Production and integrated training of adjectives in three individuals with nonfluent aphasia

Background: Current research in theoretical linguistics, experimental psychology, and clinical aphasiology suggests that adjective training may facilitate unique aspects of language production and functional communication in persons with aphasia. Although considerable research has been devoted to treatments targeting nouns and verbs, there has been relatively little treatment research directed towards adjectives. Aims: The goal of this study was to further investigate the viability of adjective training in aphasia by applying an integrated treatment approach targeting adjective production in the context of single word, sentence, and discourse levels of communication. Specific objectives were to quantify baseline adjective production, acquisition of target structures, and treatment generalisation effects. Method: A single-participant multiple-baseline design was used to evaluate treatment effects in three individuals with nonfluent chronic aphasia. A battery of experimental measures and standardised tests was also administered pre- and post-treatment to assess baseline performance and generalisation effects extending to adjectives, other parts of speech, sentence processing, and discourse production. Outcomes & Results: Two of the three participants acquired the target structures and maintained criterion performance levels 1 month after treatment. In spite of differences in baseline performance and responsiveness to treatment, all three participants demonstrated significant gains on standardised measures of language production. Conclusions: Findings add to existing literature supporting the viability of adjective training for individuals with aphasia. Participant characteristics and treatment factors that may contribute to variable outcomes are also discussed.