TY - JOUR
T1 - Maximising recovery from aphasia with central and peripheral agraphia
T2 - The benefit of sequential treatments
AU - Beeson, Pélagie M.
AU - Bayley, Chelsea
AU - Shultz, Christine
AU - Rising, Kindle
N1 - Funding Information:
This work was supported by the National Institute on Deafness and Other Communication Disorders from grant number [R01DC007647] (PMB). We gratefully acknowledge the diligent efforts of BB and her drive to work toward the best recovery possible.
Publisher Copyright:
© 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2019
Y1 - 2019
N2 - Maximal recovery from acquired language impairment may require progression from one behavioural treatment protocol to the next in order to build upon residual and relearned cognitive-linguistic and sensory-motor processes. We present a five-stage treatment sequence that was initiated at one year post stroke in a woman with acquired impairments of spoken and written language. As is typical of individuals with left perisylvian damage, she demonstrated marked impairment of phonological retrieval and sublexical phonology, but she also faced additional challenges due to impaired letter shape knowledge and visual attention. The treatment sequence included (1) written spelling of targeted words, (2) retraining sublexical sound-to-letter correspondences and phonological manipulation skills, (3) training strategic approaches to maximise interactive use of lexical, phonological, and orthographic knowledge, (4) lexical retrieval of spoken words, and finally (5) sentence-level stimulation to improve grammatical form of written narratives. This Phase II clinical study documented positive direct treatment outcomes along with evidence of a significant reduction in the underlying deficits and generalisation to untrained items and language tasks. Improvements on a comprehensive assessment battery were realised as functional gains in everyday written and spoken communication, including improved lexical retrieval and grammatical complexity of written narratives. This case provides a valuable example of the cumulative therapeutic benefit of sequential application of theoretically motivated treatment protocols.
AB - Maximal recovery from acquired language impairment may require progression from one behavioural treatment protocol to the next in order to build upon residual and relearned cognitive-linguistic and sensory-motor processes. We present a five-stage treatment sequence that was initiated at one year post stroke in a woman with acquired impairments of spoken and written language. As is typical of individuals with left perisylvian damage, she demonstrated marked impairment of phonological retrieval and sublexical phonology, but she also faced additional challenges due to impaired letter shape knowledge and visual attention. The treatment sequence included (1) written spelling of targeted words, (2) retraining sublexical sound-to-letter correspondences and phonological manipulation skills, (3) training strategic approaches to maximise interactive use of lexical, phonological, and orthographic knowledge, (4) lexical retrieval of spoken words, and finally (5) sentence-level stimulation to improve grammatical form of written narratives. This Phase II clinical study documented positive direct treatment outcomes along with evidence of a significant reduction in the underlying deficits and generalisation to untrained items and language tasks. Improvements on a comprehensive assessment battery were realised as functional gains in everyday written and spoken communication, including improved lexical retrieval and grammatical complexity of written narratives. This case provides a valuable example of the cumulative therapeutic benefit of sequential application of theoretically motivated treatment protocols.
KW - Allographic agraphia
KW - Aphasia
KW - Aphasia treatment
KW - Lexical retrieval treatment
KW - Phonological agraphia
KW - Phonological treatment
KW - Writing impairment
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U2 - 10.1080/09602011.2017.1417873
DO - 10.1080/09602011.2017.1417873
M3 - Article
C2 - 29298550
AN - SCOPUS:85040977467
SN - 0960-2011
VL - 29
SP - 1399
EP - 1425
JO - Neuropsychological Rehabilitation
JF - Neuropsychological Rehabilitation
IS - 9
ER -