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

> **NIH NIH R01** · ALBERT EINSTEIN HEALTHCARE NETWORK · 2020 · $478,683

## Abstract

With over 1 million sufferers today, aphasia is a prevalent impairment after left-hemisphere stroke that
affects the production or comprehension of spoken, written, or gestured speech. We contend, as have others,
that effective prioritization and optimization of available treatment methods for aphasia requires an
understanding of how the damaged system responds to different kinds of learning experiences, i.e., a theory
of learning. This proposal is dedicated to furthering development of a theory of learning for aphasia
rehabilitation based on powerful learning principles derived from basic psychological research (i.e., retrieval
practice or RP principles). Our prior research provided an empirical foundation for the RP theory of learning
by demonstrating its relevance for the treatment of naming impairment, a ubiquitous symptom experienced by
people with aphasia (PWA) involving difficulty reliably naming common, everyday objects. In our prior work,
we showed that treatment that provides `retrieval practice' (practice retrieving names for objects from long-
term memory) conferred greater persistent benefit than a popular form of naming treatment that does not
involve retrieval practice (errorless learning). In confirmation of a relate `spacing' principle, we also found
treatment benefits were enhanced when repeated training trials for an item were spaced over time, as opposed
to massed together. In this foundational work, we studied a relatively homogeneous group of PWA in that
naming was the sole or primary area affected. In the current proposal we take important next steps to articulate
the broader clinical and theoretical significance of our learning theory by studying how the RP principles
impact naming impairment in aphasia more generally (Study 1); examining the principles' relevance for
treating word comprehension deficits (i.e., problems reliably accessing the meanings of familiar words) in
aphasia (Studies 1 & 2); and, by developing a theoretical account of how the RP principles impact word
retrieval processes in production (Studies 3-5). Study 1 will examine how the RP principles impact naming
impairment and the transfer of benefit from naming treatment to word comprehension performance in a
heterogeneous and well-characterized sample of PWA. In individual differences analyses, we will examine
variability in response to the principles as a function of breakdown in primary components of word processing
and cognition, thereby providing benchmarks for how best to prioritize the different learning experiences
examined given a PWA's profile of cognitive-linguistic deficits. Study 2 also focuses on comprehension, asking
whether the RP principles influence the efficacy of receptive forms of treatment in PWA with severe word
comprehension deficits. Study 3 examines conditions under which failed retrieval practice confers benefit.
Study 4 investigates potential mechanisms to explain why effort enhances the benefits from successful retrieval
practi...

## Key facts

- **NIH application ID:** 9912151
- **Project number:** 5R01DC015516-04
- **Recipient organization:** ALBERT EINSTEIN HEALTHCARE NETWORK
- **Principal Investigator:** Erica Lee Middleton
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $478,683
- **Award type:** 5
- **Project period:** 2017-04-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9912151

## Citation

> US National Institutes of Health, RePORTER application 9912151, Retrieval Practice Principles: A Theory of Learning for Aphasia Rehabilitation (5R01DC015516-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9912151. Licensed CC0.

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