Boukrina Olga, Madden Elizabeth B, Giordano Nicole, Karim Dima, Staples Ryan, Graves William W
Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ.
School of Communication Science and Disorders, College of Communication and Information, Florida State University, Tallahassee.
Am J Speech Lang Pathol. 2024 Dec 12;33(6S):3263-3295. doi: 10.1044/2024_AJSLP-23-00364. Epub 2024 Aug 15.
Acquired reading deficits, or alexia, affect a significant proportion of individuals with aphasia. We sought to improve treatment for alexia by targeting specific cognitive information-processing components critical to reading (i.e., phonology or semantics).
To target either phonological or semantic processing, we administered two anomia treatments, phonomotor treatment (PMT) and semantic feature analysis, modified to include a focus on reading throughout the therapy. Chronic left-hemisphere stroke survivors ( = 5) completed one or two 60-hr treatment rounds. Based on predictions from a computational reading model, three participants received the treatment recommended for their specific reading challenges (e.g., PMT for phonological deficits), while two participants had the nonrecommended treatment first, followed by the recommended model-matched treatment. Changes in reading aloud accuracy and response times (RTs) from before to after treatment were examined as a function of matching treatment to the deficit profile, type of treatment, therapy round, and word characteristics.
Participants' reading aloud accuracy improved after treatment relative to baseline with higher accuracy for high-frequency words and shorter words. After the first treatment round, participants' accuracy and RT improved, irrespective of whether treatment was matched to the deficit profile. Furthermore, participants who completed the second treatment round continued achieving accuracy gains. Following treatment, participants demonstrated enhanced reading efficiency and generalized improvements on the selected sections of the Woodcock Reading Mastery Test.
While larger studies are needed to test for the effects of matching treatment type to the deficit profile, we conclude that treatments targeting specific information-processing components can effectively improve reading. Doubling the treatment dose offers small but significant gains.
获得性阅读障碍，即失读症，影响着相当一部分失语症患者。我们试图通过针对阅读至关重要的特定认知信息处理组件（即语音或语义）来改善对失读症的治疗。
为了针对语音或语义处理，我们实施了两种命名障碍治疗方法，即语音运动治疗（PMT）和语义特征分析，并进行了修改，使其在整个治疗过程中都侧重于阅读。慢性左半球中风幸存者（=5）完成了一轮或两轮60小时的治疗。根据一个计算阅读模型的预测，三名参与者接受了针对其特定阅读挑战推荐的治疗（例如，针对语音缺陷的PMT），而两名参与者首先接受了非推荐治疗，随后接受了推荐的模型匹配治疗。根据治疗与缺陷特征的匹配情况、治疗类型、治疗轮次和单词特征，检查治疗前后大声朗读准确性和反应时间（RT）的变化。
与基线相比，参与者治疗后的大声朗读准确性有所提高，高频词和较短单词的准确性更高。在第一轮治疗后，无论治疗是否与缺陷特征相匹配，参与者的准确性和RT都有所提高。此外，完成第二轮治疗的参与者继续提高准确性。治疗后，参与者在伍德科克阅读能力测验的选定部分表现出阅读效率提高和普遍改善。
虽然需要更大规模的研究来测试将治疗类型与缺陷特征相匹配的效果，但我们得出结论，针对特定信息处理组件的治疗可以有效改善阅读。将治疗剂量加倍可带来虽小但显著的收益。
