Attentive Reading with Constrained Summarization-Written, a multi-modality discourse-level treatment for mild aphasia

Abstract

ABSTRACT Background: Attentive Reading with Constrained Summarization-Written (ARCS-W) is a treatment in development that was adapted to improve written and spoken discourse in people with mild aphasia by targeting the cognitive requirements of discourse production. The current research represents the second report of ARCS-W and aimed to refine the protocol and replicate previous results. Aims: Determine if and to what extent ARCS-W affects the following abilities at post-treatment and one-month post-treatment:1. Micro and macrolinguistic written discourse abilities.2. Micro and macrolinguistic spoken discourse abilities.3. Other measures of language, including confrontation naming (spoken and written), sentence production and functional communication. Methods & Procedures: ARCS-W was administered to two participants with mild aphasia in a pre- to post-treatment design. Treatment required attentive reading followed by constrained summarization of novel news articles in the written and spoken modalities. Constraints were: use specific words, use complete sentences, stay on topic. Treatment outcomes evaluated micro (correct information units, complete utterances, grammatically complex utterances) and macrolinguistic (main events and main ideas, global coherence) discourse structure, confrontation naming, sentence production, and functional communication. Outcomes & Results: Both participants demonstrated improvement in untrained discourse at micro and macro levels. Participant 1 improved lexical specificity in confrontation naming and the proportion of main events and main ideas conveyed in discourse, and Participant 2 improved topic maintenance and lexical retrieval in discourse. Conclusions: There are few treatments for people with mild aphasia that work at a discourse level and these findings provide further evidence that ARCS-W may be a treatment option to improve written and spoken discourse in this population.