Integrated Training for Aphasia: An Application ofPart–Whole Learning to Treat Lexical Retrieval, Sentence Production, and Discourse-Level Communications inThree Cases of Nonfluent Aphasia

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American Journal of Speech-Language Pathology



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The purpose of this study was to evaluate integrated training for aphasia (ITA), a multicomponent language-production treatment based on part–whole learning that systematically trains lexical retrieval, sentence production, and discourse-level communications. Specific research objectives were to evaluate acquisition of target structures, statistical parameters associated with learning variables, treatment generalization, and the efficacy of individual treatment components.


ITA was administered to 3 individuals with nonfluent aphasia following a multiple-baseline, across-behaviors design. Effect size and correlational coefficients were computed to assess acquisition, generalization, and maintenance of target structures. Standardized tests and a treatment efficacy questionnaire were also completed.


A significant treatment effect was found in 2 of the 3 participants. In addition, as is seen in normal skill acquisition, practice time and error rate were significantly correlated. All participants demonstrated evidence of generalization on standardized language measures. Only 1 participant improved, however, on the communication measures. Results of the treatment component analysis revealed significant differences in the perceived efficacy of individual therapy tasks.


Findings add to the evidence supporting multicomponent aphasia treatments, provide preliminary support for ITA and the application of a part–whole learning approach, and suggest that specific treatment components may contribute differentially to outcomes and generalization effects.

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