Errorless Learning Research Articles

Errorful and errorless learning in preschoolers: at what age does the errorful advantage appear?

Explicit memory has been tested extensively in young children. The results show that young children's explicit memory is weak and decays quickly but is in many ways similar to that of adults. However, most studies showed that young children's implicit memory is intact. This inconsistency has lead to a debate about the extent to which the memory of young children resembles that of healthy adults. When adults with impaired explicit memory and intact implicit memory are tested for semantic knowledge, they show better memory under errorless learning procedures. In contrast, healthy adults show better memory under errorful procedures. We tested these two procedures in 3- and 5-year-olds. 3-year-olds remembered less than 5-year-olds, but both groups showed similar errorful learning advantages, which persisted after 5 weeks. Our data show that while 3-year-old children's memory is weak, it is more similar to intact than to impaired explicit memory in adults.

The nuts and bolts of Cognitive Remediation: Exploring how different training components relate to cognitive and functional gains

BackgroundCognitive Remediation (CR) is an evidence based treatment targeting cognitive and functional difficulties in people with psychosis. Despite the large number of effectiveness studies, only limited evidence exists for the active ingredients of this therapy. This study begins to fill this gap by exploring the relationship between CR ingredients, including alliance with a therapist, and therapy outcomes. MethodThis is a secondary analysis based on data from a published randomised controlled trial comparing CR+treatment-as-usual (TAU) to TAU alone. We considered the association between CR active ingredients including errorless learning, massed practice, strategy use and therapeutic alliance on the cognitive, functioning and symptom outcomes that significantly improved following therapy. ResultsForty-six of the 96 participants were randomised to CR. After therapy the CR group showed significant improvement in non-verbal memory, functioning and approaching significance, improvements in executive functions. All therapy ingredients were inter-related but strategy use alone was associated therapeutic alliance. Cognitive improvements were associated with massed practice, number of useful strategies and therapeutic alliance, but improvements in functioning were associated only with therapeutic alliance. ConclusionsThese findings build the evidence base for the usefulness of specific therapy components. As for other psychological therapies it appears that therapeutic alliance may be an important factor in driving change for key CR outcomes, particularly functioning, in people with psychosis.

Designing Serious Computer Games for People With Moderate and Advanced Dementia: Interdisciplinary Theory-Driven Pilot Study.

BackgroundThe field of serious games for people with dementia (PwD) is mostly driven by game-design principals typically applied to games created by and for younger individuals. Little has been done developing serious games to help PwD maintain cognition and to support functionality.ObjectivesWe aimed to create a theory-based serious game for PwD, with input from a multi-disciplinary team familiar with aging, dementia, and gaming theory, as well as direct input from end users (the iterative process). Targeting enhanced self-efficacy in daily activities, the goal was to generate a game that is acceptable, accessible and engaging for PwD.MethodsThe theory-driven game development was based on the following learning theories: learning in context, errorless learning, building on capacities, and acknowledging biological changes—all with the aim to boost self-efficacy. The iterative participatory process was used for game screen development with input of 34 PwD and 14 healthy community dwelling older adults, aged over 65 years. Development of game screens was informed by the bio-psychological aging related disabilities (ie, motor, visual, and perception) as well as remaining neuropsychological capacities (ie, implicit memory) of PwD. At the conclusion of the iterative development process, a prototype game with 39 screens was used for a pilot study with 24 PwD and 14 healthy community dwelling older adults. The game was played twice weekly for 10 weeks.ResultsQuantitative analysis showed that the average speed of successful screen completion was significantly longer for PwD compared with healthy older adults. Both PwD and controls showed an equivalent linear increase in the speed for task completion with practice by the third session (P<.02). Most important, the rate of improved processing speed with practice was not statistically different between PwD and controls. This may imply that some form of learning occurred for PwD at a nonsignificantly different rate than for controls. Qualitative results indicate that PwD found the game engaging and fun. Healthy older adults found the game too easy. Increase in self-reported self-efficacy was documented with PwD only.ConclusionsOur study demonstrated that PwD’s speed improved with practice at the same rate as healthy older adults. This implies that when tasks are designed to match PwD’s abilities, learning ensues. In addition, this pilot study of a serious game, designed for PwD, was accessible, acceptable, and enjoyable for end users. Games designed based on learning theories and input of end users and a multi-disciplinary team familiar with dementia and aging may have the potential of maintaining capacity and improving functionality of PwD. A larger longer study is needed to confirm our findings and evaluate the use of these games in assessing cognitive status and functionality.

