The effect of computerised Verb Network Strengthening Treatment on lexical retrieval in aphasia

Abstract

Background: A number of computerised treatments have been developed for aphasia, but few have remediated typing, an important functional task, and/or been implemented over the Internet via teletherapy, which can increase access to therapeutic services. The current study created a computerised version of Verb Network Strengthening Treatment (VNeST) and administered it via telerehabilitation over the Internet. VNeST is a semantic treatment which seeks to improve lexical retrieval of words through the conceptual connection between verbs and thematic roles. Previous iterations of VNeST have shown improvement in both spoken and written lexical retrieval for people with moderate and moderate-to-severe aphasia. Aims: This study investigates changes to lexical retrieval with four hierarchical outcome measures. The research questions were: Does treatment using Computerised VNeST (VNeST-C) result in pre-to post-treatment increases in: (1) spoken and typed lexical retrieval of trained (e.g., The farmer is weighing the apples.) and untrained words (e.g., The carpenter is measuring the lumber.) in a picture description task, (2) untreated singleword naming accuracy of nouns and verbs in spoken and typed modalities, (3) spoken and typed lexical retrieval as measured by informative words, efficiency of production and complete utterances within discourse, and (4) standardised measures of cognitive and language abilities? Methods & Procedures: Two people with aphasia were treated three times per week for 8 weeks using the VNeST-C program. A single-subject experimental design was used to evaluate changes in trained and untrained stimuli and tasks. Additional pre-treatment and post-treatment testing was also conducted. Outcomes & Results: Results indicate improvements on lexical retrieval during sentence production of trained and untrained stimuli. Additional improvement was observed for single-word naming of untrained nouns and verbs in spoken and typed modalities and standardised measures of aphasia and writing-by-hand. Limited generalisation to discourse was also observed, including a general increase in word output and decrease in typed neologisms.

A comparison of remote therapy, face to face therapy and an attention control intervention for people with aphasia: a quasi-randomised controlled feasibility study

“…18 Although positive, the evidence base for telerehabilitation in aphasia is very limited. Most previous treatment studies involved case series designs, 17,19,20,21 and the largest involved only eight participants. 18 The two studies that directly compared face to face with remote therapy employed cross over designs, in which participants received both forms of treatment.…”

“…[11][12][13][14][15] There is also some evidence that remote administration of treatment can improve targeted skills, and achieve good levels of patient satisfaction. [16][17][18][19][20][21][22][23] Two studies compared face to face with remote delivery of aphasia therapy. 16,18 Results showed that treatment gains were either no different across delivery modes 16 or marginally better in the remote condition.…”

A Review of Verb Network Strengthening Treatment

“…The effects of VNeST have been evaluated by Edmonds and colleagues with 19 English-speaking participants across five studies (Edmonds & Babb, 2011;Edmonds, Mammino, et al, 2014 [group data for 11 participants]; Edmonds, Nadeau, & Kiran, 2009;Edmonds, Obermeyer, et al, 2014 [individual analyses for participants from in Edmonds, Mammino, et al's, 2014, study]; Furnas & Edmonds, 2014) and by Kwag, Sun, Kim, and Cheon (2014) with three Koreanspeaking participants. The participants and pre-to posttreatment generalization results from these studies are discussed and are summarized in Table 1.…”

Effect of Verb Network Strengthening Treatment (VNeST) in Persons With Aphasia: Extension and Replication of Previous Findings

“…Treatment is also low-tech (only pen and paper required) and as such is transportable and easily delivered in multiple settings. In addition, VNeST adapts relatively easily to computer and telepractice use (Furnas & Edmonds, 2014), providing clinicians and participants with more potential opportunities for home treatment and practice. Thus, VNeST is easy to administer and potentially efficient, and it offers high potential gains.…”