Verb Network Strengthening Treatment Research Articles

Telerehabilitation with Verb Network Strengthening Treatment (VNeST) in two participants with mild-to-moderate and moderate-to-severe aphasia: A single-case experimental design study

ABSTRACT Background Verb Network Strengthening Treatment (VNeST) is a verb-centred aphasia treatment that targets the semantic relationships between a verb (e.g., dig) and related content words (e.g., gardener, hole), aiming to promote word retrieval and sentence production in aphasia. Previous research shows promising results of VNeST in several participants. Aims This study investigates the effects of VNeST through telerehabilitation on word retrieval and sentence production with treated and semantically related untreated verbs, as well as the possible generalisation to confrontation naming and connected speech. Further, functional communication, communicative participation, health-related quality of life and client satisfaction are explored. Methods and Procedures A single-case experimental design study with multiple baselines was conducted with two participants with stroke-induced mild-to-moderate Broca’s aphasia or moderate-to-severe Wernicke’s aphasia who received VNeST through telerehabilitation. Percentage of non-overlapping data, Baseline Corrected Tau and d-index effect size were used to measure improvement in word retrieval and sentence production elicited through video-clip stimuli. The study is registered with ClinicTrials.gov, number NCT05152979. Outcomes and Results The participant with Wernicke’s aphasia improved in word retrieval in sentences with trained and untrained verbs and showed some – albeit limited – generalisation to confrontation naming of nouns and verbs. The participant with Broca’s aphasia withdrew after half of the planned dosage, as he did not consider VNeST suitable for his needs. He did not improve in word retrieval or sentence production. Conclusions VNeST shows promise when it comes to improving word retrieval in trained and semantically related untrained stimuli in moderate-to-severe Wernicke’s aphasia. This study adds to the existing literature by showing potential improvement in VNeST through telerehabilitation.

Effects of Verb Network Strengthening Treatment (VNeST) using Telepractice on Word Retrieval in Korean-Speakers with Non-Fluent Aphasia

Objectives: Verb Network Strengthening Treatment (VNeST) is a semantic treatment that aims to improve lexical retrieval across a hierarchy of linguistic contexts, including sentences and discourse. So, the purpose of this study was to investigate the effects of VNeST using telepractice on Korean individuals with moderate to severe non-fluent aphasia and examine the advantages of telepractice treatment. Methods: Three Korean individuals with aphasia caused by a single lesion in the left hemisphere participated in this study. They received VNeST via ZOOM in real time at their home. VNeST protocol consisted of 6 steps: step 1, generate three agents and themes for the target verb; step 2, read each scenario aloud; step 3, choose the appropriate case marker and answer three wh-questions about agent-theme pairs; step 4, judge semantic plausibility of sentences; step 5, confront naming on animation target verb task; step 6, repeat the prompts of Step 1 without cues. Multiple-baseline design across behaviors was employed, and effect sizes of the treatment were obtained. Results: The results of this study are as follows: 1) all participants showes large effect sizes, 2) all participants showed a generalization effect, 3) the CIU rate of all participants improved, 4) all participants showed increased score or performance on language assessment task, 5) all participants and their careers responded that they were very satisfied with the telepractice treatment. Conclusion: The current study suggest that VNeST via telepractice is effective as off-line treatment in promoting generalization from single word naming in person with moderate to severe non-fluent aphasia.

Cross-language Generalization in Bilingual Aphasia: Influence of Manner of Second Language Acquisition

