Treatment and Generalization of Complex Sentence Production in Agrammatism The present study applies single-subject experimental design to examine (a) the acquisition and generalization of complex sentence production in agrammatism using Linguistic Specific Treatment (LST) and (b) the utility of syntactic theory in guiding hypotheses of treatment effects. LST trains construction and production of complex sentence structures. Four sentence types ... Research Article
Research Article  |   June 1999
Treatment and Generalization of Complex Sentence Production in Agrammatism
 
Author Affiliations & Notes
  • Kirrie J. Ballard
    Department of Communication Sciences and Disorders Aphasia Research Laboratory Northwestern University Evanston, IL
  • Cynthia K. Thompson
    Department of Communication Sciences and Disorders Aphasia Research Laboratory Northwestern University Evanston, IL
    Department of Neurology Cognitive Neurology and the Alzheimer's Center Northwestern University Evanston, IL
  • Contact author: Kirrie J. Ballard, PhD, Department of Speech Pathology and Audiology, University of Iowa, Iowa City, IA 52242.
    Contact author: Kirrie J. Ballard, PhD, Department of Speech Pathology and Audiology, University of Iowa, Iowa City, IA 52242.×
  • Corresponding author: e-mail: kirrie-ballard@uiowa.edu
Article Information
Development / Language Disorders / Aphasia / Speech, Voice & Prosody / Language / Research Articles
Research Article   |   June 1999
Treatment and Generalization of Complex Sentence Production in Agrammatism
Journal of Speech, Language, and Hearing Research, June 1999, Vol. 42, 690-707. doi:10.1044/jslhr.4203.690
History: Received July 1, 1988 , Accepted October 26, 1998
 
Journal of Speech, Language, and Hearing Research, June 1999, Vol. 42, 690-707. doi:10.1044/jslhr.4203.690
History: Received July 1, 1988; Accepted October 26, 1998

The present study applies single-subject experimental design to examine (a) the acquisition and generalization of complex sentence production in agrammatism using Linguistic Specific Treatment (LST) and (b) the utility of syntactic theory in guiding hypotheses of treatment effects. LST trains construction and production of complex sentence structures. Four sentence types were selected for study: object clefts and object-extracted matrix and embedded questions (which are noncanonical with wh-movement), and embedded actives (which are canonical with no overt movement). All sentences contain overt material in the complementizer phrase (CP) of the syntactic tree. Three of five participants (1, 2, and 3) demonstrated generalization from object cleft treatment to production of matrix questions. Thus, LST was effective in improving their ability to generate less complex sentences with wh-movement. Once production of object clefts and matrix questions was acquired, all 5 participants demonstrated generalization from treatment to improved production of embedded questions and/or embedded actives. This generalization involved improved ability to generate embedded clausal structure to form complex sentences but continuing inability to express overt material in CP. Finally, direct treatment for embedded questions did not result in accurate production of embedded actives or vice versa. There were no trends across participants toward improved production of morphosyntactic behaviors in narrative. Persons 1, 2, and 3 showed generalization to increased informativeness and efficiency of expression and were judged by independent listeners to improve in content, coherence, and fluency of spontaneous production. The remaining two participants showed no change or a decline in performance in narrative language production (4 and 5, respectively). These participants demonstrated more severe Broca's aphasia at pretesting compared to Persons 1, 2, and 3, with greater impairments in auditory comprehension, naming, and reading. Etiology and size of lesion did not appear to account for the different behavioral patterns. This study supports the use of LST, which applies syntactic theory to predict patterns of generalization, as an effective treatment approach.

Acknowledgments
This research was supported by a Northwestern University Dissertation Grant awarded to K. J. Ballard and by the National Institutes of Health Grant RO1 DC01948 awarded to C. K. Thompson. The authors wish to thank Bill Ballard, Shari Baum, Lewis Shapiro, Robert Wertz, and an anonymous reviewer for their helpful comments on an earlier draft of this paper. We also thank the participants and Beverly Jacobs, Dena Janko, Mikyong Kim, Swathi Kiran, Karla McGregor, Amy Natho, Maureen Stemmelen, and Mary Tait for assistance with data collection and reliability measures.
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