Improving Work Outcome in Supported Employment for Serious Mental Illness: Results From 2 Independent Studies of Errorless Learning.

Heterogeneity in work outcomes is common among individuals with serious mental illness (SMI). In 2 studies, we sought to examine the efficacy of adding errorless learning, a behavioral training intervention, to evidence-based supported employment to improve SMI work outcomes. Work behavior problems were targeted for intervention. We also explored associations between early work behavior and job tenure. For both studies (VA: n = 71; community mental health center: n = 91), randomization occurred at the time of job obtainment with participants randomized (1:1) to either errorless learning plus ongoing supported employment or ongoing supported employment alone and then followed for 12 months. Dependent variables included job tenure, work behavior, and hours worked and wages earned per week. For the primary intent-to-treat analyses, data were combined across studies. Findings revealed that participants in the errorless learning plus supported employment group stayed on their jobs significantly longer than those in the supported employment alone group (32.8 vs 25.6 wk). In addition, differential treatment effects favoring errorless learning were found on targeted work behavior problems (50.5% vs 27.4% improvement from baseline to follow-up assessment). There were no other differential treatment effects. For the prediction analyses involving work behavior, social skills explained an additional 18.3% of the variance in job tenure beyond levels of cognition, symptom severity, and past work history. These data support errorless learning as an adjunctive intervention to enhance supported employment outcomes and implicate the relevance of workplace social difficulties as a key impediment to prolonged job tenure.

COGNITIVE REHABILITATION OF INSTRUMENTAL ACTIVITES OF DAILY LIVING IN ALZHEIMER’S DISEASE: A CASE REPORT

In a previous randomized controlled trial (RCT), a cognitive rehabilitation program (CR) using errorless learning (EL) and spaced retrieval (SR) was efficient to relearn an instrumental activity of daily living (IADL) in patients with Alzheimer's disease (AD). However, CR did not improve quality of life (QoL). It was hypothesized that: 1) the improvement of only one IADL was insufficient to ameliorate QoL; 2) the measure of QoL wasn't sensitive enough, and 3) CR of IADLs might have greater impact on self-esteem and contentment than on QoL. To investigate the tolerability and preliminary effectiveness of CR to improve two IADL, self-esteem, contentment and QoL in AD. The participant was an 84-year old woman with mild AD. The participant received a CR program of two sessions/week during six weeks. Each session lasted 45–60 minutes and included repeated practices of an IADL using EL, SR, and a gradual reduction of level of assistance. The participant was trained for watching TV (IADL-1) and playing card games on her computer (IADL-2). CR was administered at weeks 1–3 (IADL-1) and at weeks 4–6 (IADL-2). The Direct Measure of Training was administered at baseline (BL), at the beginning of each training session, and at 1-week follow-up to assess the participant's ability to complete and maintain the task. IADL-1: At BL, the participant completed M= 55 % (7.07) of the task. After 54 practices realised over 6 sessions, the participant completed 100 % of the task. Ameliorations were maintained at 1-week (100 %) and 1-month follow-up (90 %). IADL-2: At BL, the participant completed M = 64 % (9.89) of the task. After 34 practices realised over 6 sessions, the participant completed 100 % of the task. Ameliorations were maintained at 1-week follow-up. For both IADLs, Percentage of Nonoverlapping Data (effect size) = 1. Self-esteem and contentment increased post-intervention, while QoL remained unchanged. The patient attended all sessions, and reported increased energy and activity.