ABSTRACT Background Language treatment for bilinguals with aphasia has been shown to result in gains in both the treated language and the untreated language (i.e., cross-language generalization). However, cross-language generalization is not consistently found. This inconsistency may be due to several factors, such as the age of acquisition of, and proficiency in, each language. One often-overlooked factor that may influence whether cross-language generalization occurs is the manner in which bilinguals learned their second language (L2): in a formal educational context (explicitly) or naturalistically through exposure to the language (implicitly). Prior research suggests that implicit L2 learning results in greater overlap in the representation of the first language (L1) and L2 in the brain, particularly for grammar, compared to explicit learning. In contrast, lexical processing in L1 and L2 is proposed to rely more on shared brain regions regardless of the manner of L2 acquisition. Greater overlap should provide a greater likelihood of cross-language generalization effects from treatment. Aims The goal of this study was to determine how the manner of acquisition of L2 may affect cross-language generalization following treatment in L2 separately targeting the lexicon (object naming) and grammar (sentence construction). Methods & Procedures Two Spanish-English bilinguals with aphasia each completed two treatment phases in English of 2-4 weeks each, in succession, with one week between them: semantic feature analysis (SFA) targeting object naming, and Verb Network Strengthening Treatment (VNeST) targeting verb retrieval and sentence construction. Pre- and post-treatment assessments and weekly probes were completed for each phase. Participant P1 learned English explicitly in an educational setting, while participant P2 learned English implicitly. Outcomes & Results As predicted, P2 showed cross-language generalization after verb/grammar treatment (VNeST) whereas P1 did not. However, contrary to the prediction that both participants should show cross-language generalization after noun treatment (SFA), only P1 showed cross-language generalization of object naming. Conclusions Cross-language generalization was observed for both participants but for different aspects of language. The findings suggest that naturalistic second language learning may lead to stronger links between languages in the grammatical system, whereas formal second language learning may lead to stronger links between languages in the lexical-semantic system. Future research should further explore the effects of manner of acquisition as a predictor of language co-activation and cross-language treatment generalization in bilinguals with aphasia.

Quantifying aphasia treatment: The effect of aphasia severity on treatment dose

ABSTRACT Background Treatment dose in aphasia therapy is typically measured by the overall number of treatment hours together with the distribution of treatment sessions over time. However, in order to provide accurate information on treatment dose, it is also necessary to identify and report the active components of any given intervention (Baker, 2012b; Cherney, 2012). Aims In this study, the relationship between treatment hours (overall and average per week), post-stroke language abilities, and treatment dose was examined in multilingual people with aphasia. The effect of treatment dose of a targeted linguistic process (relevant SVO sentence production) on treatment outcomes related to that linguistic process was also analysed. Methods and procedures Four multilingual people with aphasia received Verb Network Strengthening Treatment in either their L1, or both their L1 and a later-acquired language. The number of times the VNeST protocol was completed (i.e., number of verb cycles) per treatment block was compared to (a) treatment hours and post-stroke language abilities, and (b) treatment outcomes of tasks related to relevant SVO sentence production. Outcomes and results With a relatively similar number of treatment hours, a measure of post-stroke language abilities was a good predictor of the number of verb cycles completed during treatment. Furthermore, a higher number of verb cycles completed during treatment indicated more potential for within-language generalisation of relevant SVO sentence production. Conclusions Identifying the active component(s) of a given treatment and reporting this information together with post-stroke language abilities and treatment hours will provide more accurate information regarding treatment dose than is currently standardly reported. This information is crucial to a better understanding of the mechanisms of aphasia recovery.

Transcranial Direct Current Stimulation Paired With Verb Network Strengthening Treatment Improves Verb Naming in Primary Progressive Aphasia: A Case Series.

There are few evidence-based treatments for language deficits in primary progressive aphasia (PPA). PPA treatments are often adopted from the poststroke aphasia literature. The poststroke aphasia literature has shown promising results using Verb Network Strengthening Treatment (VNeST), a behavioral therapy that focuses on improving naming by producing verbs and their arguments in phrases and sentences. Emerging research in poststroke aphasia and PPA has shown promising results pairing behavioral language therapy with transcranial direct current stimulation (tDCS). This study used a double-blind, within-subjects, sham-controlled crossover design to study the effect of anodal tDCS applied to left inferior frontal gyrus (IFG) plus VNeST versus VNeST plus sham stimulation in two individuals with nonfluent variant PPA and one individual with logopenic variant PPA. Participants received two phases of treatment, each with 15 1-hr sessions of VNeST. One phase paired VNeST with tDCS stimulation, and one with sham. For each phase, language testing was conducted at baseline, and at 1 week and 8 weeks posttreatment conclusion. For each participant, treatment efficacy was evaluated for each treatment phase by comparing the mean change in accuracy between baseline and the follow-up time points for naming trained verbs (primary outcome measure), untrained verbs, and nouns on the Object and Action Naming Battery. Mean change from baseline was also directly compared between tDCS and sham phases at each time point. Results revealed a different pattern of outcomes for each of the participants. A tDCS advantage was not found for trained verbs for any participant. Two participants with nonfluent variant PPA had a tDCS advantage for generalization to naming of untrained verbs, which was apparent at 1 week and 8 weeks posttreatment. One participant with nonfluent variant also showed evidence of generalization to sentence production in the tDCS phase. VNeST plus anodal tDCS stimulation of left IFG shows promising results for improving naming in PPA.

