A novel, implicit treatment for language comprehension processes in right hemisphere brain damage: Phase I data
- 14 March 2011
- journal article
- research article
- Published by Taylor & Francis Ltd in Aphasiology
- Vol. 25 (6-7), 789-799
- https://doi.org/10.1080/02687038.2010.539784
Abstract
Background: This manuscript reports the initial phase of testing for a novel, “Contextual constraint” treatment, designed to stimulate inefficient language comprehension processes in adults with right hemisphere brain damage (RHD). Two versions of treatment were developed to target two normal comprehension processes that have broad relevance for discourse comprehension and that are often disrupted by RHD: coarse semantic coding and suppression. The development of the treatment was informed by two well-documented strengths of the RHD population. The first is consistently better performance on assessments that are implicit, or nearly so, than on explicit, metalinguistic measures of language and cognitive processing. The second is improved performance when given linguistic context that moderately-to-strongly biases an intended meaning. Treatment consisted of providing brief context sentences to prestimulate, or constrain, intended interpretations. Participants made no explicit associations or judgments about the constraint sentences; rather, these contexts served only as implicit primes. Aims: This Phase I treatment study aimed to determine the effects of a novel, implicit, Contextual Constraint treatment in adults with RHD whose coarse coding or suppression processes were inefficient. Treatment was hypothesized to speed coarse coding or suppression function in these individuals. Methods & Procedures: Three adults with RHD participated in this study, one (P1) with a coarse coding deficit and two (P2, P3) with suppression deficits. Probe tasks were adapted from prior studies of coarse coding and suppression in RHD. The dependent measure was the percentage of responses that met predetermined response time criteria. When pre-treatment baseline performance was stable, treatment was initiated. There were two levels of contextual constraint, Strong and Moderate, and treatment for each item began with the provision of the Strong constraint context. Outcomes & Results: Treatment-contingent gains were evident after brief periods of treatment, for P1 on two treatment lists, and for P2. P3 made slower but still substantial gains. Maintenance of gains was evident for P1, the only participant for whom it was measured. Conclusions: This Phase I treatment study documents the potential for considerable gains from an implicit, Contextual constraint treatment. If replicated, this approach to treatment may hold promise for individuals who do poorly with effortful, metalinguistic treatment tasks, or for whom it is desirable to minimize errors during treatment. The real test of this treatment's benefit will come from later phase studies of study, which will test broad-based generalization to various aspects of discourse comprehension.Keywords
This publication has 13 references indexed in Scilit:
- Coarse coding and discourse comprehension in adults with right hemisphere brain damageAphasiology, 2008
- Activation and maintenance of peripheral semantic features of unambiguous words after right hemisphere brain damage in adultsAphasiology, 2008
- Contextual bias and predictive inferencing in adults with and without right hemisphere brain damageAphasiology, 2005
- VISUAL AIDS AND STRUCTURED CRITERIA FOR IMPROVING VISUAL INSPECTION AND INTERPRETATION OF SINGLE‐CASE DESIGNSJournal of Applied Behavior Analysis, 2003
- Mechanisms of Discourse Comprehension Impairment After Right Hemisphere Brain DamageJournal of Speech, Language, and Hearing Research, 2001
- Mechanisms of Discourse Comprehension Impairment After Right Hemisphere Brain DamageJournal of Speech, Language, and Hearing Research, 2000
- A model for conducting clinical-outcome research: An adaptation of the standard protocol for use in aphasiologyAphasiology, 1998
- The mechanism of suppression: A component of general comprehension skill.Journal of Experimental Psychology: Learning, Memory, and Cognition, 1991
- The mechanism of suppression: A component of general comprehension skill.Journal of Experimental Psychology: Learning, Memory, and Cognition, 1991
- The role of knowledge in discourse comprehension: A construction-integration model.Psychological Review, 1988