Development of a Theoretically Based Treatment for Sentence Comprehension Deficits in Individuals With Aphasia

Abstract

Purpose We piloted two new treatments, one based on sentence to picture matching (SPM) and the other based on object manipulation (OM), that train participants on the thematic roles of sentences using pictures or by manipulating objects. Methods Using a single subject multiple baseline design, sentence comprehension was trained on the affected sentence type in one task-related protocol in 15 participants with aphasia. The two tasks were SPM and OM and the treatment stimuli were Object relatives; Object clefts; Passives and Unaccusatives as well as two control structures; Object relatives with a complex NP, active sentences with three NPs. Results The criteria for efficacious treatment was an increase in the level of performance from the pre-treatment probes to post-treatment probes for the treated structure such that accuracy rose from at or below chance to above chance and either a) accuracy on rose by 33% or b) the effect size was 2.6. Based on these criteria, the success rate for training the target structure was 4/7 participants in the OM condition and 2/6 participants in the SPM condition. Conclusions The outcome of this study illustrates the utility of this theoretically-motivated and efficacious treatment for sentence comprehension deficits in participants with aphasia.

Evaluating Treatment and Generalization Patterns of Two Theoretically Motivated Sentence Comprehension Therapies

“…The experimental design and procedures for this study were largely the same as those used in Kiran et al (2012). In brief, a single-subject multiple-baseline design was used (Thompson, 2006).…”

“…The aim of the study was to systematically examine the nature and extent of generalization, probing whether generalization occurs across task (e.g., OM to SPM), across different levels of complexity (e.g., complex wh-movement sentences to simple wh-movement sentences), and across syntax, which in this study corresponds to two types of syntactic movement and is referred to as movement (e.g., NP movement to wh-movement sentences; see Figure 1 for a schematic of target generalization patterns). On the basis of the findings of Kiran et al (2012), it is predicted that treatment will result in overall gains and that treatment outcomes will be superior following OM relative to SPM treatment, indicating that task type influences the effectiveness of sentence comprehension treatment. Generalization results will be examined in the context of specific deficit and resource reduction accounts.…”

“…Therefore, the focus of the current study is to extend the findings of Kiran et al (2012) by further examining the treatment efficacy of both OM and SPM sentence comprehension therapy and by systematically examining how patterns of generalization may be affected by syntax, complexity, and task. The current study enrolled a large group of participants in treatment and varied syntax (NP or wh-movement), complexity (simple or complex), and task (SPM or OM) across participants' treatment.…”

“…Specific deficit models attribute sentence comprehension deficits to impaired representations; one would therefore predict that treatment-related gains in comprehension would generalize to sentence structures that contain similar representations (e.g., simple sentences that share linguistic properties of trained sentences). Likewise, resource reduction accounts justify generalization to simple structures that pose similar or fewer resource demands (Kiran et al, 2012) but provide no explanation for the specificity of generalization to linguistically related structures.…”

“…Kiran et al (2012) recently evaluated two sentence comprehension treatments, comparing outcomes following two different task manipulations. In their study, Kiran et al (2012) enrolled 15 PWA in one of two pilot therapies adapted from assessment measures: sentence-to-picture matching (SPM) and object manipulation (OM). Treatment was founded on principles of syntactic processing and comprehension.…”