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Complexity and Feedback During Script Training in Aphasia: A Feasibility Study

  • Leora R. Cherney
    Correspondence
    Corresponding author Leora R. Cherney, PhD, CCC-SLP, BC-ANCDS, FACRM, Shirley Ryan AbilityLab, 355 East Erie St, Chicago, IL 60611.
    Affiliations
    Center for Aphasia Research and Treatment, Shirley Ryan AbilityLab, Chicago, Illinois

    Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois

    Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois
    Search for articles by this author
  • Sarel Van Vuuren
    Affiliations
    Institute of Cognitive Science, University of Colorado Boulder, Boulder, Colorado, United States
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Published:March 15, 2022DOI:https://doi.org/10.1016/j.apmr.2022.03.002

      Abstract

      Objective

      To explore the effect of complexity and feedback on script training outcomes in aphasia

      Design

      Randomized balanced single-blind 2 × 2 factorial design.

      Setting

      Freestanding urban rehabilitation hospital.

      Participants

      Adults with fluent and nonfluent aphasia (at least 6 months post onset).

      Interventions

      Experimental treatment was AphasiaScripts, a computer-based script training program. Scripts were 10-turns long and developed at different complexity levels to allow for comparison of high vs low complexity. The program was modified to contrast high vs low feedback conditions during sentence practice. Participants were instructed to practice three 30-minute sessions per day, 6 days per week for 3 weeks.

      Main Outcome Measures

      Gains achieved from baseline in accuracy and rate of production of trained and untrained script sentences at post treatment and at 3-, 6-, and 12-weeks after the end of treatment.

      Results

      Sixteen participants completed the intervention. On the trained script, gains were statistically significant for both accuracy and words per minute at post treatment and 3-, 6-, and 12-week maintenance. Gains on the untrained script were smaller than on the trained script; they were statistically significant only for accuracy at post treatment and 3-week maintenance. Complexity had an influence on accuracy at post-treatment (F1=4.8391, P=.0501) and at maintenance (F1=5.3391, P=.0413). Practicing scripts with high complexity increased accuracy by 11.33% at post treatment and by 9.90% at maintenance compared with scripts with low complexity. Participants with nonfluent aphasia made greater gains than those with fluent aphasia. There was no significant effect of feedback.

      Conclusions

      This study reinforces script training as a treatment option for aphasia. Results highlight the use of more complex scripts to better promote acquisition and maintenance of script production skills. There is a need for further investigation of these variables with larger samples and with other types of aphasia treatments.

      Keywords

      List of abbreviations:

      AQ (Aphasia Quotient), SE (speech entrainment), WAB-R (Western Aphasia Battery-Revised), wpm (words per minute)
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