Imaezue Gerald C, Tchernichovski Ofer, Goral Mira
Department of Communication Sciences & Disorders, University of South Florida, Tampa.
Department of Psychology, Hunter College, The City University of New York, NY.
Am J Speech Lang Pathol. 2024 Dec 12;33(6S):3343-3357. doi: 10.1044/2024_AJSLP-23-00320. Epub 2024 Sep 20.
Persons with nonfluent aphasia (PWNA) use feedback from external agents (e.g., speech-language pathologists) and self-feedback to improve their language production. The extent to which PWNA can improve their language production using their self-feedback alone is underexplored. In a proof-of-concept study, we developed an automated recursive self-feedback procedure to demonstrate the extent to which two PWNA who used self-feedback alone improved their production of sentences from trained and untrained scripts. In the current study, we use the Rehabilitation Response Specification System as a framework to replicate our initial findings.
We tested the effects of two treatments: script production with recursive self-feedback and script production with external feedback in four persons with chronic nonfluent aphasia. We compared the effects of treatment by measuring percent script produced, speaking rate, and speech initiation latency of trained and untrained scripts. The participants received the treatments remotely through mini tablets using two versions of a mobile app we developed. All the participants received each treatment intensively for 14 sessions across 2-3 weeks. We estimated clinical improvements of production of sentences from trained and untrained scripts through nonoverlap of all pairs analysis of performance pretreatment and posttreatment.
Both treatments improved PWNA's language production. Recursive self-feedback improved speaking rate and speech initiation latency, which generalized to untrained scripts in all participants. External feedback treatment did not generalize to improvement in speaking rate in two participants.
Our findings confirm our initial evidence that PWNA can self-improve their sentence production from scripts through recursive self-feedback. This novel procedure enables PWNA to autonomously enhance their language production over time. Given the evidence and the mechanics of the procedure, we propose that its utility is not constrained by linguistic idiosyncrasies across cultures. Consequently, it has the potential to bypass linguistic barriers to aphasia care.
非流畅性失语症患者（PWNA）利用外部因素（如言语治疗师）的反馈和自我反馈来改善语言表达。目前对于PWNA仅通过自我反馈能在多大程度上改善语言表达的研究还不够充分。在一项概念验证研究中，我们开发了一种自动化递归自我反馈程序，以证明两名仅使用自我反馈的PWNA在多大程度上改善了来自训练脚本和未训练脚本的句子表达。在当前研究中，我们以康复反应规范系统为框架来重复我们最初的研究结果。
我们测试了两种治疗方法的效果：对四名慢性非流畅性失语症患者进行递归自我反馈的脚本生成和外部反馈的脚本生成。我们通过测量训练脚本和未训练脚本的生成百分比、语速和言语起始潜伏期来比较治疗效果。参与者通过我们开发的移动应用程序的两个版本，使用迷你平板电脑远程接受治疗。所有参与者在2至3周内密集接受每种治疗14次。我们通过对治疗前和治疗后表现的所有配对分析的非重叠来估计训练脚本和未训练脚本句子生成的临床改善情况。
两种治疗方法都改善了PWNA的语言表达。递归自我反馈提高了语速和言语起始潜伏期，这在所有参与者中都推广到了未训练的脚本。外部反馈治疗在两名参与者中没有推广到语速的改善。
我们的研究结果证实了我们最初的证据，即PWNA可以通过递归自我反馈自我改善脚本中的句子生成。这种新颖的程序使PWNA能够随着时间的推移自主提高他们的语言表达。鉴于该程序的证据和机制，我们认为其效用不受跨文化语言特性的限制。因此，它有可能绕过失语症护理的语言障碍。
