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Purpose: Recent investigations into effects of intensity or distribution of aphasia therapy have provided moderate evidence supporting intensive therapy schedules on aphasia treatment response. The purpose of the present study was to investigate the feasibility of creating an intensive therapy session without extending the amount of daily time a person spends in treatment.
Method: Individuals who presented with chronic anomia poststroke (N = 8) participated in 2 weeks of a computerized, therapist-delivered, cued, picture-naming treatment. Dosing parameters for each session were 8 presentations of 50 pictures, totaling 400 teaching episodes per session.
Results: Of the 8 participants, 6 achieved significant increases from baseline on trained items after 400 teaching episodes(i.e., 1 treatment hr), andthe remaining 2 participants achieved significant increases from baseline after 1200 teaching episodes (i.e., 3 treatment hr). Maintenance data from 7 of the participants indicated that 6 participants maintained significant improvement from baseline on trained items.
Conclusions: Given an intensive and saturated context, anomic individuals were surprisingly quick at relearning to produce problematic words successfully. Most participants demonstrated retention of the gains 2 months after treatment ended. The high density of teaching episodes within the treatment session (i.e., the intensive treatment schedule) may have contributed to the behavioral gains.
Key Words: aphasia, intervention, language disorders
Previous rehabilitation work has demonstrated that dos- age is potent (Byl, Pitsch, & Abrams, 2008; Humm, Kozlowski, James, Gotts, & Schallert, 1998; Lisman & Spruston, 2005). Animal studies have shown that intensity of treatment determines behavioral outcomes, as neural networks require a specific number of repetitions of a skill to instantiate lasting change (Kleim et al., 2004). Kleim and Jones (2008) pointed out that a skilled reaching task delivered 400 times per day elicited increases in the number of synapses in the motor cortex (Kleim et al., 2002), whereas the same task delivered 60 times per day did not elicit these changes (Luke, Allred, & Jones, 2004). Increases in synapse formation are thought to play a role in experience- dependent neuroplasticity (Kleim et al., 2002). Moreover, there is a large discrepancy between the number of repe- titions of a skill in animal rehabilitation studies and human rehabilitation studies (Krakauer, Carmichael, Corbett, & Wittenberg, 2012; Nudo, 2011), with animal studies em- ploying many more repetitions of skill...