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Evaluation of the Effects of Response Elaboration Training for Aphasia

Primary Purpose

Aphasia, Language Disorders, Speech Disorders

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Response Elaboration Training
Sponsored by
US Department of Veterans Affairs
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Aphasia focused on measuring Aphasia, Language Therapy, Rehabilitation of speech and language disorders, Speech-language pathology

Eligibility Criteria

21 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria: Diagnosis of moderate to severe nonfluent or fluent aphasia Nonverbal intelligence within normal limits Auditory and visual acuity adequate for experimental tasks 6 months post-onset of single, focal brain injury (e.g., stroke) Exclusion Criteria: Previous history of therapy with RET Diagnosed psychological disorder other than depression Neurological condition other than that which resulted in aphasia History of alcohol or substance abuse Non-native English speaker Premorbid history of speech/language disorder

Sites / Locations

  • VA Salt Lake City Health Care System, Salt Lake City

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Arm 1

Arm Description

Single subject design - participant receives three administrations of the same treatment

Outcomes

Primary Outcome Measures

verbal production of meaningful content words in connected speech
Participants were asked to describe pictured scenes and to provide a monologue on a topic of their choice. Their speech/language was audio recorded during these tasks and recordings were transcribed by project speech/language pathologists. Counts of content words were made.

Secondary Outcome Measures

Full Information

First Posted
July 27, 2005
Last Updated
April 4, 2014
Sponsor
US Department of Veterans Affairs
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1. Study Identification

Unique Protocol Identification Number
NCT00125216
Brief Title
Evaluation of the Effects of Response Elaboration Training for Aphasia
Official Title
Evaluation of the Effects of Response Elaboration Training for Aphasia
Study Type
Interventional

2. Study Status

Record Verification Date
April 2014
Overall Recruitment Status
Completed
Study Start Date
December 2004 (undefined)
Primary Completion Date
December 2007 (Actual)
Study Completion Date
December 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
US Department of Veterans Affairs

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to evaluate the effects of Response Elaboration Training (RET), which is a speech/language therapy for aphasia. The study is designed to determine whether verbal language production improves in terms of content and length of utterances as a result of treatment.
Detailed Description
Detailed Description: Extended description of the protocol, including information not already contained in other fields, such as comparison(s) studied. Example: Sudden out-of-hospital cardiac arrest (OOH-CA) remains a significant cause of death, in spite of recent declines in overall mortality from cardiovascular disease. Existing methods of emergency resuscitation are inadequate due to time delays inherent in the transport of a trained responder with defibrillation capabilities to the side of the OOH-CA victim. Existing Emergency Medical Services (EMS) systems typically combine paramedic Emergency Medical Technician (EMT) services with some level of community involvement, such as bystander cardiopulmonary resuscitation (CPR) training. Some communities include automated external defibrillators (AEDs) at isolated sites or in mobile police or fire vehicles. A comprehensive, integrated community approach to treatment with AEDs would have community units served by these volunteer non-medical responders who can quickly identify and treat a patient with OOH-CA. Such an approach is termed Public Access Defibrillation (PAD). Comparison(s): Community units trained and equipped to provide public access defibrillation in addition to optimal standard care, compared to community units trained to provide optimal standard care (recognition of out-of-hospital cardiac arrest, 911 access, and cardiopulmonary resuscitation). The purpose of the proposed research is to thoroughly evaluate the effects of Response Elaboration Training (RET) with persons with aphasia. Specifically, the proposed research investigation is designed to delineate the outcomes that may be expected with RET. The study is also designed to improve outcomes in the area of stimulus generalization effects of treatment by testing a modification of RET designed to facilitate generalization. The specific experimental questions to be addressed are as follows: Will RET result in increased production of correct information units and increased length and changes in composition of utterances as measured in *trained and untrained picture descriptions; *story retells; *conversations with significant others/family members/friends; and *personal recounts? Will modification and extension of RET to additional training contexts result in further increases in production of CIUs and increased length and complexity of utterances? Will the effects* of RET vary among participants with fluent aphasia, participants with nonfluent aphasia who present with mild to moderate verbal production deficits, and participants with nonfluent aphasia who present with severe verbal production deficits? * Effects = effects on production of CIUs and on measures of functional communication Will changes in measures of functional communication be observed following administration of RET? A series of single-subject experimental designs across subjects, behaviors, and contexts will be conducted to address these questions. Twenty-four adults with chronic, moderate to severe aphasia secondary to unilateral, left-hemisphere brain-injury will serve as participants for this investigation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Aphasia, Language Disorders, Speech Disorders
Keywords
Aphasia, Language Therapy, Rehabilitation of speech and language disorders, Speech-language pathology

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
47 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1
Arm Type
Other
Arm Description
Single subject design - participant receives three administrations of the same treatment
Intervention Type
Behavioral
Intervention Name(s)
Response Elaboration Training
Intervention Description
Therapist modeling, reinforcement and forward-chaining are used to stimulate verbal descriptions of pictures
Primary Outcome Measure Information:
Title
verbal production of meaningful content words in connected speech
Description
Participants were asked to describe pictured scenes and to provide a monologue on a topic of their choice. Their speech/language was audio recorded during these tasks and recordings were transcribed by project speech/language pathologists. Counts of content words were made.
Time Frame
3 and 6 weeks following completion of treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Diagnosis of moderate to severe nonfluent or fluent aphasia Nonverbal intelligence within normal limits Auditory and visual acuity adequate for experimental tasks 6 months post-onset of single, focal brain injury (e.g., stroke) Exclusion Criteria: Previous history of therapy with RET Diagnosed psychological disorder other than depression Neurological condition other than that which resulted in aphasia History of alcohol or substance abuse Non-native English speaker Premorbid history of speech/language disorder
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Julie L. Wambaugh, PhD
Organizational Affiliation
VA Salt Lake City Health Care System, Salt Lake City
Official's Role
Principal Investigator
Facility Information:
Facility Name
VA Salt Lake City Health Care System, Salt Lake City
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84148
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
23695913
Citation
Wambaugh JL, Nessler C, Wright S. Modified response elaboration training: application to procedural discourse and personal recounts. Am J Speech Lang Pathol. 2013 May;22(2):S409-25. doi: 10.1044/1058-0360(2013/12-0063).
Results Reference
result

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Evaluation of the Effects of Response Elaboration Training for Aphasia

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