Word Retrieval Treatments in Aphasia: A Survey of Professional Practice

ABSTRACT Background Researchers have identified many assessment and treatment options for word retrieval impairments in individuals with aphasia. The extent to which these options are used in clinical practice is not well understood. Aims We surveyed speech-language pathologists to better understand their use and familiarity with word retrieval assessment and treatment approaches for individuals with aphasia. Methods & Procedures We developed a brief survey examining 12 assessment and 14 treatment approaches used in clinical practice for aphasic word retrieval impairments. An anonymous survey link was disseminated to speech-language pathologists. Outcomes & Results The experienced pool of 81 respondents report they commonly address word retrieval impairments. In assessment they primarily employ standardized aphasia and naming tests (e.g., Boston Naming Test; Kaplan et al., 2001). Many also use informal naming tools to supplement standardized testing. Three treatment approaches were used by the majority of respondents. Two approaches incorporate single word picture naming, cueing hierarchies and Semantic Feature Analysis, and a third fosters word retrieval in sentences, Verb Network Strengthening Treatment. Conclusions While word retrieval impairments are commonly addressed in clinical practice, further implementation science work is needed to examine clinical use of the many empirically-supported word retrieval assessment and treatment methods, including how their fidelity is maintained to foster positive outcomes across clinical settings.

Transcranial Direct-Current Stimulation as an Adjunct to Verb Network Strengthening Treatment in Post-stroke Chronic Aphasia: A Double-Blinded Randomized Feasibility Study

BackgroundDifficulties in discourse production are common in post-stroke chronic aphasia. Previous studies have found that speech and language therapy combined with transcranial direct-current stimulation (tDCS) may improve language skills like naming and enhance aphasia treatment outcomes. However, very few studies have investigated the effect of tDCS when combined with interventions for improving higher level language skills such as the Verb Network Strengthening Treatment (VNeST).AimsThis study aimed to determine the feasibility of anodal tDCS as an adjunct to VNeST to improve discourse production in post-stroke chronic aphasia.MethodsSix people with post-stroke chronic aphasia took part in this double-blinded randomized feasibility study. Participants were randomly allocated to either the experimental group receiving a 6-week block of once weekly VNeST sessions combined with active tDCS over the left inferior frontal gyrus (LIFG) or a control group that received VNeST with sham stimulation. Feasibility outcomes included screening, eligibility, retention, and completion rates, and adverse events. Preliminary response to intervention was also examined using discourse production, functional communication, quality of life, psychological state, and cognition outcomes.ResultsOverall 19 individuals were screened and ten met the inclusion criteria. Six individuals provided consent and participated in the study giving a consent rate of 60%. Participant retention and completion rates were 100% and no adverse effects were reported. Exploratory analyses revealed promising changes (i.e., estimated large effect size) in discourse production measures across discourse language tasks and functional communication for the active tDCS group.ConclusionsOur results support the feasibility of tDCS as an adjunct to VNeST. Preliminary findings provide motivation for future large-scale studies to better understand the potential of tDCS as a safe and economical tool for enhancing rehabilitation in chronic aphasia.

Preserving lexical retrieval skills across languages in a bilingual person with logopenic primary progressive aphasia

ABSTRACT Background The treatment of lexical retrieval in monolingual people with the logopenic variant of primary progressive aphasia (lvPPA) has been observed to preserve or improve skills to varying degrees. There is a paucity of treatment literature for multilingual people with PPA (across all types), although based on the stroke-induced aphasia literature we would expect treatment to be effective in the treated language and potentially the untreated language too. Aims We investigated the effects of a verb-based semantic treatment administered in a later-acquired language to an English-Hebrew speaker with lvPPA on her lexical retrieval skills in different language tasks in both the treated and untreated languages. Methods & Procedures Language skills across different tasks were assessed pre- and post-treatment, with Verb Network Strengthening Treatment (VNeST) provided in Hebrew. We evaluated whether decline continued for lexical retrieval (as observed in the years leading up to the study), and in which language(s). Outcomes & Results We observed that lexical retrieval skills in both languages did not decline for word production, sentence production, and written narratives, but did continue to decline during oral narrative production. Conclusions Our results indicate that VNeST may be an effective prophylactic treatment for the preservation of lexical retrieval skills in both a treated and untreated language of multilingual people with the logopenic variant of PPA.

