One goal of the Healthy People 2010 program is to reduce health disparities across different segments of the population. Diagnosis and treatment of sentence comprehension deficits in patients with aphasia is one area where disparities continue to exist even though this topic is of great theoretical importance. The current research on this topic, however, lacks specific recommendations on how to train sentence comprehension skills in patients with aphasia and to what extent generalization of comprehension skills occurs across sentences of similar syntactic structure and across different comprehension tasks. The goal of the project is to develop an effective, theoretically sound, treatment for sentence comprehension deficits in patients with aphasia following stroke. Our approach to developing effective therapies for these deficits will be guided by results in linguistics, psycholinguistics, and aphasiology. This project consists of two distinct phases: Phase 1: Specific Plans and Milestones for R21 (Year 1) In the first (R21) phase of the project, which will last one year, we will develop two effective therapies for syntactic comprehension deficits - one based on picture matching and one based on object enactment. Milestones will be measures of the effectiveness of these therapies. In this year, we will also develop the optimal treatment prescription (frequency and duration of therapy sessions) and the stimuli to be utilized for training and generalization. Phase 2: R33 (Years 2-5) in the second (R33) phase of the project, we will investigate the wider clinical utility of the treatment developed in Phase 1. We will address the critical issues of rate of acquisition of treated items, generalization to untrained items, maintenance of performance after termination of treatment, transfer to everyday comprehension tasks, and optimal patient selection for training. The expected outcome of this phase is a novel treatment approach whose clinical utility is well characterized and that can be used by clinicians with appropriate patients with aphasia.
This project is relevant because it will address the important issue of language recovery following a theoretically based sentence comprehension treatment for patients with aphasia. The ability to understand sentences is often affected in aphasia and impairs comprehension of sentences in which syntax determines aspects of meaning such as thematic roles. We will first develop two new methods of treatment and, in the second phase of the research, determine how successfully training one structure generalizes to others, how it leads to savings in further treatments, how it affects passage comprehension, and how long it lasts. The result is expected to be an effective and efficient training protocol that can be used to treat deficits in syntactically based comprehension people with aphasia.