Computerised training for impairments of word comprehension and retrieval in aphasia

Background: Semantic comprehension training paired with verbal production leads to improved word retrieval in individuals with aphasia. Few studies have also examined effects of such training for word comprehension. MossTalk Words includes a training module to provide semantic comprehension training via computerised exercises. Variations in the treatment schedule may influence the impact of word retrieval and comprehension treatment gains. Aims: The purpose of this study was to investigate the effects of the Multi-Mode Matching Exercises module of MossTalk Words for improving word comprehension and retrieval in individuals with aphasia. Effects of training were contrasted for two treatment schedules. Methods & Procedures: Five individuals with word retrieval impairments associated with aphasia participated. Two had word comprehension difficulties suggesting semantic anomia, and three others with intact comprehension had impairments suggesting phonologic anomia. In a single-participant design, we investigated effects of training provided via computer with MossTalk multi-mode matching exercises (spoken and written word/picture matching) paired with spoken rehearsal. All participated in two phases of training administered 1-2 times/week and 3-4 times/week, with order of phases counterbalanced across participants. Outcomes & Results: Improvements in word/picture yes/no verification for trained and some untrained words associated with large effect sizes (d > 2.5) were evident in one of two participants when trained 1-2 times/week. Increases in picture naming associated with large effect sizes for trained words were noted in 515 participants when trained 4-5 times/week, and in 2/5 participants when trained 1-2 times/week. Increases in picture naming for untrained words were evident in 2/5 participants in the more frequent training schedule. At I month post training, picture naming performance remained above baseline levels, with little difference evident between sets trained with the two different training schedules. Conclusions: Computerised lexical training exercises may lead to increases in word comprehension and production, particularly for the target words trained. More frequent training leads to greater improvements during acquisition than less frequent training, but that advantage diminishes at 1 month post treatment, suggesting that a less frequent training schedule may be just as useful as more frequent training for promoting long-term effects of lexical training.