Complexity and Feedback During Script Training in Aphasia: A Feasibility Study

Leora R. Cherney; Sarel Van Vuuren

doi:10.1016/j.apmr.2022.03.002

Complexity and Feedback During Script Training in Aphasia: A Feasibility Study

Leora R. Cherney^*, Sarel Van Vuuren

^*Corresponding author for this work

Physical Medicine and Rehabilitation

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Objective: To explore the effect of complexity and feedback on script training outcomes in aphasia Design: Randomized balanced single-blind 2 × 2 factorial design. Setting: Freestanding urban rehabilitation hospital. Participants: Adults with fluent and nonfluent aphasia (at least 6 months post onset). Interventions: Experimental treatment was AphasiaScripts, a computer-based script training program. Scripts were 10-turns long and developed at different complexity levels to allow for comparison of high vs low complexity. The program was modified to contrast high vs low feedback conditions during sentence practice. Participants were instructed to practice three 30-minute sessions per day, 6 days per week for 3 weeks. Main Outcome Measures: Gains achieved from baseline in accuracy and rate of production of trained and untrained script sentences at post treatment and at 3-, 6-, and 12-weeks after the end of treatment. Results: Sixteen participants completed the intervention. On the trained script, gains were statistically significant for both accuracy and words per minute at post treatment and 3-, 6-, and 12-week maintenance. Gains on the untrained script were smaller than on the trained script; they were statistically significant only for accuracy at post treatment and 3-week maintenance. Complexity had an influence on accuracy at post-treatment (F₁=4.8391, P=.0501) and at maintenance (F₁=5.3391, P=.0413). Practicing scripts with high complexity increased accuracy by 11.33% at post treatment and by 9.90% at maintenance compared with scripts with low complexity. Participants with nonfluent aphasia made greater gains than those with fluent aphasia. There was no significant effect of feedback. Conclusions: This study reinforces script training as a treatment option for aphasia. Results highlight the use of more complex scripts to better promote acquisition and maintenance of script production skills. There is a need for further investigation of these variables with larger samples and with other types of aphasia treatments.

Original language	English (US)
Pages (from-to)	S205-S214
Journal	Archives of physical medicine and rehabilitation
Volume	103
Issue number	7
DOIs	https://doi.org/10.1016/j.apmr.2022.03.002
State	Published - Jul 2022

Funding

Supported by the National Institute on Deafness and Other Communication Disorders, Award Nos. 1R01 DC011754 and 1R01 DC016979 to L.R.C. and S.V.V. We thank Rosalind Kaye, Rosalind Hurwitz, and Rachel Hitch who assisted with data collection. We thank Kwang-Youn Kim who provided the randomization lists and Nattawut Ngampatipatpong who provided technical support. Finally, we thank the participants with aphasia for their time and effort. Supported by the National Institute on Deafness and Other Communication Disorders, Award Nos. 1R01 DC011754 and 1R01 DC016979 to L.R.C. and S.V.V. Disclosures: Dr Cherney reports that AphasiaScripts is commercially available from the Shirley Ryan AbilityLab. Dr Cherney receives salary from the Shirley Ryan AbilityLab but has no financial interest in the software sales.

Keywords

Aphasia
Computer-assisted therapy
Rehabilitation
Therapeutics

ASJC Scopus subject areas

Rehabilitation
Physical Therapy, Sports Therapy and Rehabilitation

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10.1016/j.apmr.2022.03.002

Cite this

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title = "Complexity and Feedback During Script Training in Aphasia: A Feasibility Study",

abstract = "Objective: To explore the effect of complexity and feedback on script training outcomes in aphasia Design: Randomized balanced single-blind 2 × 2 factorial design. Setting: Freestanding urban rehabilitation hospital. Participants: Adults with fluent and nonfluent aphasia (at least 6 months post onset). Interventions: Experimental treatment was AphasiaScripts, a computer-based script training program. Scripts were 10-turns long and developed at different complexity levels to allow for comparison of high vs low complexity. The program was modified to contrast high vs low feedback conditions during sentence practice. Participants were instructed to practice three 30-minute sessions per day, 6 days per week for 3 weeks. Main Outcome Measures: Gains achieved from baseline in accuracy and rate of production of trained and untrained script sentences at post treatment and at 3-, 6-, and 12-weeks after the end of treatment. Results: Sixteen participants completed the intervention. On the trained script, gains were statistically significant for both accuracy and words per minute at post treatment and 3-, 6-, and 12-week maintenance. Gains on the untrained script were smaller than on the trained script; they were statistically significant only for accuracy at post treatment and 3-week maintenance. Complexity had an influence on accuracy at post-treatment (F1=4.8391, P=.0501) and at maintenance (F1=5.3391, P=.0413). Practicing scripts with high complexity increased accuracy by 11.33% at post treatment and by 9.90% at maintenance compared with scripts with low complexity. Participants with nonfluent aphasia made greater gains than those with fluent aphasia. There was no significant effect of feedback. Conclusions: This study reinforces script training as a treatment option for aphasia. Results highlight the use of more complex scripts to better promote acquisition and maintenance of script production skills. There is a need for further investigation of these variables with larger samples and with other types of aphasia treatments.",

