Real word effects in phonological treatment for word retrieval

描述（由申请人提供）： 本Merit审查提案的目的是继续进行基于语音（例如声音）的失语症单词检索缺陷治疗计划的II期开发。失语症最常见的特征是命名物体的能力受损。对这个问题的传统治疗方法是训练失语症患者，向他们展示物体的图片，并要求他们说出或重复多次该物体的名称。对照研究表明，这种方法可能是有效的，但泛化通常仅限于训练的单词。泛化的机制还没有很好的理解。由于“命名疗法”的概括性非常有限，目前还没有可行的方法来训练患者了解他们在日常生活中可能需要的完整单词库（也许有几千个）。可以采取两种方法来解决这个问题：（1）开发成本效益高的方法来提供几千字的培训;（2）开发替代培训方法，例如，语音疗法，可以推广到更广泛的领域这一系统的研究重点是后者。由VA RR&D（PI：Kendall）资助的一项I期初步研究表明，通过对语音系统（例如声音）水平进行治疗，失语症患者的阅读和口语产生得到改善（Kendall et al，2003）。第二阶段的工作（VA RR&D PI：Kendall）通过1）比较实验性语音治疗与对照治疗以及2）在同质患者人群方面改进实验治疗并增加治疗频率和强度来扩展第一阶段的研究。结果显示，语音治疗组的显著治疗和概括效果上级语义组（Kendall等人，2008）。虽然只是初步的，这些结果证明需要一个更大的调查，这种方法来恢复失语症。因此，本建议的目的是继续第二阶段的发展，语音为基础的治疗程序的单词检索缺陷失语症。该项目涉及一项纵向研究，以评估30例左半球病变和失语症患者的治疗和维持效果，这些患者与单词检索受损相关，目标是完成治疗和3个月随访。

DESCRIPTION (provided by applicant): The purpose of this Merit Review proposal is to continue Phase II development of a phonologic (e.g. sound) based treatment program for word retrieval deficits in aphasia. The most common feature of aphasia is impairment in ability to name objects. The traditional treatment approach to this problem is to train aphasic patients by showing them pictures of objects and asking them to say or repeat the name of that object several times. Controlled studies have shown that this approach may be effective, however generalization is typically limited to just the words trained. The mechanisms underlying generalization are not well understood. Because generalization is so limited with "naming therapies", there currently exists no viable means of training patients on the full corpus of words (perhaps several thousand) they are likely to need in daily life. Two approaches might be taken to solving this problem: (1) develop cost effective means for providing training on several thousand words; and (2) develop alternative training methods, e.g., phonological therapy, that could potentially generalize widely. This systematic line of research focuses on the latter. A Phase I pilot study funded by VA RR&D (PI: Kendall) showed that by applying treatment to the level of the phonologic system (e.g. sounds), reading and spoken word production improved in individuals with aphasia (Kendall et al, 2003). Phase II work (VA RR&D PI: Kendall) extended the Phase I research by 1) comparing the experimental phonologic treatment to a control treatment and 2) refining the experimental treatment in terms of a homogeneous patient population and increasing the frequency and intensity of treatment. Results showed significant treatment and generalization effects in the phonologic treatment group were superior to the semantic group (Kendall et al, 2008). While only preliminary, these results warrant the need for a larger investigation of this approach to the rehabilitation of aphasia. Thus, the purpose of this proposal is to continue Phase II development of a phonologic based treatment program for word retrieval deficits in aphasia. This project involves a longitudinal study to assess treatment and maintenance effects in 30 subjects with left hemisphere lesions and aphasia associated with impaired word retrieval with the goal of completing therapy and 3-month follow-up.