Retrieval Practice Principles: A Theory of Learning for Aphasia Rehabilitation

失语症是左半球中风后的一种普遍损害，目前有100多万患者。 影响口语、书面语或手势语的产生或理解。我们争辩说，就像其他人一样， 对失语症的现有治疗方法进行有效的优先排序和优化需要一个 理解受损的系统对不同类型的学习经验的反应，即一种理论 学习的力量。这项建议致力于进一步发展失语症的学习理论。 康复基于强大的学习原则，源于基础心理学研究(即，提取 实践或RP原则)。我们之前的研究为快速原型学习理论提供了经验基础 通过证明其与治疗命名障碍的相关性，一种普遍存在的症状 失语症(PWA)患者难以可靠地命名常见的日常物品。在我们之前的工作中， 我们展示了提供“检索练习”的处理方法(练习从长单词中检索对象的名称)。 术语记忆)比一种流行的命名疗法具有更大的持久益处 涉及提取练习(无错误学习)。在确认一个相关的“间隔”原则时，我们还发现 当一个项目的重复训练试验随着时间的推移而间隔时，治疗益处得到了增强，而不是 聚集在一起。在这项基础性工作中，我们研究了PWA的一个相对齐次的群 命名是唯一或主要受影响的区域。在目前的提案中，我们采取了重要的下一步来阐明 通过研究RP原理对我们学习理论的更广泛的临床和理论意义 影响失语症患者的命名障碍(研究1)；检查这些原则与 治疗单词理解缺陷(即可靠地获取熟悉单词的意义的问题) 失语症(研究1和2)；以及，通过发展一种关于快速反应原则如何影响单词的理论描述 生产中的检索过程(研究3-5)。研究1将考察RP原则如何影响命名 命名治疗对单词理解成绩的损害和利益转移 PWA样品的异质性和良好的特性。在个体差异分析中，我们将检查 作为字处理主要组成部分故障的原则的可变性 和认知，从而为如何最好地确定不同学习体验的优先顺序提供基准 给出了PWA对认知-语言缺陷的描述。研究2还侧重于理解、询问 RP原则是否影响严重言语障碍患者接受方式的疗效 理解缺陷。研究3考察了失败的检索实践带来好处的条件。 研究4调查了可能的机制，以解释为什么努力可以提高成功检索的益处 练习一下。最后，研究5将在计算框架中将RP理论形式化，这将促进 整合现有的词汇学习和使用模式。

With over 1 million sufferers today, aphasia is a prevalent impairment after left-hemisphere stroke that affects the production or comprehension of spoken, written, or gestured speech. We contend, as have others, that effective prioritization and optimization of available treatment methods for aphasia requires an understanding of how the damaged system responds to different kinds of learning experiences, i.e., a theory of learning. This proposal is dedicated to furthering development of a theory of learning for aphasia rehabilitation based on powerful learning principles derived from basic psychological research (i.e., retrieval practice or RP principles). Our prior research provided an empirical foundation for the RP theory of learning by demonstrating its relevance for the treatment of naming impairment, a ubiquitous symptom experienced by people with aphasia (PWA) involving difficulty reliably naming common, everyday objects. In our prior work, we showed that treatment that provides `retrieval practice' (practice retrieving names for objects from long- term memory) conferred greater persistent benefit than a popular form of naming treatment that does not involve retrieval practice (errorless learning). In confirmation of a relate `spacing' principle, we also found treatment benefits were enhanced when repeated training trials for an item were spaced over time, as opposed to massed together. In this foundational work, we studied a relatively homogeneous group of PWA in that naming was the sole or primary area affected. In the current proposal we take important next steps to articulate the broader clinical and theoretical significance of our learning theory by studying how the RP principles impact naming impairment in aphasia more generally (Study 1); examining the principles' relevance for treating word comprehension deficits (i.e., problems reliably accessing the meanings of familiar words) in aphasia (Studies 1 & 2); and, by developing a theoretical account of how the RP principles impact word retrieval processes in production (Studies 3-5). Study 1 will examine how the RP principles impact naming impairment and the transfer of benefit from naming treatment to word comprehension performance in a heterogeneous and well-characterized sample of PWA. In individual differences analyses, we will examine variability in response to the principles as a function of breakdown in primary components of word processing and cognition, thereby providing benchmarks for how best to prioritize the different learning experiences examined given a PWA's profile of cognitive-linguistic deficits. Study 2 also focuses on comprehension, asking whether the RP principles influence the efficacy of receptive forms of treatment in PWA with severe word comprehension deficits. Study 3 examines conditions under which failed retrieval practice confers benefit. Study 4 investigates potential mechanisms to explain why effort enhances the benefits from successful retrieval practice. Finally, Study 5 will formalize the RP theory in a computational framework that will promote integration of existing models of lexical learning and use.