The research proposed here is a series of clinical studies of therapy for individuals with aphasia, directed at the interface between cognitive and linguistic processing. The objective of this research is to provided tested alternatives to traditional aphasia therapy that attempt to modify language performance by direct work on patient deficits. The research has two phases. In Phase I, two groups of studies will use single-case research methods to develop and test a series of innovative cognitively based interventions. One set of these interventions will focus on patients whose aphasia is accompanied by nonverbal cognitive disorders and is directed to remediation for them. The second set of studies in Phase I, will focus on a different set of individuals with aphasia, those who demonstrate good cognitive skills. These studies are aimed at enlisting these good cognitive skills to aid in the development of compensatory support for poor language performance. In Phase II, a group study is proposed. Individuals with aphasia whose cognitive skills are similar to those studied in Phase I, will be tested with the treatments validated in Phase I and their performance will be compared with a matched group of patients treated with direct intervention for their language disorders. In both phases of this project, external criterial tests of cognition, language, and functional language skills will be used to measure comparative effectiveness of the training protocols. All treatment in this study will be provided at an intensity that approximates that of current reimbursed clinical practice, so its usefulness for ongoing clinical environments can be evaluated.
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