Analysing the language therapy process: The implicit role of learning and memory

Abstract

Background : Analysis of language recovery has focused primarily on the linguistic aspects of language therapy provided to people with aphasia. The preservation and influence of cognitive skills has been taken for granted, although factors such as memory, attention, and learning are fundamental to an understanding of the language rehabilitation process. Aims : The goals of this paper are to elucidate the ELA-syntax treatment protocol, which aims at ameliorating oral sentence production, and to demonstrate how significant gains in performance might be attributed to aspects of its structure and content, in particular, its use of verbal recall in the therapy procedure. Methods & Procedures : A qualitative analysis of the structure of a single ELA therapy session and data from a single-case study, TH, will be presented in support of the issues being addressed. Transcriptions of single therapy sessions from the beginning, middle, and end of the three protocols are analysed with particular emphasis on sentence recall. Outcomes & Results : From early on in language therapy, TH demonstrated a relatively good ability to recall, i.e., convey the content of the sentences worked on in therapy sessions. This performance contrasted with his poor initial spontaneous production of each sentence. TH's severe verb retrieval difficulties improved and the length of the sentences produced in therapy increased from an average of 5.25 to 10.0 words. A carryover to discourse and pragmatic-level tasks and to written sentence production is also observed. Conclusions : The use of “delay” and a form of personalised cueing appear to play a crucial role in facilitating the retrieval of information from memory for oral sentence production. Incorporating the task of recalling the content of a therapy session at the beginning of the next session and at the end of each session provides an immediate and repeated measure of a participant's learning abilities and his/her response to the ongoing therapy programme. It is postulated that this distinct feature of the treatment programme facilitates the use of language in everyday life.