Treatment and Generalization of Complex Sentence Production in Agrammatism

Abstract

The present study applies single-subject experimental design to examine (a) the acquisition and generalization of complex sentence production in agrammatism using Linguistic Specific Treatment (LST) and (b) the utility of syntactic theory in guiding hypotheses of treatment effects. LST trains construction and production of complex sentence structures. Four sentence types were selected for study: object clefts and object-extracted matrix and embedded questions (which are noncanonical with wh-movement), and embedded actives (which are canonical with no overt movement). All sentences contain overt material in the complementizer phrase (CP) of the syntactic tree. Three of five participants (1, 2, and 3) demonstrated generalization from object cleft treatment to production of matrix questions. Thus, LST was effective in improving their ability to generate less complex sentences with wh-movement. Once production of object clefts and matrix questions was acquired, all 5 participants demonstrated generalization from treatment to improved production of embedded questions and/or embedded actives. This generalization involved improved ability to generate embedded clausal structure to form complex sentences but continuing inability to express overt material in CP. Finally, direct treatment for embedded questions did not result in accurate production of embedded actives or vice versa. There were no trends across participants toward improved production of morphosyntactic behaviors in narrative. Persons 1, 2, and 3 showed generalization to increased informativeness and efficiency of expression and were judged by independent listeners to improve in content, coherence, and fluency of spontaneous production. The remaining two participants showed no change or a decline in performance in narrative language production (4 and 5, respectively). These participants demonstrated more severe Broca's aphasia at pretesting compared to Persons 1, 2, and 3, with greater impairments in auditory comprehension, naming, and reading. Etiology and size of lesion did not appear to account for the different behavioral patterns. This study supports the use of LST, which applies syntactic theory to predict patterns of generalization, as an effective treatment approach.

Prediction of strategy usage by adults with aphasia

“…While many patients are able to acquire a targeted skill in a structured format, many patients do not successfully use the trained skill in more functional situations (Ballard & Tompson, 1999;Coelho, 1990; Purdy, Duffy & Coelho, 1994;Robson, Pring, Marshall, Morrison, & Chiat, 1998;Rostron, Ward & Plant, 1996; Yoshihata and colleagues, 1998). Purdy, Duffy, and Coelho (1994) performed a study examining use of symbols trained in verbal, gestural, and communication board modes.…”

The Neurobiology of Language Recovery in Aphasia

“…The treatment approach also might result in markedly different outcomes. Thompson and colleagues have shown, for example, that linguistic specific treatment of sentence production deficits in agrammatic aphasia results in generalization to untrained sentences that are linguistically similar to those trained, indicating improved access to the structures and computations required to produce sentences (Ballard & Thompson, 1999;Thompson & Shapiro, 1995;Thompson et al, 1998). Conversely, treatment aimed at teaching certain functional behavior results in increased use of trained responses, but little generalization to untrained responses (Thompson 1989).…”

Evaluating Treatment and Generalization Patterns of Two Theoretically Motivated Sentence Comprehension Therapies

“…In particular, as noted in the introduction, studies of the TUF approach (Ballard & Thompson, 1999;Jacobs & Thompson, 2000;Thompson & Shapiro, 2005;Thompson et al, 1993Thompson et al, , 1996Thompson et al, , 1997 frequently observed greater generalization to sentences with the same type of movement than to sentences with a different type of movement. Furthermore, it is important to highlight that the focus of the treatments in the current study was on the identification of thematic role in comprehension, which addresses movement only implicitly.…”

“…One of the goals of TUF is to promote generalization from trained to untrained sentences; therefore, researchers systematically probe progress on syntactically related and unrelated untrained sentence structures. It has been found that generalization following TUF is greatest to linguistically related sentences (Ballard & Thompson, 1999;Jacobs & Thompson, 2000;Thompson & Shapiro, 2005;Thompson, Shapiro, & Roberts, 1993;Thompson, Shapiro, Tait, Jacobs, & Schneider, 1996;Thompson et al, 1997), lending support for specific deficit hypotheses that suggest that specific syntactic operations lie at the root of deficits. Furthermore, generalization occurs frequently from complex to simple structures but less frequently from simple to complex structures (Thompson, Ballard, & Shapiro, 1998;Thompson & Shapiro, 2005Thompson, Shapiro, Kiran, & Sobecks, 2003;Thompson et al, 1993Thompson et al, , 1997.…”

“…Furthermore, generalization occurs frequently from complex to simple structures but less frequently from simple to complex structures (Thompson, Ballard, & Shapiro, 1998;Thompson & Shapiro, 2005Thompson, Shapiro, Kiran, & Sobecks, 2003;Thompson et al, 1993Thompson et al, , 1997. Together, these observations have led to the establishment of the complexity account of treatment efficacy (CATE), which states that training complex sentences leads to generalization to less complex sentences with shared underlying linguistic properties (Ballard & Thompson, 1999;Jacobs & Thompson, 2000;Thompson & Shapiro, 1995Thompson et al, 1997Thompson et al, , 1998Thompson et al, , 2003. These generalization results can be interpreted within specific deficit accounts.…”