Acquisition and Maintenance of Scripts in Aphasia: A Comparison of Two Cuing Conditions

Abstract

Purpose This study was designed to compare acquisition and maintenance of scripts under two conditions: high cue, which provided numerous multimodality cues designed to minimize errors, and low cue, which provided minimal cues. Method In a randomized controlled crossover study, eight individuals with chronic aphasia received intensive computer-based script training under two cuing conditions. Each condition lasted 3 weeks, with a 3-week washout period. Trained and untrained scripts were probed for accuracy and rate at baseline, during treatment, immediately posttreatment, and at 3 and 6 weeks posttreatment. Significance testing was conducted on gain scores, and effect sizes were calculated. Results Training resulted in significant gains in script acquisition with maintenance of skills at 3 and 6 weeks posttreatment. Differences between cuing conditions were not significant. When severity of aphasia was considered, there also were no significant differences between conditions, although magnitude of change was greater in the high-cue condition versus the low-cue condition for those with more severe aphasia. Conclusions Both cuing conditions were effective in acquisition and maintenance of scripts. The high-cue condition may be advantageous for those with more severe aphasia. Findings support the clinical use of script training and the importance of considering aphasia severity.