Delineating the Impact of Retrieval Practice in Aphasia

描述(申请人提供)：失语症目前有100多万患者，是左半球中风后常见的一种损害，影响口语、书面或手势语言的产生或理解。这项建议旨在提供基础研究，以支持基于基础心理学研究得出的强大学习原则的“治疗理论”的发展。这一理论的贡献将是最大限度地发挥现有针对失语症口语障碍的治疗方法的有效性和长期影响。这项研究将通过对照实验评估以下核心学习原则在失语症中的应用：(1)从长期记忆中提取目标信息(即， (2)检索练习的效果随着检索努力的增加而增加，达到“理想难度”的程度，此时检索难度最大，但检索成功；(3)间隔检索练习随着时间的推移促进长期保持。这项拟议的研究试图描述这些原则在改善失语症患者单词提取障碍方面的作用。在研究1中，提取练习训练将涉及在线索支持下呈现要命名的图片(即， 第一个字母/发音)。提取练习训练对以后命名成绩的影响将是 根据不涉及从长期记忆中提取的基线条件(即，重复训练，其中看到/听到并重复单词)来衡量。研究2将操纵 在最初的重复机会和检索练习之间经过了一段时间(即训练滞后)。 根据先前的工作，训练滞后预计与训练期间检索成功率的下降有关(反映检索难度的增加)。然而，为了支持后续命名中检索努力的作用，训练滞后的增加应该与最终命名评估中表现的提高相关联。研究3将把研究2的最优滞后纳入分布式学习时间表，其中对单个项目进行多次提取。这种“优化的”分布式时间表将与非分布式时间表进行比较，以确定间隔提取练习在失语症患者的命名表现中的相关性。这项拟议的研究将作为R01的先导研究，该R01致力于开发有效的失语症语言表达障碍治疗方法，以基于本文研究的原则的治疗理论为指导。

DESCRIPTION (provided by applicant): With over 1 million sufferers today, aphasia is an impairment common after left-hemisphere stroke that affects the production or comprehension of spoken, written, or gestured speech. This proposal seeks to provide foundational research to support development of a "treatment theory" based on powerful learning principles derived from basic psychological research. The contribution of this theory will be to maximize the efficacy and long-term impact of existing treatments targeting spoken language impairments in aphasia. The proposed research will evaluate with controlled experimentation the application of the following core learning principles in aphasia: (1) retrieving target information from long-term memory (i.e., retrieval practice) powerfully bolsters future success in retrieving the same information; (2) retrieval practice effects increase with increasing retrieval effort up to the point of "desirable difficulty," where retrieval is maximally difficult, yet successful; (3) spacing retrieval practiceover time promotes long-term retention. The proposed studies seek to delineate the role of these principles in the amelioration of word-retrieval impairments in aphasia. In Study 1, retrieval practice training will involve the presentation of a picture to be named with cueing support (i.e., first letter/sound). The effects of retrieval practice training on later naming performance will be measured against a baseline condition that does not involve retrieval from long-term memory (i.e., repetition training, where the word is seen/heard and repeated). Study 2 will manipulate the time elapsed (i.e., training lag) between an initial repetition opportunity and retrieval practice. Based on prior work, training lag is expected to be associated with decreasing retrieval success during training (reflecting increasing retrieval difficulty). However, supporting a role for retrieal effort on subsequent naming, increases in training lag should be associated with increasing performance at final naming assessment. Study 3 will incorporate the most optimal lag from Study 2 into a distributed schedule of learning where retrieval is practiced for individual items multiple times. This "optimized" distributed schedule will be compared to a non-distributed schedule in order to establish the relevance of spaced retrieval practice in the naming performance of speakers with aphasia. The proposed research will serve as pilot studies for an R01 dedicated to the development of efficacious treatments of expressive language impairment in aphasia, guided by a theory of treatment based on the principles investigated here.