Off Catherine A, Griffin Jenna R, Spencer Kristie A, Rogers Margaret
Communicative Sciences and Disorders, University of Montana, 32 Campus Drive, Missoula, MT 59812, USA, (406) 243-2104,
Communicative Sciences and Disorders, University of Montana, Missoula, USA.
Aphasiology. 2016;30(9):983-1011. doi: 10.1080/02687038.2015.1100705. Epub 2016 Oct 16.
Although aphasia rehabilitation has been shown to be efficacious, many questions remain regarding how best to deliver treatment to maximize functional gains for persons with aphasia. Treatment delivery variables, such as intensity and dosage, are likely to influence both behavioral and structural changes during anomia treatment. While numerous protocols have concluded that treatment intensity positively impacts functional outcomes, few studies to date have examined the role that dose plays in patient outcomes for anomia treatment.
This study sought to investigate how manipulating dose of repeated confrontation naming within sessions influences naming in persons with aphasia. Repeated practice of confrontation naming, without feedback, was hypothesized to improve trained but not untrained words, to be persistent after withdrawal, and to be sensitive to the number of trials (i.e., dose) within sessions.
A single-subject ABA design with replication across seven participants with aphasia was used to investigate the influence of repeated confrontation naming attempts on the acquisition and maintenance of trained pictures relative to untrained pictures. Training involved repeated attempts to name pictures, along with repeated exposure to pictures of objects (nouns) and their names, without feedback. The primary independent variable was within session dose; the dependent variable was naming accuracy.
Naming accuracy improved for all participants for trained pictures across both acquisition and maintenance phases per visual inspection; such positive effects were not observed for untrained pictures. Effect size calculations indicate that three of seven participants demonstrated considerable change for trained items, while one of seven participants demonstrated meaningful change for untrained items. The high-dose condition elicited small effect sizes for one participant, and large effect sizes for two of seven participants, while the low-dose condition elicited small and medium effect sizes for two of seven participants.
Participants across a variety of aphasia severity levels responded positively to two doses of repeated confrontation naming practice, without feedback, across phases of this naming protocol. Results are in line with principles of neuroplasticity and demonstrate that repeated practice, without feedback, can produce significant and persistent changes in naming ability for some persons with aphasia.
尽管失语症康复已被证明是有效的，但关于如何以最佳方式提供治疗以最大限度地提高失语症患者的功能恢复，仍存在许多问题。治疗实施变量，如强度和剂量，可能会影响命名障碍治疗期间的行为和结构变化。虽然众多方案得出结论认为治疗强度对功能结果有积极影响，但迄今为止，很少有研究探讨剂量在命名障碍治疗患者结果中所起的作用。
本研究旨在调查在治疗过程中操纵重复对答命名的剂量如何影响失语症患者的命名。假设在没有反馈的情况下重复对答命名练习可改善已训练但未训练的单词，在停止练习后仍具有持续性，并且对治疗过程中的试验次数（即剂量）敏感。
采用单受试者ABA设计，对7名失语症患者进行重复实验，以研究重复对答命名尝试对已训练图片相对于未训练图片的习得和保持的影响。训练包括在没有反馈的情况下重复尝试命名图片，以及反复接触物体（名词）的图片及其名称。主要自变量是治疗过程中的剂量；因变量是命名准确性。
通过视觉检查，所有参与者在习得和保持阶段对已训练图片的命名准确性均有所提高；未训练图片未观察到这种积极效果。效应量计算表明，7名参与者中有3名在已训练项目上表现出相当大的变化，而7名参与者中有1名在未训练项目上表现出有意义的变化。高剂量条件下，1名参与者的效应量较小，7名参与者中有2名的效应量较大；而低剂量条件下，7名参与者中有2名的效应量较小和中等。
在这个命名方案的各个阶段，不同失语症严重程度水平的参与者对两种剂量的无反馈重复对答命名练习均有积极反应。结果符合神经可塑性原则，并表明无反馈的重复练习可以使一些失语症患者的命名能力产生显著且持久的变化。
