SLPOtherAphasiology2017

Implicit learning and implicit treatment outcomes in individuals with aphasia.

Julia Schuchard, Michaela Nerantzini, Cynthia K Thompson

PMID 28603329

WHAT IT FOUND

Repeated passive sentence exposure did not improve comprehension in people with agrammatic aphasia, even though many learned a hidden button-press pattern without being told it existed.

This training alone did not help.

Key findings

01During the initial implicit treatment protocol, two participants increased and three participants decreased in overall passive sentence comprehension, and effect sizes did not surpass 6.0 except for passive sentences with untrained verbs for P3.

02During the revised implicit treatment protocol, visual inspection showed no clear changes in passive sentence comprehension, and effect sizes did not surpass 6.0.

03Participants with aphasia showed slower reaction times when the hidden sequence was replaced by random trials, and 7 of 9 participants with aphasia showed this increase.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The treatment experiments included only 5 and 4 participants with aphasia, so they cannot establish whether the approach works for a larger group. The learning experiment included 9 participants with aphasia and 21 neurologically intact adults, and the aphasia group was smaller. Baseline sentence comprehension testing was administered only 2 to 4 times, and some participants showed variable baseline performance. The study trained only passive sentences over five sessions, so it does not address other sentence structures or longer treatment. Implicit learning was assessed with only one nonverbal button-press task, so it may not capture learning relevant to language. Because the implicit treatment did not improve comprehension, the researchers could not test whether implicit learning ability predicted treatment response.

The easy way to misread this

Do not conclude that learning a hidden nonverbal pattern predicts success with exposure-only language treatment. The participants showed implicit sequence learning on the button task, but the implicit passive sentence training did not improve comprehension.

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