keywords = "Aphasia, Computer-assisted therapy, Rehabilitation, Therapeutics",

author = "Cherney, {Leora R.} and {Van Vuuren}, Sarel",

note = "Publisher Copyright: {\textcopyright} 2022 American Congress of Rehabilitation Medicine",

year = "2022",

month = jul,

doi = "10.1016/j.apmr.2022.03.002",

language = "English (US)",

volume = "103",

pages = "S205--S214",

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AU - Cherney, Leora R.

AU - Van Vuuren, Sarel

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N2 - Objective: To explore the effect of complexity and feedback on script training outcomes in aphasia Design: Randomized balanced single-blind 2 × 2 factorial design. Setting: Freestanding urban rehabilitation hospital. Participants: Adults with fluent and nonfluent aphasia (at least 6 months post onset). Interventions: Experimental treatment was AphasiaScripts, a computer-based script training program. Scripts were 10-turns long and developed at different complexity levels to allow for comparison of high vs low complexity. The program was modified to contrast high vs low feedback conditions during sentence practice. Participants were instructed to practice three 30-minute sessions per day, 6 days per week for 3 weeks. Main Outcome Measures: Gains achieved from baseline in accuracy and rate of production of trained and untrained script sentences at post treatment and at 3-, 6-, and 12-weeks after the end of treatment. Results: Sixteen participants completed the intervention. On the trained script, gains were statistically significant for both accuracy and words per minute at post treatment and 3-, 6-, and 12-week maintenance. Gains on the untrained script were smaller than on the trained script; they were statistically significant only for accuracy at post treatment and 3-week maintenance. Complexity had an influence on accuracy at post-treatment (F1=4.8391, P=.0501) and at maintenance (F1=5.3391, P=.0413). Practicing scripts with high complexity increased accuracy by 11.33% at post treatment and by 9.90% at maintenance compared with scripts with low complexity. Participants with nonfluent aphasia made greater gains than those with fluent aphasia. There was no significant effect of feedback. Conclusions: This study reinforces script training as a treatment option for aphasia. Results highlight the use of more complex scripts to better promote acquisition and maintenance of script production skills. There is a need for further investigation of these variables with larger samples and with other types of aphasia treatments.

AB - Objective: To explore the effect of complexity and feedback on script training outcomes in aphasia Design: Randomized balanced single-blind 2 × 2 factorial design. Setting: Freestanding urban rehabilitation hospital. Participants: Adults with fluent and nonfluent aphasia (at least 6 months post onset). Interventions: Experimental treatment was AphasiaScripts, a computer-based script training program. Scripts were 10-turns long and developed at different complexity levels to allow for comparison of high vs low complexity. The program was modified to contrast high vs low feedback conditions during sentence practice. Participants were instructed to practice three 30-minute sessions per day, 6 days per week for 3 weeks. Main Outcome Measures: Gains achieved from baseline in accuracy and rate of production of trained and untrained script sentences at post treatment and at 3-, 6-, and 12-weeks after the end of treatment. Results: Sixteen participants completed the intervention. On the trained script, gains were statistically significant for both accuracy and words per minute at post treatment and 3-, 6-, and 12-week maintenance. Gains on the untrained script were smaller than on the trained script; they were statistically significant only for accuracy at post treatment and 3-week maintenance. Complexity had an influence on accuracy at post-treatment (F1=4.8391, P=.0501) and at maintenance (F1=5.3391, P=.0413). Practicing scripts with high complexity increased accuracy by 11.33% at post treatment and by 9.90% at maintenance compared with scripts with low complexity. Participants with nonfluent aphasia made greater gains than those with fluent aphasia. There was no significant effect of feedback. Conclusions: This study reinforces script training as a treatment option for aphasia. Results highlight the use of more complex scripts to better promote acquisition and maintenance of script production skills. There is a need for further investigation of these variables with larger samples and with other types of aphasia treatments.

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KW - Computer-assisted therapy

KW - Rehabilitation

KW - Therapeutics

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Complexity and Feedback During Script Training in Aphasia: A Feasibility Study

Abstract

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