Retrieval Practice Principles: A Theory of Learning for Aphasia Rehabilitaion

失语症是一种影响口语、书面语或手势语的产生或理解的障碍。 有效区分和优化失语症(PWA)的可用治疗方法 需要了解受损系统对不同类型的学习体验的反应，即， 一种学习理论。这项建议继续发展失语症康复的学习理论。 基于提取练习(RP)的原则，强大的学习原则源于基本心理学 研究。这份续签意见书的基础是关于衰弱的治疗的以下发现 失语症中普遍存在的单词提取缺陷：(A)基于提取练习的命名治疗，其中 PWA尝试命名后跟随反馈的对象，为以后命名相同的对象提供了更大的好处 与无错误学习相比的项目，其中名称是为对象提供的，并由PWA重复； (B)与失败的检索相比，检索练习中正确的检索可带来更大的改进；(C) 一个项目的试验间隔越大，就会带来更大的改进。基础研究阶段的产品， 这些观察是从研究设计中得出的，该研究设计涉及对每个患者进行固定数量的试验 项目，无论在训练中达到的掌握程度如何。此续订提交采取了重要的后续步骤 通过检查基于检索练习的命名治疗来扩大RP理论的临床相关性 称为规范学习。在标准学习中，每个项目分配的标准水平决定了 在将该项目从会话中的进一步训练中删除之前，该项目被正确取回的时间。准则 学习最好地结合了RP理论中最有效的元素，从而使检索实践相去甚远 在训练中强调正确的取回。通过检查调度和配料参数，以及 家庭分娩的可行性，本研究将为优化标准提供重要的观察结果 学习治疗失语症患者的文字处理缺陷。研究1将确定最佳的 将标准水平和培训课程数量相结合，以有效地掌握命名 功能，个人相关词汇的PWA与单词检索缺陷。使用多个案例，在- 参与者，多基线设计，研究2将衡量早期疗效和最佳剂量的使用- 研究1中确定的掌握功能词汇的时间表组合。两个处理模块 在研究2中，将包括实验室练习和无人监督的家庭练习。脑成像的获取将会 允许针对治疗进行个体差异探索。研究3将检查练习是否 语义相关组中的项目在多节训练方案中增强命名治疗益处 使用规范学习。研究4将调查命名处理是否涉及标准学习 对PWA中的单词理解有好处，如果这样做的话，比没有错误更健壮和持久 学习。

Aphasia is an impairment that affects the production or comprehension of spoken, written, or gestured speech. Effective prioritization and optimization of available treatment methods for people with aphasia (PWA) requires an understanding of how the damaged system responds to different kinds of learning experiences, i.e., a theory of learning. This proposal continues development of a theory of learning for aphasia rehabilitation based on retrieval practice (RP) principles, powerful learning principles derived from basic psychological research. This renewal submission builds on the following findings concerning the treatment of the debilitating and pervasive word retrieval deficit in aphasia: (a) retrieval practice-based naming treatment, in which the PWA attempts to name an object followed by feedback, confers greater benefit to later naming of the same items compared to errorless learning, in which the name is provided for the object and repeated by the PWA; (b) correct retrievals during retrieval practice confer greater improvement compared to failed retrievals; (c) greater spacing between an item’s trials confers greater improvement. Products of a basic phase of research, these observations were derived from study designs involving the administration of a fixed number of trials per item, regardless of the mastery achieved during training. This renewal submission takes important next steps to broaden the clinical relevance of the RP theory by examining a retrieval practice-based naming treatment termed criterion learning. In criterion learning, each item’s assigned criterion level dictates the number of times that item is correctly retrieved before it is dropped from further training within a session. Criterion learning optimally incorporates the most potent elements of the RP theory thus far—spaced retrieval practice with emphasis on correct retrievals during training. By examining scheduling and dosing parameters, and feasibility of at-home delivery, the present studies will provide critical observations for optimizing criterion learning for treating word processing deficits in people with aphasia. Study 1 will identify the optimal combination of criterion level and number of training sessions for efficiently attaining naming mastery of functional, personally-relevant vocabulary for PWA with word retrieval deficit. Using a multiple-case, within- participant, multiple baseline design, Study 2 will measure early efficacy and use of the optimal dosage- schedule combination for mastery of functional vocabulary identified in Study 1. The two modules of treatment in Study 2 will involve in-lab practice and unsupervised at-home practice. Brain imaging acquisition will permit individual differences explorations in response to treatment. Study 3 will examine whether practicing items in semantically related groups enhances naming treatment benefit in a multiple-session training regimen using criterion learning. Study 4 will investigate whether naming treatment involving criterion learning confers a benefit to word comprehension in PWA, and if it does so more robustly and durably than errorless learning.