Rehabilitation of lexical and semantic communicative impairments: An overview of available approaches

An examination of retrieval practice and production training in the treatment of lexical-semantic comprehension deficits in aphasia

OBJECTIVE

Little research has addressed the treatment of lexical-semantic comprehension deficits (i.e., difficulty retrieving the meanings of words) in people with aphasia (PWA). Research suggests that practice retrieving names for depicted objects from long-term memory (production-based retrieval practice) more strongly benefits word retrieval for production in PWA compared to errorless learning (i.e., word repetition), which eschews retrieval practice. This study assessed whether production-based and comprehension-based retrieval practice enhance performance on errorful word-comprehension items in PWA measured relative to nonretrieval forms of training and untrained control items.

METHOD

In a within-participant group study of PWA, errorful comprehension items were assigned to (a) a production-based training module (retrieval practice vs. errorless learning); (b) a comprehension-based training module (a receptive form of retrieval practice vs. restudy). Each module comprised one training session and a 1-day and 1-week comprehension posttest on the module's trained items and an untrained item set.

RESULTS

The comprehension module conditions produced similar and superior posttest performance relative to untrained items. Both production module conditions improved posttest performance relative to untrained items, with retrieval practice conferring more durable learning and generalization indicative of refinement of semantic representations compared to errorless learning.

CONCLUSIONS

Results suggest comprehension- and production-based forms of training are both beneficial for improving lexical-semantic deficits in aphasia, with production-based retrieval practice conferring additional benefits to the targeted deficit compared to errorless learning. Future studies should examine these learning factors in schedules of training more commensurate with clinical practice and in other neurological populations (e.g., semantic dementia). (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Language training for oral and written naming impairment in primary progressive aphasia: a review

BACKGROUND

Primary progressive aphasia (PPA) is a neurodegenerative disorder characterized by a gradual, insidious and progressive loss of language abilities, with naming difficulties being an early and persistent impairment common to all three variants. In the absence of effective pharmacological treatments and given the progressive nature of the disorder, in the past few decades, many studies have investigated the effectiveness of language training to minimize the functional impact of word-finding difficulties in daily life.

MAIN BODY

We review language treatments most commonly used in clinical practice among patients with different variants of PPA, with a focus on the enhancement of spoken and written naming abilities. Generalization of gains to the ability to name untrained stimuli or to other language abilities and the maintenance of these results over time are also discussed. Forty-eight studies were included in this literature review, identifying four main types of language treatment: a) lexical retrieval treatment, b) phonological and/or orthographic treatment, c) semantic treatment, and d) a multimodality approach treatment. Overall, language training is able to induce immediate improvements of naming abilities in all variants of PPA. Moreover, despite the large variability among results, generalization and long-term effects can be recorded after the training. The reviewed studies also suggest that one factor that determines the choice of a particular approach is the compromised components of the lexical/semantic processing system.

CONCLUSION

The majority of studies have demonstrated improvements of naming abilities following language treatments. Given the progressive nature of PPA, it is essential to apply language treatment in the early stages of the disease.

Remembering a name: Neuropsychological validity studies and a computer proposal for detection of anomia

There are contradictory results or lack of validity studies concerning the naming function and brain laterality. Although anomia is a frequent symptom of memory impairment, and the most relevant symptom of aphasia, few studies have been conducted to evaluate its validity for detecting patients with left-hemisphere damage (LD), as per the MeSH definition.