# Retrieval Practice Principles: A Theory of Learning for Aphasia Rehabilitaion

> **NIH NIH R01** · THOMAS JEFFERSON UNIVERSITY · 2024 · $617,179

## Abstract

Aphasia is an impairment that affects the production or comprehension of spoken, written, or gestured speech.
Effective prioritization and optimization of available treatment methods for people with aphasia (PWA)
requires an understanding of how the damaged system responds to different kinds of learning experiences, i.e.,
a theory of learning. This proposal continues development of a theory of learning for aphasia rehabilitation
based on retrieval practice (RP) principles, powerful learning principles derived from basic psychological
research. This renewal submission builds on the following findings concerning the treatment of the debilitating
and pervasive word retrieval deficit in aphasia: (a) retrieval practice-based naming treatment, in which the
PWA attempts to name an object followed by feedback, confers greater benefit to later naming of the same
items compared to errorless learning, in which the name is provided for the object and repeated by the PWA;
(b) correct retrievals during retrieval practice confer greater improvement compared to failed retrievals; (c)
greater spacing between an item’s trials confers greater improvement. Products of a basic phase of research,
these observations were derived from study designs involving the administration of a fixed number of trials per
item, regardless of the mastery achieved during training. This renewal submission takes important next steps
to broaden the clinical relevance of the RP theory by examining a retrieval practice-based naming treatment
termed criterion learning. In criterion learning, each item’s assigned criterion level dictates the number of
times that item is correctly retrieved before it is dropped from further training within a session. Criterion
learning optimally incorporates the most potent elements of the RP theory thus far—spaced retrieval practice
with emphasis on correct retrievals during training. By examining scheduling and dosing parameters, and
feasibility of at-home delivery, the present studies will provide critical observations for optimizing criterion
learning for treating word processing deficits in people with aphasia. Study 1 will identify the optimal
combination of criterion level and number of training sessions for efficiently attaining naming mastery of
functional, personally-relevant vocabulary for PWA with word retrieval deficit. Using a multiple-case, within-
participant, multiple baseline design, Study 2 will measure early efficacy and use of the optimal dosage-
schedule combination for mastery of functional vocabulary identified in Study 1. The two modules of treatment
in Study 2 will involve in-lab practice and unsupervised at-home practice. Brain imaging acquisition will
permit individual differences explorations in response to treatment. Study 3 will examine whether practicing
items in semantically related groups enhances naming treatment benefit in a multiple-session training regimen
using criterion learning. Study 4 will investigate whether naming t...

## Key facts

- **NIH application ID:** 10864011
- **Project number:** 5R01DC015516-07
- **Recipient organization:** THOMAS JEFFERSON UNIVERSITY
- **Principal Investigator:** Erica Lee Middleton
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $617,179
- **Award type:** 5
- **Project period:** 2017-04-01 → 2028-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10864011

## Citation

> US National Institutes of Health, RePORTER application 10864011, Retrieval Practice Principles: A Theory of Learning for Aphasia Rehabilitaion (5R01DC015516-07). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10864011. Licensed CC0.

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