SHORT-TERM REHABILITATION FOR LINGUISTIC IMPAIRMENTS IN PRIMARY PROGRESSIVE APHASIA: A CASE SERIES

Language rehabilitation has been a valid strategy in order to slow the progression of symptoms and to increase quality of life for patients with primary progressive aphasia (PPA). The objective is to report the results of intensive short-term treatment administered to a case series of patients with non-fluent PPA (PPA-NF), semantic PPA (PPA-S), logopenic PPA (PPA-L) and unclassified PPA (PPA- NC), focusing on sentence production, lexical retrieval and working memory. Thirteen patients (5 PPA-S, 3 PPA-NF, 3 PPA-L and 2 PPA-NC) were submitted to a standardized training either targetting naming deficits (PPA-S and PPA-NC), sentence production or production of multisyllabic words (PPA-NF) and naming deficits or working memory (PPA-L and PPA-NC), based on principles of errorless learning. Thirty-minute rehabilitation sessions were offered twice a week, with daily workouts at home. The trained items (pre and post-treatment) and untrained items (pre and post-treatment) were compared. Generalization to other language tasks and functional communication was also informed. Follow-up results are reported for three patients. The sample comprised 5 women and 8 men. Mean age was 65 years and mean schooling was 13.7 years. A significant improvement for treated items was seen for all patients. Nine patients also improved in untreated items. In addition, seven generalized for other tasks. Three patients were evaluated one month after the end of the treatment and demonstrated maintenance of treatment results. Even being a progressive syndrome, patients were able to relearn target vocabulary and strategies to improve sentence construction during the active phase of treatment. These preliminary results suggest that linguistic-based treatment strategies may constitute an effective approach in the clinical management of PPA patients.

A MULTIDOMAIN STRUCTURED COGNITIVE STIMULATION PROGRAMME FOR ASIAN PATIENTS WITH MILD DEMENTIA: THE OWOW! PROGRAMME

Non-pharmacological treatment has been shown to be beneficial in the maintenance of cognitive function. However, the usefulness and acceptance of such a programme for Asian patients has not been adequately studied. The OWOW! Cognitive stimulation programme was conceived by adapting a holistic approach in encompassing the physical, cognitive and social aspects of the wellbeing of a person with dementia. OWOW! Programme was structured as an eight week cognitive stimulation programme comprising of three hour long, once weekly sessions. Each session included the following components: physical exercise, cognitive stimulation activities, game segments that promote social interaction and relaxation exercises, as well as sessions for caregivers. The activities were planned based on the principle of errorless learning to enhance the participants’ confidence level. Care partners were briefed at every session on the activities of the programme and encouraged to engage their love ones with these activities at home. The sessions were rated by the participants using a ten points visual analogue scale. The scale items included aspects of emotional responses and satisfaction on the activities. A total of 24 participants were enrolled in the programme. Majority were females (67%) with mean age of 77.0 years (±7.07) and with 9.79 (±3.24) years of education. Mean baseline MMSE score for the group was 22 (±3.67). The satisfaction rating improved significantly across the sessions with higher scores at the end of session (1.15 vs 0.71; overall p<0.01). Participants rated their overall function to be improved and that their daily struggles to be better appreciated by their loved ones. The strategy that provided the highest satisfaction was the use of relaxation techniques employed within the sessions. The OWOW! Programme has been well received by persons with dementia and their loved ones. The outcome with regards to the participants’ physical, cognitive and social wellbeing has been encouraging. Plans are in the pipeline to further engage carers in the sessions so that they can be actively involved in maintaining optimal cognitive functioning levels of their loved ones.

