The Roles of Retrieval Practice Versus Errorless Learning in Strengthening Lexical Access in Aphasia Purpose The purpose of this study was to determine how 2 methods known to improve naming impairment in aphasia (i.e., retrieval practice and errorless learning) affect lexical access. We hypothesized that instances of naming during retrieval practice use and strengthen item-specific connections in each of 2 stages of lexical access: ... Research Article
Research Article  |   July 13, 2018
The Roles of Retrieval Practice Versus Errorless Learning in Strengthening Lexical Access in Aphasia
 
Author Affiliations & Notes
  • Julia Schuchard
    Moss Rehabilitation Research Institute, Elkins Park, PA
  • Erica L. Middleton
    Moss Rehabilitation Research Institute, Elkins Park, PA
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Julia Schuchard: jrschuchard@gmail.com
  • Editor-in-Chief: Sean Redmond
    Editor-in-Chief: Sean Redmond×
  • Editor: Charles Ellis
    Editor: Charles Ellis×
Article Information
Normal Language Processing / Language Disorders / Aphasia / Attention, Memory & Executive Functions / Speech, Voice & Prosody / Language / Research Articles
Research Article   |   July 13, 2018
The Roles of Retrieval Practice Versus Errorless Learning in Strengthening Lexical Access in Aphasia
Journal of Speech, Language, and Hearing Research, July 2018, Vol. 61, 1700-1717. doi:10.1044/2018_JSLHR-L-17-0352
History: Received September 17, 2017 , Revised January 31, 2018 , Accepted March 15, 2018
 
Journal of Speech, Language, and Hearing Research, July 2018, Vol. 61, 1700-1717. doi:10.1044/2018_JSLHR-L-17-0352
History: Received September 17, 2017; Revised January 31, 2018; Accepted March 15, 2018

Purpose The purpose of this study was to determine how 2 methods known to improve naming impairment in aphasia (i.e., retrieval practice and errorless learning) affect lexical access. We hypothesized that instances of naming during retrieval practice use and strengthen item-specific connections in each of 2 stages of lexical access: Stage 1, meaning-to-word connections, and Stage 2, word-to-phonology connections. In contrast, errorless learning prioritizes opportunities for repeating words, which we expect to primarily strengthen item-specific connections in Stage 2 because repetition circumvents the need for semantically driven word retrieval.

Method We tested the outcomes of retrieval practice versus errorless learning training for items that were selected because the naming errors they elicited suggested weakened connections at Stage 1 or at Stage 2 of lexical access for each of 10 individuals with chronic aphasia. Each participant's Stage 1 items and Stage 2 items were divided evenly between the 2 training conditions. Naming tests were administered 1 day and 1 week after training to assess retention of training gains. We also examined whether the participants' pretraining naming error profiles were associated with the relative efficacy of retrieval practice versus errorless learning.

Results The posttraining naming tests showed an advantage of retrieval practice over errorless learning for Stage 1 items and an advantage of errorless learning over retrieval practice for Stage 2 items. In addition, greater percentages of phonological error naming responses prior to training were associated with greater posttraining accuracy in the errorless learning condition relative to the retrieval practice condition.

Conclusions The findings suggest that the advantage of retrieval practice for naming impairment in aphasia largely results from greater strengthening of practiced semantic–lexical connections compared with errorless learning, which prioritizes repetition and, therefore, mainly confers strengthening of practiced lexical–phonological connections. Understanding how specific training conditions improve naming can help predict the relative efficacy of each method for individuals with aphasia.

Acknowledgments
This work was supported by the National Institutes of Health under Award Numbers R01 DC015516-01A1 (awarded to Erica Middleton), R03 DC012426 (Erica Middleton), and T32 HD071844 (John Whyte) and by the Albert Einstein Society, Einstein Healthcare Network, Philadelphia, PA, under Research Grant 17-06 (Julia Schuchard). The authors would like to acknowledge Mackenzie Stabile and Taylor Echevarria for assistance in data processing.
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