repetition priming and anomia: an investigation of stimulus dosage catherine a. off, ph.c., ccc-slp...
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Repetition Priming and Anomia: An Investigation of Stimulus DosageRepetition Priming and Anomia: An Investigation of Stimulus DosageCatherine A. Off, Ph.C.,Catherine A. Off, Ph.C., CCC-SLP CCC-SLP 11; Holly Kavalier, B.A. ; Holly Kavalier, B.A. 11; Margaret A. Rogers, Ph.D.; Margaret A. Rogers, Ph.D.1, 21, 2; CCC-SLP; Kristie Spencer, Ph.D., CCC-SLP ; CCC-SLP; Kristie Spencer, Ph.D., CCC-SLP 11
ParticipantsParticipants
1Department of Speech & Hearing Sciences, University of Washington, Seattle, Washington; 2American Speech-Language-Hearing Association, Rockville, MD
DesignDesignSingle Subject ABA Design with Replication across 4 Individuals with Aphasia and 1 Non-Brain-Injured, Age- and Gender-Matched Control
Probe Sessions: 40 Trained Items; 20 Untrained Items; Balanced for Syllable Length and Word Frequency
Training Sessions: 40 Trained Items; 20 1-Trials/Session; 20 4-Trials/Session; Balanced for Syllable Length and Word Frequency
Dependent Variables: Response Accuracy (Live and Audio-Recorded Samples) and Response Time (Measured by E-Prime - milliseconds)
Reliability: All Probe Sessions Transcribed and Coded for both Accuracy and Error Type by Independent Judges Blinded to Training Variables
Delivery Schedule
SESSION # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22
Baseline Probes
Training Sessions
Training Probes
Stimulus Generalization
Maintenance
Training Sessions
Characteristics of Repetition Priming (Healthy Adults)
•Increases Reaction Time and Improves Accuracy on Subsequent Trials
•Persistent Across Time (Cave, 1997)
•Sensitive to # of Repetitions (Brown, Jones, & Mitchell, 1988; Reber, Gitelman, Parrish, & Mesulam, 2004 )
•Item Specific (Brown, Jones, & Mitchell, 1996)
•Generalizes to Alternate Exemplars (Koutstaal, Wagner, Rotte et al., 2001)
Repetition MattersRepetition Matters
A102 A103 A104 A106 CONTROL
# Training Sessions 15 6 12 15 9
# Exposures 600 240 480 600 160
Naming Attempts w/o support
300; 1200 120; 480 240; 960 300; 1200 180; 720
Naming attempts w/ support
300; 1200 120; 480 240; 960 300; 1200 180; 720
Total Naming Attempts 600; 2400 240; 960 480; 1920 600; 2400 360; 1440
Integrating Principles of Neuroplasticity into clinical practice is necessary to optimize rehabilitative outcomes.• Repetition is fundamental to skill learning and re-learning• Motor learning, at both behavioral and neural levels, requires hundreds of trials
The current investigation examines the application of repetition to improve naming performance in individuals with chronic aphasia. Though repetition is a ubiquitous component of anomia treatment protocols, and may be one of the most potent sources of change, systematic investigation of the influence of stimulus dosage on naming performance has yet to be reported, particularly with respect to the acquisition and maintenance of trained items, generalization to untrained items and generalization to alternate exemplars of trained items.
Is Repetition Priming: Independent Variables
Persistent across Time?Immediate vs. Delayed probes; Baseline vs. Maintenance Probes (6 weeks after final training session)
Sensitive to # of Exposures/Session? 1 vs. 4 Trials per Training Session
Item Specific? Trained vs. Untrained Stimuli
Generalize to Alternate Exemplars? Stimulus Generalization Probes
Stimulus Dosage by Participant
Experimental Questions and Independent Variables
X* X *
coffee
Response Time Results (ms)Response Time Results (ms)
Accuracy ResultsAccuracy Results
A102 A103 A104 A106 Control
Baseline Probes Overall 1851 1897 1151 733 691
Last Two TrainingProbes
Trained 1549 1409 1041 755 568
Untrained 2103 1092 1118 1002 711
1 Trial 1533 1360 1029 758 571
4 Trials 1556 1462 1054 749 564
Maintenance Probes
Trained 1092 1800 pending pending pending
Untrained 1585 1887 pending pending pending
1 Trial 1106 1765 pending pending pending
4 Trials 1086 1806 pending pending pending
DiscussionDiscussionIs Repetition Priming: Individuals with Aphasia Age- & Gender-Matched Control (Matched A103)
Persistent across Time?
Response Accuracy: Yes – A102 & A103 maintained improved response accuracy for trained items 6 weeks after last training session; awaiting results from A104 & A106; stronger priming effects for immediate post-training probes vs. delayed probes
Response Time: Yes for A102; A103 demonstrated a RT for accuracy trade-off
Reaction Time: Pending Maintenance Probes
Sensitive to # of Exposures/Session?
Response Accuracy: Inconclusive – may depend on underlying impairment or time post onset
Response Time: Inconclusive
Reaction Time: Yes – 7 ms difference between 4 trials per session and 1 trial per sessions
Item Specific?
Response Accuracy: No evidence of generalization to untrained items presented during experiment; however, note positive changes of BNT and PALPA scores pre/post
Response Time: Yes for A102, A104 & A106: trained items were responded to faster than untrained items; A103 demonstrated a RT for accuracy trade-off
Reaction Time: Yes – No evidence of generalization from trained to untrained items (143 ms difference between trained and untrained items)
Generalize to Alternate Exemplars?
Response Accuracy: Inconclusive, but no obvious trends towards stimulus generalization
Response Time: Yes for A102, A106; No for A103, A104
Reaction Time: Yes – 165 ms difference between first stimulus generalization probe to the last stimulus generalization probe
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d=7.30
d=4.19
pending
pendingpending
pending
* d=Busk & Serlin’s d
A102 A102 A104 A106
Age 90 47 76 78
Gender Female Female Female Female
Time post CVA 6 months 3.5 yrs 1.5 yrs 8 months
Type of CVA Embolic Hemorrhagic Hemorrhagic Embolic/Thrombolic
Location of CVA L MCAL Temporal
lobeL Basal Ganglia
L MCA; L frontal lobe, ant. insula region
L frontal operculum
Cognitive-Linguistic Battery
Pre Post Pre Post Pre Post Pre Post
WAB 73.9 61.4 60.2 70.8 82.8 81 54.1 pending
BNT 10/60 14/60 5/60 10/60 27/60 24/60 12/60 pending
PALPA 25/60 43/60 26/60 38/60 50/60 52/60 35/60 pending
Cognitive-Linguistic Battery
Administered only once at study onset. Data used for inclusionary & descriptive purposes.
Pyramids & Palms
38/52 48/52 48/52 49/52
ABA No apraxia No apraxia No apraxiaDNT - Complicated
by conduction aphasia
RCBA 29/30 30/30 30/30 30/30
Visual Agnosia 10/10 10/10 10/10 10/10
Raven’s 18/36 36/36 20/36 18/36
BDI-II 3/63 10/63 18/63 7/63