Teaching visual conditional discriminations using errorless learning: The role of prompts requiring simple and conditional discriminative control

ABSTRACTErrorless learning procedures were first developed in Basic Research Laboratories with nonhuman subjects to teach simple (i.e., nonconditional) discriminations (SD). Today, errorless procedures are widely used for teaching both simple and conditional discriminations (CD), often to developmentally limited learners. The present article puts forward the idea that the stimulus control engendered by prompts in errorless learning procedures may also be classified as requiring simple versus conditional discriminative control. The present paper presents data comparing two errorless prompting procedures to teach visual CDs to six typically developing children and three children diagnosed with autism spectrum disorder (ASD). A matching-to-sample procedure with unfamiliar forms as visual stimuli was used. A comparison of two different prompts was conducted: prompts requiring SD control and prompts requiring conditional discriminative control. Results indicated that eight of nine participants acquired CDs in fewer trials when the prompts required conditional control; one child with ASD required fewer trials when prompts required simple discriminative control. Results suggest an advantage for teaching CDs using prompts requiring conditional discriminative control.

EEG Error Prediction as a Solution for Combining the Advantages of Retrieval Practice and Errorless Learning.

Given the frequency of naming errors in aphasia, a common aim of speech and language rehabilitation is the improvement of naming. Based on evidence of significant word recall improvements in patients with memory impairments, errorless learning methods have been successfully applied to naming therapy in aphasia; however, other evidence suggests that although errorless learning can lead to better performance during treatment sessions, retrieval practice may be the key to lasting improvements. Task performance may vary with brain state (e.g., level of arousal, degree of task focus), and changes in brain state can be detected using EEG. With the ultimate goal of designing a system that monitors patient brain state in real time during therapy, we sought to determine whether errors could be predicted using spectral features obtained from an analysis of EEG. Thus, this study aimed to investigate the use of individual EEG responses to predict error production in aphasia. Eight participants with aphasia each completed 900 object-naming trials across three sessions while EEG was recorded and response accuracy scored for each trial. Analysis of the EEG response for seven of the eight participants showed significant correlations between EEG features and response accuracy (correct vs. incorrect) and error correction (correct, self-corrected, incorrect). Furthermore, upon combining the training data for the first two sessions, the model generalized to predict accuracy for performance in the third session for seven participants when accuracy was used as a predictor, and for five participants when error correction category was used as a predictor. With such ability to predict errors during therapy, it may be possible to use this information to intervene with errorless learning strategies only when necessary, thereby allowing patients to benefit from both the high within-session success of errorless learning as well as the longer-term improvements associated with retrieval practice.

Structured relearning of activities of daily living in dementia: the randomized controlled REDALI-DEM trial on errorless learning

BackgroundErrorless learning (EL) is a method for optimizing learning, which uses feed-forward instructions in order to prevent people from making mistakes during the learning process. The majority of previous studies on EL taught patients with dementia artificial tasks of little or no relevance for their daily lives. Furthermore, only a few controlled studies on EL have so far been performed and just a handful of studies have examined the long-term effects of EL. Tasks were not always trained in the patients’ natural or home environment, limiting the external validity of these studies. This multicenter parallel randomized controlled trial examines the effects of EL compared with trial and error learning (TEL) on the performance of activities of daily living in persons with Alzheimer’s or mixed-type dementia living at home.MethodsPatients received nine 1-hour task training sessions over eight weeks using EL or TEL. Task performance was measured using video observations at week 16. Secondary outcome measures were task performance measured at week 26, satisfaction with treatment, need for assistance, challenging behavior, adverse events, resource utilization and treatment costs.ResultsA total of 161 participants were randomized, of whom 71 completed the EL and 74 the TEL arm at week 11. Sixty-nine EL patients and 71 TEL patients were assessed at the 16-week follow-up (the primary measurement endpoint). Intention-to-treat analysis showed a significantly improved task performance in both groups. No significant differences between the treatment groups were found for primary or secondary outcomes.ConclusionsStructured relearning improved the performance of activities of daily living. Improvements were maintained for 6 months. EL had no additional effect over TEL.Trial registrationGerman Register of Clinical Trials DRKS00003117. Registered 31 May 2011.

