Evaluation of the Effects of Response Elaboration Training for Aphasia

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

47 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-12-31

Study Completion Date

2012-12-31

Brief Summary

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The purpose of this study is to evaluate the effects of Response Elaboration Training (RET), which is a speech/language therapy for aphasia. The study is designed to determine whether verbal language production improves in terms of content and length of utterances as a result of treatment.

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Detailed Description

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Detailed Description:

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Sudden out-of-hospital cardiac arrest (OOH-CA) remains a significant cause of death, in spite of recent declines in overall mortality from cardiovascular disease. Existing methods of emergency resuscitation are inadequate due to time delays inherent in the transport of a trained responder with defibrillation capabilities to the side of the OOH-CA victim. Existing Emergency Medical Services (EMS) systems typically combine paramedic Emergency Medical Technician (EMT) services with some level of community involvement, such as bystander cardiopulmonary resuscitation (CPR) training. Some communities include automated external defibrillators (AEDs) at isolated sites or in mobile police or fire vehicles. A comprehensive, integrated community approach to treatment with AEDs would have community units served by these volunteer non-medical responders who can quickly identify and treat a patient with OOH-CA. Such an approach is termed Public Access Defibrillation (PAD).

Comparison(s): Community units trained and equipped to provide public access defibrillation in addition to optimal standard care, compared to community units trained to provide optimal standard care (recognition of out-of-hospital cardiac arrest, 911 access, and cardiopulmonary resuscitation).

The purpose of the proposed research is to thoroughly evaluate the effects of Response Elaboration Training (RET) with persons with aphasia. Specifically, the proposed research investigation is designed to delineate the outcomes that may be expected with RET. The study is also designed to improve outcomes in the area of stimulus generalization effects of treatment by testing a modification of RET designed to facilitate generalization. The specific experimental questions to be addressed are as follows:

* Will RET result in increased production of correct information units and increased length and changes in composition of utterances as measured in \*trained and untrained picture descriptions; \*story retells; \*conversations with significant others/family members/friends; and \*personal recounts?
* Will modification and extension of RET to additional training contexts result in further increases in production of CIUs and increased length and complexity of utterances?
* Will the effects\* of RET vary among participants with fluent aphasia, participants with nonfluent aphasia who present with mild to moderate verbal production deficits, and participants with nonfluent aphasia who present with severe verbal production deficits?

\* Effects = effects on production of CIUs and on measures of functional communication
* Will changes in measures of functional communication be observed following administration of RET?

A series of single-subject experimental designs across subjects, behaviors, and contexts will be conducted to address these questions. Twenty-four adults with chronic, moderate to severe aphasia secondary to unilateral, left-hemisphere brain-injury will serve as participants for this investigation.

Conditions

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Aphasia Language Disorders Speech Disorders

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Arm 1

Single subject design - participant receives three administrations of the same treatment

Group Type OTHER

Response Elaboration Training

Intervention Type BEHAVIORAL

Therapist modeling, reinforcement and forward-chaining are used to stimulate verbal descriptions of pictures

Interventions

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Response Elaboration Training

Therapist modeling, reinforcement and forward-chaining are used to stimulate verbal descriptions of pictures

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of moderate to severe nonfluent or fluent aphasia
* Nonverbal intelligence within normal limits
* Auditory and visual acuity adequate for experimental tasks
* 6 months post-onset of single, focal brain injury (e.g., stroke)

Exclusion Criteria

* Previous history of therapy with RET
* Diagnosed psychological disorder other than depression
* Neurological condition other than that which resulted in aphasia
* History of alcohol or substance abuse
* Non-native English speaker
* Premorbid history of speech/language disorder

Minimum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes