Beeson Pélagie M, Rising Kindle, Volk Jennifer
Department of Speech and Hearing Sciences, The University of Arizona, Tucson 85721-0071, USA.
J Speech Lang Hear Res. 2003 Oct;46(5):1038-60. doi: 10.1044/1092-4388(2003/083).
Writing treatment that involved repeated copying and recall of target words was implemented with 8 individuals with severe aphasia in order to discern the best candidates for the treatment. Four of the 8 participants had strong positive responses to the copy and recall treatment (CART), relearning spellings for 15 targeted words during 10 to 12 weeks of treatment and up to 5 additional words during a month-long homework-based program. Of the 4 other participants, 3 learned the spellings of some target words but failed to reach criterion, and 1 had a poor treatment outcome. Insights regarding possible factors that limited success were gained by examination of individual responses to treatment as well as performance on the pretreatment assessments of semantic, phonological, and orthographic processes. Among the factors associated with success were (a) consistent, accurate completion of daily homework, (b) a relatively preserved semantic system, (c) the ability to discern words from nonwords, and (d) adequately preserved nonverbal visual problem-solving skills. Aphasia severity and minimal pretreatment spelling abilities did not necessarily limit the response to treatment. Participants with positive treatment outcomes demonstrated improved spelling of target words following repeated copying within a single treatment session, and accurately completed daily writing homework. Thus, pretreatment assessment and stimulability within initial treatment sessions provided indications of likely outcome.
为了确定最适合接受该治疗的患者，对8名重度失语症患者实施了涉及重复抄写和回忆目标单词的治疗。8名参与者中有4名对抄写和回忆治疗（CART）有强烈的积极反应，在10至12周的治疗期间重新学习了15个目标单词的拼写，在为期一个月的基于家庭作业的计划中又额外学习了多达5个单词。在其他4名参与者中，3名学习了一些目标单词的拼写但未达到标准，1名治疗效果不佳。通过检查个体对治疗的反应以及在语义、语音和正字法过程的治疗前评估中的表现，获得了关于限制成功的可能因素的见解。与成功相关的因素包括：（a）持续、准确地完成日常家庭作业；（b）相对保留的语义系统；（c）从非单词中辨别单词的能力；（d）充分保留的非语言视觉问题解决技能。失语症严重程度和治疗前的最低拼写能力不一定会限制对治疗的反应。治疗效果良好的参与者在单次治疗中重复抄写后，目标单词的拼写有所改善，并准确完成了日常写作作业。因此，治疗前评估和初始治疗阶段的可激发性提供了可能结果的指示。