Should we change targets and methods of early intervention in autism, in favor of a strengths-based education?

Early intensive behavioral intervention (EIBI) and its recent variant, naturalist developmental behavioral intervention (NDBI) aim to increase socialization and communication, and to decrease repetitive and challenging behaviors in preschool age autistic children. These behaviorist techniques are based on the precocity and intensity of the intervention, face-to-face interaction, errorless learning, and information fragmentation. Once considered to be “scientifically proven”, the efficacy of these approaches has been called into question in the last decade due to poor-quality data, small effects, low cost-efficiency, and the evolution of ethical and societal standards. Grounded on a reappraisal of the genetic and cognitive neuroscience of autism, we question three aspects of EIBI/NDBI: their focus on prerequisites for typical socio-communicative behaviors, their lack of consideration of autistic language development and learning modes, and their negative view of repetitive behaviors and restricted interests. We propose alternative predictions for empirical validation, based on the strengths of prototypical autistic children: (a) their non-verbal intelligence should be normally distributed and within the normal range; (b) improving access to non-communicative verbal and written auditory language material should favor their subsequent speech development and (c) decrease their problematic behavior; (d) lateral tutorship should increase the well-being of children and parents to a greater extent than personalized, face-to-face interventions by professionals; (e) admission to regular, but supervised daycare centers, combined with parental support and on-site crisis solving, represents a more cost-effective educational intervention than EIBI/NDBI.

Retrieval Practice Principles: A Theory of Learning for Naming Rehabilitation

Event Abstract Back to Event Retrieval Practice Principles: A Theory of Learning for Naming Rehabilitation Erica Middleton1* 1 Moss Rehabilitation Research Institute, United States This presentation reviews progress towards development of a theory of learning for naming impairment in aphasia that is based on powerful learning principles derived from basic psychological research (i.e., retrieval practice or RP principles): (a) retrieving information from long-term memory (i.e., retrieval practice) strengthens the future accessibility of that information, especially when retrieval is effortful (for reviews, see [1-2]); (b) learning is superior when repeated training opportunities for an item are spaced over time as opposed to massed (for reviews, see [3-4]). The standard paradigm in the psychological literature for delineating how retrieval practice impacts learning begins with initial familiarization of the to-be-learned (i.e., target) information. Familiarization is followed by a training phase in which the information is either presented again in its entirety for further study opportunities (restudy), or tests are administered in which participants attempt to retrieve the target information from long-term memory (i.e., retrieval practice). A retrieval practice effect is demonstrated when performance on a later test is greater following retrieval practice training compared to restudy training. The spacing effect refers to superior performance on a later test following spaced versus massed practice schedules. In spaced schedules, an item’s training trials are separated by enough time or intervening material to exceed the limits of short-term memory, in contrast to massed trials in which the item remains accessible in short-term memory. The current studies explore the applicability of the RP principles for treating lexical access deficits in chronic aphasia, or difficulty reliably and fluently retrieving known words for production as manifest in picture naming. The studies seek to explicate the relevance of the RP principles for treating affected vocabulary, (i.e., the focus is on item-specific treatment effects). Each study employs a within-subjects design where items that elicit naming error for a participant are matched into different training conditions. The effects of training are measured on retention tests of naming administered in later sessions. In two initial studies [5-6], naming treatment that emphasized retrieval practice (i.e., confrontation naming) conferred superior retention test performance compared to errorless learning naming treatment. In errorless learning, the name is provided and the PWA repeats the name for the object (i.e., word repetition task), a procedure that eliminates errors during treatment but also bypasses retrieval practice. Also, retention test performance was superior when multiple training trials for an item were presented in a spaced versus a massed schedule [6]. In these studies [5-6], items were only trained in one session and retention tests were administered at 1-day and 1-week following training. A third study examined whether retrieval practice and spacing principles apply when items are trained in dosages more representative of clinical practice (i.e., in multiple sessions). In that study, a retrieval practice effect and spacing effect were found after 1-week, with the retrieval practice effect persisting after 1-month. The presentation concludes with preliminary findings suggesting that the potency of retrieval practice versus errorless learning varies as a function of the locus (i.e., lexical-semantic versus phonological) of naming impairment.

