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How is generalization managed in anomia research? An analysis of current practice and future directions

Janet Patterson1* and Patrick Coppens2
  • 1 VA Northern California Health Care System, United States
  • 2 SUNY Plattsburgh, United States

By necessity, in aphasia rehabilitation, clinical activities center on a small sample of exemplars that are representative of the target behavior. However, a truly successful therapeutic intervention should ideally generalize to all exemplars in all environments. The aphasiology literature is replete with clinical studies showing a positive treatment effect that does not translate to positive generalization gains. Further, if generalization is present, the causal mechanism is generally unknown. These two observations lead to a powerful but disappointing conclusion: Clinicians do not know how to facilitate generalization (Coppens & Patterson, 2018). At best, clinical studies merely measure the changes in untrained exemplars, an approach described as “train and hope” (Stokes & Baer,1977) or “fishing for evidence of change” (Webster, Whitworth, & Morris, 2015). It is humbling that, since Stokes and Baer’s report, very little improvement has occurred in our understanding of generalization phenomena. Clinicians and researchers should strive to insert appropriate strategies in anomia rehabilitation to maximize generalization. It behooves us to understand more precisely how generalization is addressed in clinical and research studies. One effective way to describe current practice is through a scoping review. A scoping review provides an overview of an issue. The product is a quantitative and qualitative analysis of the current state in a specific field (Pham et al., 2014). It distinguishes itself from a systematic review by including qualitative as well as quantitative analyses. Scoping reviews have been published in health care and health policy (e.g., Archer, Fevrier-Thomas, Lokker, McKibbon, & Straus, 2011; Brien, Lorenzetti, Lewis, Kennedy, & Ghali, 2010; Crooks, Kingsbury, Snyder, & Johnston, 2010; Hamm et al., 2013; Mitton, Smith, Peacock, Evoy, & Abelson, 2009; Reeves et al., 2011) and in higher education (e.g., O’Flaherty & Phillips, 2015), however are rare in aphasiology. Following our interest in treatment for anomia and generalization, our scoping review asked how generalization is measured in anomia therapy. Eight databases were searched with the following key words in the abstract: “aphasia”, “anomia” or “naming”, “therapy” or “rehabilitation” or “treatment”; and anywhere: “generalization”. After eliminating duplicates, 157 articles remained. Further exclusionary criteria applied to the articles were: adults, original data, naming treatment variable, and generalization data of any kind. Results describing response generalization (generalization to untrained exemplars) and stimulus generalization (e.g., generalization to discourse) will be reviewed separately and presented in quantitative and qualitative formats. Quantitative data, expressed in tally or frequency, note the characteristics of the included studies (e.g. number of participants, treatment technique). Qualitative data report trends across studies in methods of measuring generalization, data interpretation, and generalization environments (e.g., to untreated exemplars or to discourse). Conclusions drawn from the characteristics and trends identified in this scoping review will be compared to best practices for generalization previously reported in the literature (e.g., Coppens & Patterson, 2018). We hope that we can influence clinical practice by offering suggestions that can be easily implemented in contemporary clinical Aphasiology in order to support clinicians in planning for generalization prior to beginning intervention.

References

Archer, N., Fevrier-Thomas, U., Lokker, C., McKibbon, K. A., & Straus, S. E. (2011). Personal
health records: A scoping review. Journal of the American Information Association, 18, 515-522.
Baer, D. M. (1999). How to plan for generalization. Austin, TX: Pro-Ed.
Brien, S. E., Lorenzetti, D. L., et al. (2010). Overview of a formal scoping review on health
system report cards. Implementation Science, 5, 2.
Coppens, P., & Patterson, J. (2018). Generalization in aphasiology: What are the best strategies?
In P. Coppens & J. Patterson (Eds.), Aphasia rehabilitation. Clinical challenges (pp. 205-248). Burlington, MA: Jones & Bartlett Learning.
Crooks, V. A., Kingsbury, P., Snyder, J., & Johnston, R. (2010). What is known about the
patient’s experience of medical tourism? A scoping review. BMC Health Services Research, 10, 266.
Dijkers, M. (2015). What is a scoping review? KT Update, 4(1), 1-5.
Hamm, M. P., Chisholm, A. et al. (2013). Social media use among patients and caregivers: A
scoping review. BMJ Open, 3, e002819.
Hughes, D. L. (1985). Language treatment and generalization. A clinician’s handbook. San
Diego, CA: College Hill.
Mitton, C., Smith, N., Peacock, S., Evoy, B., & Abelson, J. (2009). Public participation in health
care priority setting: A scoping review. Health Policy, 91, 219-228.
O’Flaherty, J., & Phillips, C. (2015). The use of flipped classrooms in higher education: A
scoping review. Internet and Higher Education, 25, 85-95.
Peters, M. D. J., Godfrey, C. M., McInerney, P. Baldini Soares, C., Khalil, H., & Parker, D.
(nd). Methodology for JBI scoping reviews. The Joanna Briggs Institute.
https://joannabriggs.org/assets/docs/sumari/Reviewers-Manual_Methodology-for-JBI-Scoping-Reviews_2015_v2.pdf
Pham. M.T., Racjic, A., Greig, J.D., Sargent, J.M., Papadopoulos, A & McEwen, S.S. (2014). A scoping review of scoping reviews: Advancing the approach and enhancing the consistency. Research Synthesis Methods, 5, 371-385.
Reeves, S., Goldman, J., Gilbert, J. et al. (2011). A scoping review to improve conceptual clarity
of interprofessional interventions. Journal of Interprofessional Care, 25, 167-174.
Stokes, T. F., & Baer, D. M. (1977). An implicit technology of generalization. Journal of
Applied Behavioral Analysis, 10(2), 349-367.
Thompson, C. K. (1989). Generalization in the treatment of aphasia. In L. McReynolds & J.
Spradlin (Eds.), Generalization strategies in the treatment of communication disorders (pp. 82–115). Toronto, Canada: B.C. Decker.
Webster, J., Whitworth, A., & Morris, J. (2015). Is it time to stop “fishing”? A review of
generalization following aphasia intervention. Aphasiology, 29(11), 1240–1264.

Keywords: Anomia therapy, Aphasia, Scoping review, Generalization, Stimulus, Generalization, Response

Conference: Academy of Aphasia 56th Annual Meeting, Montreal, Canada, 21 Oct - 23 Oct, 2018.

Presentation Type: poster presentation

Topic: not eligible for a student prize

Citation: Patterson J and Coppens P (2019). How is generalization managed in anomia research? An analysis of current practice and future directions. Conference Abstract: Academy of Aphasia 56th Annual Meeting. doi: 10.3389/conf.fnhum.2018.228.00058

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Received: 26 Apr 2018; Published Online: 22 Jan 2019.

* Correspondence: Dr. Janet Patterson, VA Northern California Health Care System, Mather, United States, Janet.Patterson3@va.gov