Maintenance of Treatment Effects in Anomia Rehabilitation
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1
Georgetown University, Neurology, United States
Reports of successful treatments for language impairments in persons with aphasia subsequent to stroke are growing. Unfortunately, treatment effects often fade soon after the treatment ends. This study borrows from research in the fields of psychology and education in an attempt to improve long-term maintenance of treatment effects.
Participants.
Participants were five individuals who had anomia subsequent to stroke. Aphasia severity ranged from mild to moderate (WAB AQ: 89 to 58.4/100). However, their naming impairment ranged from mild to severe (WAB Naming and Word Finding: 74/100 to 9/100). Two were right-handed; three were left-handed.
Procedure.
Stimuli and Initial Training. Participants named 384 pictures with high name agreement on three separate occasions, one week apart. For each participant we chose 120 items that were named incorrectly all three times. Twenty-four of those served as untrained items. They were not seen again until post-testing.
Treatment sessions occurred twice per week for about two hours each. Each session consisted of four blocks: test, study, test, study. During ‘study’ blocks each of the 96 pictures to be trained was presented on the computer screen simultaneously with its written name. The spoken name was heard through headphones at the same time. The participant was asked to read/repeat the name of the picture out loud, and then to “study” it. The picture and word disappeared after five seconds. During ‘test’ blocks the picture appeared alone and the participant was asked to name it aloud. At the end of five seconds the name was presented over the headphones.
Over-training. An item was considered “learned” when it was named correctly on the first test block of two consecutive sessions. Once learned, it was placed into one of four over-training conditions: test, study, test and study, no over-training (drop-out). Items in the over-training test condition appeared only during test blocks; items in the over-training study condition were seen only during study blocks; items in the test and study condition appeared in all four blocks. Treatment continued until no new items were learned. Participants returned for post-testing at one month and again at four months post-treatment.
Results.
As seen in the figure, over-training provided a significant boost to maintenance. This was particularly true for test over-training, which was consistently superior to drop-out (trained but not over-trained) for all participants at both time points. Further, the effect of testing on maintenance was greater than the effect of studying. There was a significant advantage for over-tested items as compared to over-studied items at both one month (χ2 (5, 603) = 26.69, p < .0001), and four months (χ2 (5, 603) = 7.89, p = .0061) following the end of training.
Conclusions.
The inclusion of over-training, particularly via testing, in treatment paradigms for remediation of aphasia symptoms may be a key element in promoting retention of restored information. Importantly, findings were consistent across participants regardless of degree of anomia.
Our results demonstrate the greater effect of over-testing versus over-studying in anomia rehabilitation, an effect that persists at four months post-training.
Acknowledgements
We thank Rachael Campbell, MacKenzie Fama, William Hayward, Dr. Aaron Meyer, and Dr. Peter Turkeltaub for their input on various aspects of this work. We would also like to acknowledge the dedication and commitment of our five participants. This work was supported by the Dean’s Pilot grant from Georgetown University.
Keywords:
Rehabilitation,
Maintenance,
test effect,
Anomia,
Aphasia,
over-training
Conference:
54th Annual Academy of Aphasia Meeting, Llandudno, United Kingdom, 16 Oct - 18 Oct, 2016.
Presentation Type:
Poster Sessions
Topic:
Academy of Aphasia
Citation:
Friedman
RB,
Jones
KT and
Snider
SF
(2016). Maintenance of Treatment Effects in Anomia Rehabilitation.
Front. Psychol.
Conference Abstract:
54th Annual Academy of Aphasia Meeting.
doi: 10.3389/conf.fpsyg.2016.68.00064
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Received:
28 Apr 2016;
Published Online:
15 Aug 2016.
*
Correspondence:
Dr. Rhonda B Friedman, Georgetown University, Neurology, Washington, DC, 20854, United States, friedmar@georgetown.edu