A Systematically Conducted Scoping Review of the Evidence and Fidelity of Treatments for Verb and Sentence Deficits in Aphasia: Sentence Treatments.

This review article synthesizes and evaluates the evidence for sentence production treatments in aphasia, systematically charting impairment-based and functional communication outcomes. It reports (a) the level of evidence and fidelity of sentence treatments; (b) the impact of treatment on production of trained and untrained verbs and sentences, functional communication, and discourse; and (c) the potential active ingredients of treatment. The search included studies from January 1980 to June 2019. The level of evidence of each study was documented, as was fidelity in terms of treatment delivery, enactment, and receipt. Studies were also categorized according to treatment methods used. Thirty-three studies were accepted into the review and predominantly constituted Level 4 evidence (e.g., case control studies and case series). Thirty studies (90%) described treatment in sufficient detail to allow replication, but dosage was poorly reported, and fidelity of treatment was rarely assessed. The most commonly reported treatment techniques were mapping (10 studies: 30%), predicate argument structure treatment (six studies: 18%), and verb network strengthening treatment (five studies: 15%). Production of trained sentences improved for 83% of participants, and improvements generalized to untrained sentences for 59% of participants. Functional communication was rarely assessed, but discourse production improved for 70% of participants. The evidence for sentence treatments is predominantly generated from Level 4 studies. Treatments were effective for the majority of participants regarding trained sentence and discourse production. However, there is inconsistent use of statistical analysis to verify improvements, and diverse outcome measures are used, which makes interpretation of the evidence difficult. The quality of sentence treatment research would be improved by agreeing a core set of outcome measures and extended by ascertaining the views of participants on sentence treatments.

Combination of Verb Network Strengthening Treatment with TMS and tDCS: Preliminary results

Non-invasive brain stimulation (NIBS) techniques combined with behavioral speech/language therapies have recently been suggested as a promising method for language recovery in people with aphasia (PWA). Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are currently the most common types of NIBS for aphasia rehabilitation. In this study, we combined either rTMS or tDCS with a behavioral therapy approach, Verb Network Strengthening Treatment (VNeST), that has neither been used before in a Russian-speaking post-stroke population nor combined with any type of NIBS. In a case series study, we demonstrate the results of two groups of participants: 1) 4 PWA who received one daily session of VNeST preceded by 20-minutes of rTMS for 8 – 12 days; and 2) 4 PWA who received 2 sessions of VNeST a day, with the first 20 minutes of the first daily session combined with tDCS, for 10 days. We assessed the accuracy of action naming and sentence production and found a significant improvement in sentence production in the tDCS + VNeST group, while the other group did not show a significant improvement in these tasks. Interestingly, we found a correlation between improvement in sentence production and the number of sessions regardless of the stimulation type and another correlation between improvement in action naming and initial aphasia severity. This study is a first attempt to apply the combination of these techniques in Russian. Our preliminary findings prompt larger-scale research to study the potential of this method.

Effects of Verb Network Strengthening Treatment on Sound-Level and Speech Production Errors in Individuals With Aphasia and Acquired Apraxia of Speech.

Purpose This retrospective pilot study investigated whether sound-level and speech production errors decreased in confrontation naming following Verb Network Strengthening Treatment (VNeST) for four participants with acquired apraxia of speech (A-AOS) and aphasia for whom lexical retrieval was previously reported. Specifically, we investigated a potential increase in correct number of syllables per word and posttreatment changes across three domains of speech: segmental production, fluency, and prosody. It was hypothesized that treatment shown to increase lexical retrieval in persons with aphasia and A-AOS could potentially facilitate a reduction in sound-level and speech production errors consistent with dual diagnoses of A-AOS and aphasia. Method Naming responses from four participants with aphasia and A-AOS who previously participated in VNeST studies were investigated for correct number of syllables per word and measures of segmental speech, fluency, and prosody. Results Significant gains in at least one measure of speech production were reported for three of the participants. One participant demonstrated decreased segmental speech errors, two showed significant reduction on syllable segmentation, and two demonstrated a significant reduction on false starts and pauses. Significant gains in production of correct number of syllables were limited to one participant, and one participant did not demonstrate increased accuracy on any measure of speech production. Conclusions While speech production errors consistent with motor speech impairment cannot always be definitively distinguished from the confound of aphasia, two participants produced significantly decreased segmentation of syllables, a characteristic unique to A-AOS. The sound-level and speech production changes recorded may be attributed to a combination of interacting motor and language processes and resource allocation. In addition, specific components of VNeST may have contributed to speech production changes. Future work will focus on a prospective study of effects of language therapy (e.g., VNeST) on measures of speech production with investigation beyond the single-word level.

