Word repetition and retrieval practice effects in aphasia: Evidence for use-dependent learning in lexical access

ABSTRACT

This study tested the hypothesis that a use-dependent learning mechanism operates at each of two stages of lexical access: retrieval of a word from semantics (“Stage 1”), followed by retrieval of the word’s constituent phonemes (“Stage 2”). Two participants with aphasia were selected due to their contrasting types of naming impairment (Stage 1 versus Stage 2 difficulty). For each participant, items were assigned to naming training that involved retrieval practice (retrieval of the name from semantics) or repetition practice (hear the name and orally repeat it). Naming tests were administered one day and one week after training. The results supported the predicted training effects: (a) Because successful naming via retrieval practice requires both Stage 1 and Stage 2, this technique uses and strengthens item-specific connections in both stages. (b) Because word repetition circumvents semantically driven retrieval, this technique primarily uses and strengthens item-specific connections in Stage 2.

KEYWORDS:

• Aphasia
• retrieval practice
• errorless learning
• naming
• lexical access

Acknowledgements

The authors would like to acknowledge Mackenzie Stabile for assistance with data processing. The authors thank Brenda Rapp, two anonymous reviewers, Myrna Schwartz, Dan Mirman, and members of the Moss Rehabilitation Research Institute (MRRI) Language and Learning Lab for their feedback on this manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 Training began with the retrieval practice block in the first and third cycles of the study and with the repetition practice block in the second cycle. Post hoc logistic regression analyses did not indicate a significant effect of training order on naming accuracy at Test 1 (estimate = −0.34, SE = 0.21, p = .10) or at Test 2 (estimate = −0.31, SE = 0.20, p = .11).

Additional information

Funding

This work was supported by the National Institute on Deafness and Other Communication Disorders [award number R01 DC015516-01A1], [award number R03 DC012426]; the National Institutes of Health [award number T32 HD071844]; and Albert Einstein Society, Einstein Healthcare Network, Philadelphia, PA.