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：缺乏用于修复右脑半球中风和创伤性脑损伤引起的脑损伤相关的沟通缺陷的工具。虽然用标准的失语症测试电池来衡量并不是典型的失语症，但许多患有这类损伤的患者表现出一系列的非字面语言交流障碍，这对他们的生活产生了负面影响。训练任务的动机是对隐喻理解缺陷的神经心理学和相关主题的理论分析。一种观点认为，右后脑区的损伤限制了患者处理词语间隐含关联的能力。第二种观点是，对右额叶和双侧前额叶区域的损伤会影响工作记忆，影响患者回顾信息和从一组信息中选择最相关选项的能力。这种训练基于一种简单的模式，即在单词和叙述中表示语义关系的思维地图，这种模式在儿童中广泛使用。思维地图明确列出了单词之间共享的语义特征或关联，为隐喻提供了潜在的基础。思维地图使隐喻的成分以具体的形式存在于实践和复习中。该协议基于单受试者实验设计，旨在评估和纠正：1)难以产生适当的单词关联；2)难以评价内涵共享意义；3)难以从不同的解释中选择。根据患者认知障碍的具体情况，每个患者都希望在项目中取得进展，在某些任务上花费更多的时间，在其他任务上花费更少的时间。该议定书将审查训练期间的具体变化以及训练强度对收益持续时间和普遍性的影响。此外，该方案将评估治疗效果随时间的消退，并探索减缓或预防这种消退的方法！

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!