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：缺乏工具来补救与右脑中风和创伤性脑损伤引起的脑损伤相关的沟通障碍。虽然用标准的失语症测试电池来衡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字面语言的沟通障碍，对他们的生活产生了负面影响。对隐喻理解缺陷的神经心理学和相关话题的理论分析推动了训练计划中的任务。一种观点认为，右后部区域的损伤限制了患者处理单词之间隐含联系的能力。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备选方案的能力。培训基于一种简单的模式，即在单词和叙事中表示语义关系的思维地图，这种模式在儿童中得到了广泛的应用。思维地图明确列出了词汇之间共享的语义特征或联系，为隐喻提供了潜在的基础。思维地图以具体的形式提供了隐喻的成分，供练习和复习。该协议基于单一受试者的实验设计，旨在评估和补救：1)难以产生适当的词语联想；2)难以评估内涵共享的含义；3)难以从不同的解释中进行选择。根据患者认知障碍的具体情况，预计每个患者都会在计划中进步，在一些任务上花费更多的时间，在其他任务上花费更少的时间。该议定书将审查培训期间具体发生了什么变化，以及培训强度对收获的持续时间和普遍性的影响。此外，该议定书将评估治疗成果随时间的消退情况，并将探索减缓或防止这种消退的方法！

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!