Real word effects in phonological treatment for word retrieval

单词检索语音处理中的真实单词效果

• 批准号: 8004034
• 负责人: DIANE L. KENDALL
• 金额: --
• 依托单位: VA PUGET SOUND HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8004034
• 关键词: Adult; Aftercare; Alexia; Annual Reports; Anomia; Aphasia; Auditory; Award; Binding; Caregivers; Caring; Child; Communication; Communities; Controlled Study; Data; Databases; Development; Enrollment; Equipment and Supplies; Feedback; Frequencies; Funding; Goals; Growth; Hawthorne Effect; Health; High Prevalence; Home environment; Hour; Impairment; Individual; Institutional Review Boards; Intervention; Investigation; Knowledge; Knowledge acquisition; Language; Language Therapy; Lead; Learning; Left; Lesion; Life; Longitudinal Studies; Maintenance; Manuscripts; Measures; Methods; Modeling; Motivation; Names; Neighborhoods; Outcome Measure; Participant; Pathologist; Patient Education; Patients; Performance; Phase; Pilot Projects; Positioning Attribute; Principal Investigator; Probability; Problem Solving; Process; Production; Publications; Randomized; Randomized Controlled Trials; Reading; Receptive aphasia; Recruitment Activity; Rehabilitation Research; Rehabilitation therapy; Relative (related person); Reliability of Results; Reporting; Research; Research Personnel; Research Training; Residual state; Retrieval; Semantics; Site; Societies; Speech; Stimulus; Stroke; Structure; System; Tactile; Testing; Time; Training; Treatment Efficacy; Treatment Protocols; Veterans; Videotape; Visual; Vocabulary; Work; World Health Organization; Writing; aphasia rehabilitation; aphasic; base; career; clinical practice; cost; cost effective; density; design; disability burden; dosage; efficacy testing; follow-up; human subject; improved; lexical; lexical processing; meetings; novel; patient population; phase 2 study; phonology; primary outcome; programs; research and development; research study; response; sound; standard measure; therapy development; treatment program

DESCRIPTION (provided by applicant): The purpose of this Merit Review proposal is to continue Phase II development of a phonologic (e.g. sound) based treatment program for word retrieval deficits in aphasia. The most common feature of aphasia is impairment in ability to name objects. The traditional treatment approach to this problem is to train aphasic patients by showing them pictures of objects and asking them to say or repeat the name of that object several times. Controlled studies have shown that this approach may be effective, however generalization is typically limited to just the words trained. The mechanisms underlying generalization are not well understood. Because generalization is so limited with "naming therapies", there currently exists no viable means of training patients on the full corpus of words (perhaps several thousand) they are likely to need in daily life. Two approaches might be taken to solving this problem: (1) develop cost effective means for providing training on several thousand words; and (2) develop alternative training methods, e.g., phonological therapy, that could potentially generalize widely. This systematic line of research focuses on the latter. A Phase I pilot study funded by VA RR&D (PI: Kendall) showed that by applying treatment to the level of the phonologic system (e.g. sounds), reading and spoken word production improved in individuals with aphasia (Kendall et al, 2003). Phase II work (VA RR&D PI: Kendall) extended the Phase I research by 1) comparing the experimental phonologic treatment to a control treatment and 2) refining the experimental treatment in terms of a homogeneous patient population and increasing the frequency and intensity of treatment. Results showed significant treatment and generalization effects in the phonologic treatment group were superior to the semantic group (Kendall et al, 2008). While only preliminary, these results warrant the need for a larger investigation of this approach to the rehabilitation of aphasia. Thus, the purpose of this proposal is to continue Phase II development of a phonologic based treatment program for word retrieval deficits in aphasia. This project involves a longitudinal study to assess treatment and maintenance effects in 30 subjects with left hemisphere lesions and aphasia associated with impaired word retrieval with the goal of completing therapy and 3-month follow-up. PUBLIC HEALTH RELEVANCE: The VA currently cares for approximately 15,000 new stroke cases each year with related VA costs estimated at one billion dollars annually (Department of Veterans Affairs, 1999). One third of these strokes are associated with aphasia. The World Health Organization has deemed stroke a worldwide health problem based upon its high prevalence, associated disability, and the burden it places on the individual, community and society (Janca et al, 2000). The treatment of aphasia is currently unsatisfactory. This proposal seeks to further develop an aphasia treatment that has high potential for improving the daily communicative lives of stroke patients.

描述（由申请人提供）： 该优点审查提案的目的是继续针对失语症单词检索缺陷的基于语音（例如声音）的治疗计划的第二阶段开发。失语症最常见的特征是命名物体的能力受损。解决这个问题的传统方法是通过向失语症患者展示物体的图片并要求他们多次说出或重复该物体的名称来训练他们。对照研究表明，这种方法可能是有效的，但泛化通常仅限于训练过的单词。泛化背后的机制尚不清楚。由于“命名疗法”的泛化能力非常有限，目前还没有可行的方法来训练患者了解他们在日常生活中可能需要的完整单词语料库（可能有数千个）。可以采取两种方法来解决这个问题：（1）开发成本有效的方法来提供数千个单词的培训； (2) 开发可替代的训练方法，例如语音疗法，这种方法有可能广泛推广。这一系统的研究重点是后者。由 VA RR&D（PI：Kendall）资助的一期试点研究表明，通过对语音系统（例如声音）水平进行治疗，失语症患者的阅读和口语表达能力得到改善（Kendall 等，2003）。 II 期工作（VA RR&D PI：Kendall）通过以下方式扩展了 I 期研究：1）将实验性语音治疗与对照治疗进行比较，2）根据同质患者群体改进实验性治疗，并增加治疗的频率和强度。结果显示，语音治疗组的显着治疗和泛化效果优于语义治疗组（Kendall 等，2008）。虽然这些结果只是初步的，但需要对这种失语症康复方法进行更大规模的研究。因此，本提案的目的是继续针对失语症单词检索缺陷的基于语音的治疗方案的第二阶段开发。该项目涉及一项纵向研究，旨在评估 30 名患有左半球病变和与单词检索受损相关的失语症受试者的治疗和维持效果，目标是完成治疗和 3 个月的随访。 公共卫生相关性： 目前，退伍军人事务部每年照顾大约 15,000 名新中风病例，退伍军人事务部每年的相关费用估计为 10 亿美元（退伍军人事务部，1999 年）。其中三分之一的中风与失语症有关。由于中风的高患病率、相关的残疾以及它给个人、社区和社会带来的负担，世界卫生组织已将中风视为世界范围的健康问题（Janca 等，2000）。目前失语症的治疗效果并不理想。该提案旨在进一步开发一种失语症治疗方法，该疗法对于改善中风患者的日常生活具有很大潜力。