Effects of a Cooking Program Based on Brain-activating Rehabilitation for Elderly Residents with Dementia in a Roken Facility: A Randomized Controlled Trial.

Rehabilitation for dementia is important in Roken Geriatric Health Service Facilities in Japan. This study evaluated the effects of a cooking program as rehabilitation for elderly residents with dementia. We carried out a 12-week cooking program based on the five principles of brain-activating rehabilitation (BAR): fostering a pleasant atmosphere, interactive communication, establishing social roles, giving and receiving praise, and errorless learning. The program was carried out in small groups and consisted of 90-min classes once a week. Participants were 36 elderly residents with dementia (mean 85.4 ± 6.5 years) who were randomly divided into intervention (n = 18) and control (n = 18) groups. The control group participated in recreation and both groups received individual conventional rehabilitation twice a week for 30 min. The effects of intervention were evaluated using nine outcome measures. A total of 29 participants were included in the analysis (two-way analysis of variance). The attendance rate was 86.6% in the intervention group (n = 13). The Yamaguchi Kanji Symbol Substitution Test (executive function) showed significant interaction (F(1, 27) = 4.305, P = 0.048) between the two groups: the control group (n = 16) showed significant deterioration (pre 4.9 ± 5.6 to post 3.0 ± 4.9; P = 0.032). The dementia behavior disturbance scale also showed significant interaction (F(1, 29) = 13.298, P = 0.001): the intervention group (n = 16) showed significant improvement (pre 21.6 ± 12.2 to post 11.4 ± 11.5; P < 0.001). No significant differences were observed in the other outcome measures. Our findings suggest that a cooking program based on BAR can reduce the behavioral and psychological symptoms of dementia and maintain executive function.

When is the test effect most effective in aphasia rehabilitation?

When is the test effect most effective in aphasia rehabilitation?

Interaction between motor ability and skill learning in children: Application of implicit and explicit approaches

The benefits of implicit and explicit motor learning approaches in young adults have been studied extensively, but much less in children. This study investigated the relationship between fundamental motor ability and implicit/explicit learning in children using the errorless learning paradigm. First, the motor ability of 261 children (142 boys, 119 girls) aged 9–12 years (M = 9.74, SD = 0.67) was measured. Second, children with motor ability scores in the upper and lower quartile learned a golf-putting skill in either an errorless (implicit) or errorful (explicit) learning condition. Four groups were formed: Errorless High-Ability (n = 13), Errorless Low-Ability (n = 11), Errorful High-Ability (n = 10), and Errorful Low-Ability (n = 11). Learning consisted of 300 practice trials, while testing included a 50-trial retention test, followed by a 50-trial secondary task transfer test, and another 50-trial retention test. The results showed that for high- and low-ability errorless learners, motor performance was unaffected by the secondary task, as was the case for high-ability errorful learners. Low-ability errorful learners performed worse with a secondary task and were significantly poorer than the corresponding high-ability group. These results suggest that implicit motor learning (errorless) may be beneficial for children with low motor ability. The findings also show a trend that children of high motor ability might benefit from learning explicitly (errorful). Further research is recommended to examine the compatibility of implicit and explicit approaches for children of different abilities.

From Rehab to Recess

From Rehab to Recess

Towards a Theory of Learning for Naming Rehabilitation: Retrieval Practice and Spacing Effects.

