Department of Physical and Rehabilitation Medicine, AP-HP, La Pitié-Salpêtrière-Charles Foix University Hospital, Paris, France.
Sorbonne Université, GRC n°24, Handicap Moteur et Cognitif & Réadaptation (HaMCRe) AP-HP, Sorbonne Université, Paris, France.
Int J Lang Commun Disord. 2024 Jan-Feb;59(1):255-275. doi: 10.1111/1460-6984.12942. Epub 2023 Aug 1.
Despite its potentially significant functional and emotional impact, acalculia is still too rarely assessed and managed by speech and language therapists. Research on the rehabilitation of numerical transcoding remains scarce in the literature and, despite positive results, presents a low level of evidence.
The present study aims to evaluate the effectiveness of a targeted rehabilitation of numerical transcoding in two patients suffering from a chronic secondary acalculia.
METHODS & PROCEDURES: Two post-brain injury females with secondary acalculia took part in a single-case experimental design with multiple baseline across subjects according to a three-phase experimental protocol: baseline involving global cognitive rehabilitation (5-7 measurements with randomized sequential introduction); targeted intervention (10 measurements); follow-up (2 immediate measurements and 1 month after the end of the intervention). Repeated outcome measures consisted of six lists composed of numbers of equivalent difficulty that were used alternately to assess numerical transcoding. We used a reverse digit span as a control measure to assess the specificity of the intervention. Rehabilitation lasted 5 weeks and consisted of errorless learning with colour cues, tables and number-words cards.
OUTCOMES & RESULTS: During baseline period involving global cognitive rehabilitation, transcoding scores remained unchanged. In contrast, there was a significant improvement in scores for both patients during the intervention phase targeting transcoding and maintenance of benefits 1-month post-intervention.
CONCLUSIONS & IMPLICATIONS: This study demonstrates that a specific rehabilitation targeting numerical transcoding following chronic secondary acalculia can be effective in improving transcoding skills.
What is already known on the subject Transcoding difficulties in patients with acalculia can cause a significant disability in everyday life activities. In secondary acalculia, rehabilitation of cognitive functions associated with number processing (attention, working memory, language) is not sufficient for improvement of transcoding. What this paper adds to existing knowledge An intervention specifically targeting numerical transcoding significantly and durably improves the skills of patients with chronic secondary acalculia. What are the potential or actual clinical implications of this work? Procedural error-free intervention using colour cueing, tables, cards with number-words, copy and repetition seems effective to improve transcoding skills in chronic acalculia.
尽管计算障碍可能会对患者的功能和情绪产生重大影响，但言语治疗师对其进行评估和管理的情况仍然很少见。关于数值转换康复的研究在文献中仍然很少，尽管有积极的结果，但证据水平较低。
本研究旨在评估针对两名患有慢性继发性计算障碍的患者进行的数值转换靶向康复的有效性。
两名患有脑损伤后继发性计算障碍的女性患者参与了一项单病例实验设计，根据三阶段实验方案进行了跨受试者的多项基线测试：基线包括全面认知康复（5-7 次测量，随机顺序引入）；靶向干预（10 次测量）；随访（2 次即时测量和干预结束后 1 个月）。重复的结果测量包括六个难度相当的数字列表，交替使用这些列表来评估数值转换。我们使用反向数字跨度作为控制措施，以评估干预的特异性。康复持续 5 周，包括无错误学习、颜色提示、表格和数字单词卡片。
在涉及全面认知康复的基线期间，转换得分保持不变。相比之下，在针对转换和干预后 1 个月的维持效益的靶向干预阶段，两名患者的得分都有显著提高。
本研究表明，针对慢性继发性计算障碍的特定数值转换康复可以有效提高转换技能。