Measuring treatment outcome in severe Wernicke’s aphasia

ABSTRACT Background Chronic severe Wernicke’s aphasia has a poor prognosis and is challenging to treat. Furthermore, even when there is potential for improvement, formal assessments using accuracy scores only to measure changes in language abilities after treatment may not be sensitive enough to capture improvements. Less-constrained language tasks, such as discourse analysis, may be more sensitive to measuring change than more standard constrained tasks, such as confrontation naming and picture-based sentence construction. Aims In this study, we asked whether it is possible to rehabilitate language abilities in a participant with severe Wernicke’s aphasia using a verb-based sentence-level treatment (Verb Network Strengthening Treatment – VNeST) that has been successful for moderate Wernicke’s aphasia, as well as other types of moderate to severe aphasia. Furthermore, we investigated whether using less-constrained language tasks would be more, less or equally sensitive to measuring any treatment effects than more-constrained language tasks. Methods and procedures In this case study, we compared post-treatment language abilities to pre-treatment language abilities by analysing comprehension and production at the word, sentence and discourse levels, using both quantitative analyses (e.g., accuracy scores) and qualitative analyses (e.g., error analyses). Outcomes and results We found that discourse analysis was sensitive enough to identify improvements in quality of production concomitant with an overall reduction of output. Furthermore, in certain more-constrained tasks, a reduction in the production of neologistic jargon was observed, as well as stable comprehension requiring less repetition of stimuli, indicating improvement that was not captured by accuracy scores. Conclusions People with chronic severe Wernicke’s aphasia may improve after treatment but formal assessments are not always sensitive enough to identify these improvements. Speech-language therapists are encouraged to include discourse analysis in their assessments as well as the analysis of more formal assessments qualitatively as well as quantitatively.

Effect of Mandarin Verb Network Strengthening Treatment (VNeST) in Mandarin-English bilinguals with aphasia: A single-case experimental design

ABSTRACT This study aimed to improve verb retrieval ability in Mandarin-English bilinguals with aphasia by adapting the Verb Network Strengthening Treatment (VNeST) into Mandarin Chinese. Two Mandarin-English bilingual patients with chronic post-stroke aphasia participated in this study via online conferencing system following a multiple-baseline design. Both of them completed a 10-week of Mandarin VNeST treatment, and were probed on verb retrieval ability in a sentence context in both languages. Response accuracy was analysed to investigate the treatment acquisition, within-language generalization, and cross-language generalization effects. Standardized language assessments in both languages were administered pre- and post-treatment to further examine generalization to other linguistic tasks. Error analysis was conducted to investigate the evolution of within- and cross-language errors. Both patients improved after training in Mandarin VNeST, and showed different patterns of within-language and cross-language generalizations. They also improved in a variety of standardized language tasks. Error analysis showed a decline in semantic errors over the course of treatment in both patients, with cross-linguistic errors showing a decrease during Mandarin probes and an increase during English probes in one of the patients. This study contributes to our current understanding of theories of bilingual verb processing, and provides treatment guidance in Mandarin-English bilinguals with aphasia.

Treatment Fidelity Procedures for an Aphasia Intervention Within a Randomized Controlled Trial: Design, Feasibility, and Results

