Name it again! investigating the effects of repeated naming attempts in aphasia

ABSTRACT

Background: In the context of therapy for word retrieval in aphasia, the person with aphasia is often required to attempt to name treated items on multiple occasions. However, there is limited information about the impact of these repeated attempts at naming in and of themselves.

Aim: The aim of this study was to examine if repeated attempts at naming, with no treatment or feedback, improve naming accuracy in people with aphasia.

Methods & Procedures: 23 participants with stroke aphasia named 50 pictures on seven occasions, approximately six weeks apart. No support, cues (written or spoken) or feedback on accuracy was provided at the time or between naming attempts. This was part of a larger study investigating two different types of therapy on different items.

Outcomes & Results: After excluding any potential influence from treatment of other items, four participants showed significant improvements in accuracy and two participants showed a worsening of accuracy for the stimuli that received repeated naming attempts (but were untreated). We found evidence that significant change in accuracy was predicted by the variability of naming accuracy between sessions, executive functioning skills (as measured by the Wisconsin Card Sorting Task), and picture naming ability (Nickels’ Naming Test).

Conclusions: We hypothesised that in the context of variability in naming accuracy, intact executive functioning may help monitor responses, such that only correctly named items are reinforced. Critically, without the ability to monitor responses without feedback, incorrect responses may be reinforced, leading to a worsening of performance. The fact that four individuals with aphasia showed improved naming accuracy by naming items once every six weeks is striking and suggests that further investigation of effects of repeated naming at closer intervals is warranted, as for some participants any advantage from a naming attempt may have decayed by the time of repetition.

KEYWORDS:

• Aphasia
• word retrieval
• naming
• repeated naming
• priming

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. Note that there are many studies where participants do attempt to name the picture, but written and/or spoken words or cues are also provided in the absence of feedback (e.g., Fillingham et al., 2005a; Off, Griffin, Spencer, & Rogers, 2016) or alternatively feedback on accuracy is provided (e.g., Wingfield, Brownell, & Hoyte, 2006).

2. Note that for the M-WCST, three participants could not complete (P13, P15 & P24). They were assigned the lowest score of 70. P1 required a lot of direction from the experimenter and therefore was removed from this analysis given their true score was unknown. If all four of these participants are removed, or if P1 is also assigned a score of 70, the same three factors remain significant.

3. Lambon Ralph and Fillingham (2007) note that in addition to reinforcing correct stimulus-response pairings, there may be an error-correcting mechanism that will adjust the representation (stimulus-response pairing) in such a way that the error will be less likely on the next occasion.

Additional information

Funding

This work was supported by the European Commission [2015-1603/001-001-EMJD (Framework Partnership Agreement)];National Institute for Health Research [PB-PG-0609-18074].