Thompson C K, McReynolds L V
J Speech Hear Res. 1986 Jun;29(2):193-206.
The effects of auditory-visual stimulation treatment derived from principles associated with a stimulation approach for aphasia treatment and direct-production treatment derived from a behavioral or learning approach were examined in 4 neurologically stable agrammatic aphasic subjects. Subjects were trained to produce selected exemplars of wh interrogative morphemes in complete sentence contexts, while the acquisition, response generalization (both within and across interrogative forms), stimulus generalization (to language samples), and maintenance effects of the two treatments were assessed. An alternating treatments design (ATD) in combination with a multiple-baseline design across behaviors and a multiple-baseline design across subjects was employed. Interrogative constructions were counterbalanced across subjects and treatments, and probes were administered daily to assess treatment effects. Results indicated that direct-production treatment was consistently more effective than auditory-visual stimulation treatment in facilitating acquisition of target responses for all subjects. Response generalization within interrogative forms paralleled acquisition regardless of treatment approach. Stimulus generalization to the elicited language-sample condition was not evident, however, trained responses were maintained subsequent to treatment. These data provided support for using direct-production treatment for interrogative intervention with agrammatic aphasic patients and indicated that training a selected number of exemplars of target interrogatives results in generalization of that question form to novel language responses. However, the lack of generalization across interrogatives indicated that wh interrogatives do not constitute a response class and, thus, pointed out a need for programming generalization to untrained members of that linguistic class and to spontaneous language.
在4名神经功能稳定的语法缺失性失语症患者中，研究了源自失语症治疗刺激方法相关原则的视听刺激疗法，以及源自行为或学习方法的直接生成疗法的效果。训练患者在完整句子语境中生成特定的wh疑问语素范例，同时评估两种疗法的习得、反应泛化（在疑问形式内和跨疑问形式）、刺激泛化（对语言样本）和维持效果。采用了交替治疗设计（ATD），结合行为间的多基线设计和患者间的多基线设计。疑问结构在患者和治疗方法之间进行了平衡，并且每天进行探测以评估治疗效果。结果表明，在促进所有患者获得目标反应方面，直接生成疗法始终比视听刺激疗法更有效。无论治疗方法如何，疑问形式内的反应泛化与习得情况相似。然而，对引出的语言样本条件的刺激泛化并不明显，不过训练后的反应在治疗后得以维持。这些数据支持使用直接生成疗法对语法缺失性失语症患者进行疑问干预，并表明训练选定数量的目标疑问句范例可使该疑问形式泛化到新的语言反应中。然而，跨疑问形式缺乏泛化表明wh疑问句并不构成一个反应类别，因此指出需要对该语言类别的未训练成员以及自发语言进行泛化编程。