Purpose This study reports on the treatment fidelity procedures implemented during a 5-year randomized controlled trial comparing intensive and distributed comprehensive aphasia therapy. Specifically, the results of 1 treatment, verb network strengthening treatment (VNeST), are examined. Method Eight participants were recruited for each of 7 consecutive cohorts for a total of 56 participants. Participants completed 60 hr of aphasia therapy, including 15 hr of VNeST. Two experienced speech-language pathologists delivered the treatment. To promote treatment fidelity, the study team developed a detailed manual of procedures and fidelity checklists, completed role plays to standardize treatment administration, and video-recorded all treatment sessions for review. To assess protocol adherence during treatment delivery, trained research assistants not involved in the treatment reviewed video recordings of a subset of randomly selected VNeST treatment sessions and completed the fidelity checklists. This process was completed for 32 participants representing 2 early cohorts and 2 later cohorts, which allowed for measurement of protocol adherence over time. Percent accuracy of protocol adherence was calculated across clinicians, cohorts, and study condition (intensive vs. distributed therapy). Results The fidelity procedures were sufficient to promote and verify a high level of adherence to the treatment protocol across clinicians, cohorts, and study condition. Conclusion Treatment fidelity strategies and monitoring are feasible when incorporated into the study design. Treatment fidelity monitoring should be completed at regular intervals during the course of a study to ensure that high levels of protocol adherence are maintained over time and across conditions.

Effect of Chinese Verb Network Strengthening Treatment in Mandarin-English Bilinguals with Aphasia

Effect of Chinese Verb Network Strengthening Treatment in Mandarin-English Bilinguals with Aphasia

Delivering word retrieval therapies for people with aphasia in a virtual communication environment

ABSTRACTBackground: Delivering therapy remotely, via digital technology, can enhance provision for people with aphasia. EVA Park is a multi-user virtual island that can be used for such delivery. The first EVA Park study showed that daily language stimulation delivered via the platform improved functional communication and was positively received by users. This paper reports two single case studies, evaluating its capacity to deliver targeted language interventions. The first employed therapy for noun retrieval, using cued picture naming and modified Sematic Feature Analysis. The second employed modified Verb Network Strengthening Treatment (VNeST).Aims: This study aimed to determine if treatment delivery was feasible in EVA Park, as assessed by participant compliance, treatment fidelity and participants’ views. It explored the impact of the therapies on treated and untreated word production, connected speech and functional communication.Methods & Procedures: Two participants with aphasia each received 20 sessions of individual therapy in EVA Park, delivered over 5 weeks. Feasibility was assessed by measuring compliance with the therapy regime, recording and checking the fidelity of 20% of treatment sessions, and using post-therapy interviews to explore participant views. Treatment outcomes were evaluated via repeated measures single case designs, in which assessments were administered twice before therapy, immediately post therapy and 5 weeks later. Outcome measures included Object Picture Naming (study 1), Sentence Elicitation Pictures (study 2), Naming 84 items from the Object and Action Naming Battery (study 2), Narrative Production (Study 2), the Northwestern Assessment of Verb and Sentences: Argument Structure Production Test (Study 2) and Communication Activities of Daily Living – 2 (Study 1 and 2).Outcomes & Results: Feasibility results were excellent. Both participants were fully compliant with the therapy regime. There was at least 90% fidelity with the treatment protocols, and participant views were positive. Outcomes varied across the studies. The noun therapy significantly improved the naming of treated words, with good maintenance. Lexical gains were less evident on the Sentence Elicitation Pictures used in the VNeST study. Neither study demonstrated generalisation to untreated words, connected speech or functional communication.Conclusions: Two treatment approaches, designed for face-to-face delivery, could be delivered remotely in EVA Park. Outcomes for the noun treatment were comparable to previous evaluations. Comparisons with previous research were more challenging for VNeST, owing to differences in methodology. Further evaluations of other treatment approaches are warranted.

A Comparison of Two Treatment Approaches for Agrammatic Broca's Aphasia: Script Therapy vs. Verb Network Strengthening Treatment

A Comparison of Two Treatment Approaches for Agrammatic Broca's Aphasia: Script Therapy vs. Verb Network Strengthening Treatment

Combining Aerobic Exercise and Speech Language Treatment for Aphasia Rehabilitation: A Case Study

Combining Aerobic Exercise and Speech Language Treatment for Aphasia Rehabilitation: A Case Study

The effect of multimodality (spoken and written) Verb Network Strengthening Treatment (VNeST) on spoken and written outcomes for three people with distinct clinical presentations of aphasia

The effect of multimodality (spoken and written) Verb Network Strengthening Treatment (VNeST) on spoken and written outcomes for three people with distinct clinical presentations of aphasia

Within- and cross- language generalization after Verb Network Strengthening Treatment (VNeST) in a Hebrew-English bilingual with aphasia

Within- and cross- language generalization after Verb Network Strengthening Treatment (VNeST) in a Hebrew-English bilingual with aphasia