Translation and Clinical Implementation of a Test of Language and Short-term Memory (STM) in Aphasia

失语症语言和短期记忆（STM）测试的翻译和临床实施

• 批准号: 9440757
• 负责人: Nadine Martin
• 金额: $ 70.32万
• 依托单位: TEMPLE UNIV OF THE COMMONWEALTH
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-12-15 至 2022-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9440757
• 关键词: Address; Adverse effects; Affect; Age; Aphasia; Area; Behavior Therapy; Brain Injuries; Characteristics; Chronic; Clinic; Clinical; Cognitive; Communication; Communications Media; Computers; Craniocerebral Trauma; Data; Detection; Development; Diagnosis; Diagnostic; Disease; Focus Groups; Goals; Human; Image; Impairment; Individual; Interview; Knowledge; Laboratories; Language; Language Tests; Lead; Left; Life Style; Linguistics; Maintenance; Manuals; Measures; Memory; Memory impairment; Methods; Modeling; Motivation; Names; Neurologic; Older Population; Performance; Persons; Phase; Preparation; Process; Publications; Quality of life; Questionnaires; Rehabilitation Research; Research; Retrieval; Role; Secure; Semantics; Short-Term Memory; Site; Specific qualifier value; Speech; Stimulus; Stroke; Structure; Surveys; Test Result; Testing; Theoretical model; Time; Training; Translating; Translations; United States; Universities; Validation; Washington; Word Processing; aphasia rehabilitation; base; career; clinical implementation; computerized; effective intervention; improved; innovation; interest; language impairment; language processing; meetings; phonology; relating to nervous system; research clinical testing; response; satisfaction; screening; theories; tool; web site

Aphasia is an acquired impairment of language abilities resulting from damage to the left hemisphere from stroke, head trauma or other neurological conditions. It can affect any aspect of spoken and/or written language processing and can range from mild to severe. As language provides us with a unique form of communication, aphasia can have profound adverse effects on one's quality of life. Although aphasia is more common in older populations, it can occur at any age, and many people with aphasia want to find ways to return to their premorbid lifestyles, including active careers, to the extent that this is possible. Clearly, there is a need for effective clinical tools to diagnose and treat aphasia, but a third factor makes the possibility of meeting this need a reality: More than 30 years of rehabilitation research provides strong evidence that even in chronic stages of aphasia, behavioral interventions lead to improved language function and changes in neural activity of cortical areas known to support language. This project aims to translate a theory-driven and empirically supported diagnostic battery for aphasia (Temple Assessment of Language and Short-term memory in Aphasia, TALSA) to a clinically feasible test battery that can be used for screening or in-depth measures of a language impairment. Importantly, the TALSA is based on a theoretical model of language that incorporates a role of verbal short-term memory (STM) in language processing. Language and verbal STM impairments commonly co-occur in aphasia, and this model attributes that co-occurrence to a common impairment of processes that support access and retrieval of words: weak activation and/or the inability to maintain activation of linguistic representations during word processing. This level of diagnosis is needed to guide impairment-based treatment approaches that directly stimulate access and retrieval processes. The TALSA is unique in that it includes language tests that add memory load and processing time, variables which are sensitive to these processing impairments. The research version of the TALSA is administered on a computer but is lengthy and not practical in a clinical setting. Our aim is to develop a computerized adaptive test version for clinical use. This project will use a Milestone based approach to develop this innovative clinical tool. In the first two years, we will develop the clinical version using focus groups and item response theory to identify the best items and subtests to use in the clinical version of this test (Milestone 1). Goals to meet Milestone 2 will include (1) assessment of participating clinicians' views of current and best practices in aphasia rehabilitation and (2) training participating clinicians on the concepts behind the TALSA, as well as specifics about its administration and interpretation. Milestone 3 will involve implementation of the clinical version in the clinical settings and assessment of clinicians' responses to its usefulness and validation of the clinical version, in relation to the original version. Plans for dissemination of the final clinical version of the TALSA will include development of a secured website enabling access to the preliminary version (in Years 3-5) and arrangements for publication of the final version in Year 5.

失语症是因损坏左半球而导致的语言能力的损害 中风，头部外伤或其他神经系统状况。它可以影响口语和/或书面语言的任何方面 处理，从轻度到重度不等。由于语言为我们提供了独特的交流形式， 失语症可能会对自己的生活质量产生深远的不利影响。虽然失语症在较旧的情况下更为普遍 人群，它可以在任何年龄发生 生活方式，包括活跃的职业，以至于这是可能的。显然，需要有效的临床 诊断和治疗失语症的工具，但第三个因素使实现这一现实的可能性：更多 超过30年的康复研究提供了有力的证据，即即使在慢性失语阶段， 行为干预导致语言功能改善和皮质区域神经活动的变化 已知支持语言。该项目旨在翻译理论驱动和经验支持的诊断 失语症的电池（talsa中的语言和短期记忆评估，Talsa） 可行的测试电池可用于筛查或深入的语言障碍措施。重要的是， TALSA基于语言的理论模型，该模型结合了口头短期记忆的作用 （STM）语言处理。语言和口头STM障碍通常在失语症中共同发生，这 模型属性将共同发生的属性与支持访问和检索的过程的共同损害 单词：弱激活和/或无法在单词期间保持语言表示的激活 加工。需要这种诊断水平来指导基于损伤的治疗方法直接 刺激访问和检索过程。 TALSA的独特之处在于它包括添加的语言测试 内存负载和处理时间，对这些处理障碍敏感的变量。 Talsa的研究版本是在计算机上管理的，但在临床上是冗长且不实用的 环境。我们的目的是开发用于临床使用的计算机化自适应测试版本。这个项目将使用 基于里程碑的方法来开发这种创新的临床工具。在头两年中，我们将开发临床 使用焦点小组和项目响应理论的版本来识别用于临床中使用的最佳项目和子测验 该测试的版本（里程碑1）。达到里程碑2的目标将包括（1）评估参与临床医生 对失语症康复的当前和最佳实践的看法以及（2）培训参与的临床医生 Talsa背后的概念以及有关其管理和解释的细节。里程碑3将 涉及在临床环境中实施临床版本，并评估临床医生对 与原始版本有关的临床版本的有用性和验证。传播计划 TALSA的最终临床版本将包括开发一个有担保网站，以访问该网站 初步版本（3 - 5年）和第5年最终版本的安排。