体的形式提供给练习和复习。该方案基于单受试者实验设计，旨在评估和补救：1）难以产生与单词的适当关联; 2）难以评估内涵共享意义; 3）难以从替代解释中进行选择。根据患者的认知障碍的具体情况，预计每个患者都会通过该计划在某些任务上花费更多时间，在其他任务上花费更少时间。该协议将检查在训练过程中具体发生了什么变化，以及训练强度对持续时间和增益的普遍性的影响。此外，该方案将评估治疗收益随时间的衰减，并将探索减缓或防止这种下降的方法！

DESCRIPTION (provided by applicant): This project addresses an important gap in the clinical literature: the dearth of tools for remediation of the communication deficits associated with brain damage caused by stroke in the right cerebral hemisphere and by traumatic brain injury. While not typically aphasic as measured by standard aphasia test batteries, many patients with these types of injury exhibit a range of communication impairments with non literal language that impact their lives in negative ways. The tasks comprising the training program are motivated by a theoretical analysis of the neuropsychology of metaphor comprehension deficits and related topics. One notion is that damage to right posterior regions limits a patient's ability to process connotative associations between words. A second notion is that damage to right frontal and bilateral prefrontal regions can affect working memory and a patient's ability to review information and to select a most relevant alternative from a set. The training is based on a simple mode of representing semantic relations in words and narratives, Thinking Maps, that has been used extensively with children. Thinking Maps explicitly list the semantic features or associations shared between words that provide potential bases for metaphors. Thinking Maps make available the ingredients of metaphor in concrete form for practice and review. The protocol, which is based on single subject experimental design, is designed to evaluate and remediate: 1) difficulty generating appropriate associations to words; 2) difficulty evaluating connotative shared meaning; and 3) difficulty selecting from among alternative interpretations. Each patient is expected to progress through the program spending more time on some tasks and less time on others as a function of that patient's specific profile of cognitive impairment. The protocol will examine what specifically changes during training and the impact of the intensity of training on the duration and generalizability of gains. In addition, the protocol will assess the fading of treatment gains over time and will explore approaches to slowing or preventing that decline!