Video implemented script training in a Spanish-English bilingual patient with aphasia : a case study
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Purpose: This study examines the utility of a script-based treatment protocol for improving speech production and fluency in a Spanish-English bilingual individual with non-fluent aphasia (RC). Method: In this single-subject multiple-baseline intervention study, a video implemented script training treatment (VISTA) was designed to facilitate fluent and intelligible speech through training with a visual and auditory speech model. Scripts were rehearsed via synchronized spoken production in daily homework. Treatment sessions with the clinician targeted memorization and conversational usage. Scripts were topics of interest to the participant, tailored for speech rate and level of difficulty based on the participant’s habitual rate of speech and motor and linguistic profile. One script in each language contained a high proportion of cross-linguistic cognates to observe potential differences in cross-linguistic generalization. Primary and secondary outcome measures for trained and untrained scripts were percent correct and intelligible scripted words, performance on targets with varying cognate status, errors by word class, total number of grammatical errors, and total percent intelligibility. Results: RC showed significant improvement in intelligibility and accuracy of trained scripts and a reduction in grammatical errors after treatment. Results revealed that Spanish-trained scripts yielded a larger effect size relative to English-trained scripts. In addition, Spanish-trained scripts displayed a greater degree of unidirectional cross-linguistic generalization to English. Scripts that contained a high proportion of cognates yielded minimal effect sizes relative to non-cognate dense scripts, and in fact dampened cross-linguistic generalization. Conclusion: Video implemented script training is a viable treatment method for Spanish-English individuals with non-fluent aphasia for improving speech production and fluency. This study also provides evidence that cross-linguistic transfer can be diminished when incorporating tasks with a high proportion of cognates. Future studies should take into account the cognitive-linguistic profile of participants when considering treatment options.