Because individuals with acquired language disorders are frequently unable to reliably access the names of common everyday objects (i.e., naming impairment), rehabilitation efforts often focus on improving naming. The present study compared two rehabilitation strategies for naming impairment, reflecting contradictory prescriptions derived from different theoretical principles. The prescription derived from psychological research on test-enhanced learning advocates providing patients opportunities to retrieve target names from long-term memory (i.e., retrieval practice) in the course of treatment. In contrast, the errorless learning approach derived from cognitive rehabilitation research eschews retrieval practice in favor of methods that minimize naming errors, and thus the potential for error learning, in the course of treatment. The present study directly compared these approaches and showed that, despite superior (and errorless) performance during errorless treatment, treatment that prioritized retrieval practice produced greater retention 1-day and 1-week following treatment. These findings have implications for clinical practice, as well as theoretical accounts of lexical access and test-enhanced learning.
This study examined spontaneous self-monitoring of picture naming in people with aphasia. Of primary interest was whether spontaneous detection or repair of an error constitutes an error signal or other feedback that tunes the production system to the desired outcome. In other words, do acts of monitoring cause adaptive change in the language system? A second possibility, not incompatible with the first, is that monitoring is indicative of an item’s representational strength, and strength is a causal factor in language change. Twelve PWA performed a 615-item naming test twice, in separate sessions, without extrinsic feedback. At each timepoint, we scored the first complete response for accuracy and error type and the remainder of the trial for verbalizations consistent with detection (e.g., “no, not that”) and successful repair (i.e., correction). Data analysis centered on: (a) how often an item that was misnamed at one timepoint changed to correct at the other timepoint, as a function of monitoring; and (b) how monitoring impacted change scores in the Forward (Time 1 to Time 2) compared to Backward (Time 2 to Time 1) direction. The Strength hypothesis predicts significant effects of monitoring in both directions. The Learning hypothesis predicts greater effects in the Forward direction. These predictions were evaluated for three types of errors – Semantic errors, Phonological errors, and Fragments – using mixed-effects regression modeling with crossed random effects. Support for the Strength hypothesis was found for all three error types. Support for the Learning hypothesis was found for Semantic errors. All effects were due to error repair, not error detection. We discuss the theoretical and clinical implications of these novel findings.
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