Communication Outcomes for Naming Treatments in Aphasia

描述(申请人提供)：每年有数以千计的人中风影响左脑，并发展为失语症，这是一种后天语言障碍。失语症最常见的症状之一是单词提取障碍，这可能会扰乱表达基本想法和需求的能力。已经描述了几种行为处理方法，这些方法对单词提取能力有积极影响，主要是在受限的图片命名任务中。在会话词语检索期间，即在交流活动/参与的层面上，也需要认识到治疗成果的真正影响(世卫组织，2001年)。关于在语篇层面的交流中，最有效的治疗方法能带来积极结果的证据要少得多。此外，单词提取治疗研究通常显示，在具有轻到中度损害的个体中具有最大的治疗效果，其特征通常是在单词提取的词汇音系学阶段失败，而在具有严重的基于语义的单词提取障碍的个体中效果更为有限。也就是说，那些最需要交流的人，即使只用一个单词，对单词提取治疗的反应也最差。本项目的目的是调查两种单词提取处理方法的修改版本，即无错误命名处理和语言+手势处理，不仅对图片命名，而且对交流活动/参与的衡量标准。此外，我们将检查有语音和语义单词提取障碍的个体的治疗结果。由于我们的治疗仍处于探索开发阶段，我们计划测试16名参与者，每个治疗方案8人，使用在词集和参与者中重复的单一参与者多基线实验设计。接受每种治疗的参与者中有一半会有基于语义的障碍。我们将在图片命名和语篇样本中，以及在治疗完成时和一个月随访时测量的交流评定量表中，检查我们对单词提取和手势产生的处理的效果。最后，我们将比较每天给予图片命名探针的结果与治疗前和治疗后给予的结果，以确定这种错误的研究设计对无错误训练的任何影响。与公共卫生相关：数十万人生活在中风的后果中，包括失语症，这是一种通过单词和句子理解和表达自己的能力受损。该项目旨在确定更有效的言语治疗方法，以帮助中风和失语症恢复期的个人最大限度地提高在日常生活活动中表达想法和基本需求的能力。

DESCRIPTION (provided by applicant): Thousands of individuals each year suffer a stroke affecting the left hemisphere of the brain and develop aphasia, an acquired language disability. One of the most common symptoms of aphasia is word retrieval impairment, which can disrupt the ability to express even basic thoughts and needs. Several behavioral treatment methods have been described that have positive impact on word retrieval abilities, largely in constrained picture naming tasks. The true impact of treatment gains need to be appreciated as well during conversational word retrieval, that is, at the level of communication activities/participation (WHO, 2001). Much less evidence is available about the most effective treatments leading to positive outcomes in discourse level- communication. Further, word retrieval treatment studies have often shown largest treatment effects in individuals with mild-to-moderate impairments, often characterized by failure in lexical phonologic stages of word retrieval, and more limited effects in individuals with severe semantically-based word retrieval impairments. That is, those with the greatest needs to communicate, if only with single words, have the poorest response to word retrieval treatment. The purpose of this project is to investigate modified versions of two word retrieval treatment approaches, errorless naming treatment and verbal+gestural treatment, for their effects not only for picture naming, but also for measures of communication activities/participation. Further, we will examine treatment outcomes in individuals with phonologic and semantic word retrieval impairments. Because our treatments are still in exploratory stages of development, we plan to test 16 participants, 8 in each treatment protocol, using single participant multiple baseline experimental designs replicated across word sets and participants. Half of the participants receiving each treatment will have semantically-based impairments. We will examine the effects of our treatments for word retrieval and gesture production in picture naming and discourse samples, as well as in communication rating scales measured at treatment completion and at one month follow up. Finally, we will compare outcomes for picture naming probes administered daily versus those administered at pre- and post- treatment to determine any impact of this errorful research design for errorless training. PUBLIC HEALTH RELEVANCE: Hundreds of thousands of individuals are living with the consequences of stroke, including aphasia, an impairment in the ability to understand and express oneself through words and sentences. This project aims to identify more effective methods of speech therapy to assist individuals who are recovering from stroke and aphasia to maximize their ability to express ideas and basic needs during daily life activities.