Translation and Clinical Implementation of a Test of Language and Short-term Memory (STM) in Aphasia

NIH RePORTER · NIH · R01 · $596,719 · view on reporter.nih.gov ↗

Abstract

Aphasia is an acquired impairment of language abilities resulting from damage to the left hemisphere from stroke, head trauma or other neurological conditions. It can affect any aspect of spoken and/or written language processing and can range from mild to severe. As language provides us with a unique form of communication, aphasia can have profound adverse effects on one's quality of life. Although aphasia is more common in older populations, it can occur at any age, and many people with aphasia want to find ways to return to their premorbid lifestyles, including active careers, to the extent that this is possible. Clearly, there is a need for effective clinical tools to diagnose and treat aphasia, but a third factor makes the possibility of meeting this need a reality: More than 30 years of rehabilitation research provides strong evidence that even in chronic stages of aphasia, behavioral interventions lead to improved language function and changes in neural activity of cortical areas known to support language. This project aims to translate a theory-driven and empirically supported diagnostic battery for aphasia (Temple Assessment of Language and Short-term memory in Aphasia, TALSA) to a clinically feasible test battery that can be used for screening or in-depth measures of a language impairment. Importantly, the TALSA is based on a theoretical model of language that incorporates a role of verbal short-term memory (STM) in language processing. Language and verbal STM impairments commonly co-occur in aphasia, and this model attributes that co-occurrence to a common impairment of processes that support access and retrieval of words: weak activation and/or the inability to maintain activation of linguistic representations during word processing. This level of diagnosis is needed to guide impairment-based treatment approaches that directly stimulate access and retrieval processes. The TALSA is unique in that it includes language tests that add memory load and processing time, variables which are sensitive to these processing impairments. The research version of the TALSA is administered on a computer but is lengthy and not practical in a clinical setting. Our aim is to develop a computerized adaptive test version for clinical use. This project will use a Milestone based approach to develop this innovative clinical tool. In the first two years, we will develop the clinical version using focus groups and item response theory to identify the best items and subtests to use in the clinical version of this test (Milestone 1). Goals to meet Milestone 2 will include (1) assessment of participating clinicians' views of current and best practices in aphasia rehabilitation and (2) training participating clinicians on the concepts behind the TALSA, as well as specifics about its administration and interpretation. Milestone 3 will involve implementation of the clinical version in the clinical settings and assessment of clinicians' responses to its usefulness ...

Key facts

NIH application ID
10055960
Project number
5R01DC016094-04
Recipient
TEMPLE UNIV OF THE COMMONWEALTH
Principal Investigator
Nadine Martin
Activity code
R01
Funding institute
NIH
Fiscal year
2021
Award amount
$596,719
Award type
5
Project period
2017-12-15 → 2022-11-30