The purpose of this article was to examine how different types of learning experiences affect naming impairment in aphasia. In 4 people with aphasia with naming impairment, we compared the benefits of naming treatment that emphasized retrieval practice (practice retrieving target names from long-term memory) with errorless learning (repetition training, which preempts retrieval practice) according to different schedules of learning. The design was within subjects. Items were administered for multiple training trials for retrieval practice or repetition in a spaced schedule (an item's trials were separated by multiple unrelated trials) or massed schedule (1 trial intervened between an item's trials). In the spaced condition, we studied 3 magnitudes of spacing to evaluate the impact of effortful retrieval during training on the ultimate benefits conferred by retrieval practice naming treatment. The primary outcome was performance on a retention test of naming after 1 day, with a follow-up test after 1 week. Group analyses revealed that retrieval practice outperformed errorless learning, and spaced learning outperformed massed learning at retention test and at follow-up. Increases in spacing in the retrieval practice condition yielded more robust learning of retrieved information. This study delineates the importance of retrieval practice and spacing for treating naming impairment in aphasia.

The benefits of errorless learning for people with amnestic mild cognitive impairment

ABSTRACTThe aim of this study was to explore whether errorless learning leads to better outcomes than errorful learning in people with amnestic mild cognitive impairment (MCI), and to examine whether accuracy in error recognition relates to any observed benefit of errorless over errorful learning. Nineteen participants with a clinical diagnosis of amnestic MCI were recruited. A word-list learning task was used and learning was assessed by free recall, cued recall and recognition tasks. Errorless learning was significantly superior to errorful learning for both free recall and cued recall. The benefits of errorless learning were less marked in participants with better error recognition ability. Errorless learning methods are likely to prove more effective than errorful methods for those people with MCI whose ability to monitor and detect their own errors is impaired.

Interrater Reliability and Concurrent Validity of a New Rating Scale to Assess the Performance of Everyday Life Tasks in Dementia: The Core Elements Method.

Errorless learning (EL) is an instructional procedure involving error reduction during learning. Errorless learning is mostly examined by counting correctly executed task steps or by rating them using a Task Performance Scale (TPS). Here, we explore the validity and reliability of a new assessment procedure, the core elements method (CEM), which rates essential building blocks of activities rather than individual steps. Task performance was assessed in 35 patients with Alzheimer's dementia recruited from the Relearning methods on Daily Living task performance of persons with Dementia (REDALI-DEM) study using TPS and CEM independently. Results showed excellent interrater reliabilities for both measure methods (CEM: intraclass coefficient [ICC] = .85; TPS: ICC = .97). Also, both methods showed a high agreement (CEM: mean of measurement difference [MD] = -3.44, standard deviation [SD] = 14.72; TPS: MD = -0.41, SD = 7.89) and correlated highly (>.75). Based on these results, TPS and CEM are both valid for assessing task performance. However, since TPS is more complicated and time consuming, CEM may be the preferred method for future research projects.

Behavioural and neuroimaging changes after naming therapy for semantic variant primary progressive aphasia

The objectives of this study were to examine the effects of a successful naming intervention on naming performance and brain activity in individuals with the semantic variant of primary progressive aphasia (svPPA). Four participants with svPPA were scanned while performing phonologically- and semantically-based tasks before and after an intense, 20-h naming therapy that followed the principles of errorless learning whereby errors were eliminated from the learning process. Five healthy control participants were scanned at the outset of the study and did not receive treatment. The results showed that in svPPA participants, successful re-learning of forgotten vocabulary was accompanied by activation of a larger network in bilateral brain regions and that the level of activation in the left anterior lobe may be inversely correlated with severity of semantic impairment. Our findings have implications for treatment in svPPA patients and suggest that semantic cues can improve naming, in spite of significant semantic impairment. The results indicate that intensive language therapy can lead to behavioural gains and neuroplastic changes even in individuals with more advanced anterior temporal lobe atrophy.