Sentactics®: Computer-Automated Treatment of Underlying Forms

Abstract

BACKGROUND: Treatment of Underlying Forms (TUF) is a linguistically-based treatment for improving agrammatic sentence deficits, which enjoys a substantial database attesting to its efficacy for improving both sentence comprehension and production in agrammatic aphasia. However, TUF requires considerable linguistic background to administer and administration time can exceed the number of treatment sessions allotted in toto for reimbursement by third party payors in the United States. Thus, Sentactics®, an interactive computer system that enables delivery of TUF by a virtual clinician was developed. AIMS: This study tested the effects of Sentactics® on the acquisition and generalized production and comprehension of complex sentences. Additionally, a direct comparison of the results of computer-delivered Sentactics® and clinician-delivered TUF was undertaken. METHODS #ENTITYSTARTX00026; PROCEDURES: Twelve agrammatic aphasic speakers participated in the study, with six receiving Sentactics® and six serving as experimental controls, who received no treatment. All participants were administered pre- and post-treatment sentence comprehension and production tests and other measures to evaluate the effects of Sentactics®. Performance of the Sentactics® group also was compared to eight agrammatic patients who previously received clinician-delivered TUF treatment, identical to that delivered via Sentactics®, but with a human clinician. OUTCOMES #ENTITYSTARTX00026; RESULTS: Sentactics® significantly improved all six aphasic speakers' ability to comprehend and produce both trained and untrained, linguistically related, complex sentences as compared to six agrammatic control participants who did not receive Sentactics®. In addition, comparing the results of the Sentactics® to clinician-delivered TUF revealed no significant differences between approaches with regard to acquisition or generalization patterns. CONCLUSIONS: These data provide further support for the efficacy of TUF and demonstrate the viability of computer-delivered therapies in the field of aphasia treatment.

Figure 1

Sample Sentactics® sentence production test screen. A similar screen was used for testing comprehension, although for comprehension testing, neither picture in the pair was highlighted.

Figure 2

Proportion of correct responses on pre- and post-treatment production tests for Sentactics®-trained participants for object relative, object cleft and object wh-question structures. Error bars, which represent standard errors (SEs), have been inserted for the group mean scores.

Figure 3

Proportion of correct responses on pre- and post-treatment production tests for object relative, object cleft and object wh-question structures for the control participants. Error bars, which represent standard errors (SEs), have been inserted for the group mean scores.

Figure 4

Proportion of correct responses on pre- and post-treatment comprehension tests for Sentactics®-trained participants for object relative, object cleft and object wh-question structures. Error bars, which represent standard errors (SEs), have been inserted for the group mean scores.

Figure 5

Proportion of correct responses on pre- and post-treatment comprehension tests for object relative, object cleft, and object wh-question structures for control participants. Error bars, which represent standard errors (SEs), have been inserted for the group mean scores.

Figure 6

Proportion of correct responses for object relatives, object clefts, and object wh-questions on production tests administered prior to and following clinician-delivered TUF. Data are from Dickey & Thompson (2007), Thompson et al. (2003), and Thompson et al. (2008). Error bars, which represent standard errors (SEs), have been inserted for the group mean scores.

Figure 7

Percent change from pre- to post-treatment on production of trained object relative (OR) and untrained object cleft (OC) and object wh-question (OWH) structures derived from clinician-delivered TUF and Sentactics®. Error bars, which represent standard errors (SEs), have been inserted for the group mean scores.

Figure 8

Proportion of correct responses for object relatives, object clefts, and object wh-questions on comprehension tests administered prior to and following clinician-delivered TUF. Data are from Dickey & Thompson (2007), Thompson et al. (2003), and Thompson et al. (2008). Error bars, which represent standard errors (SEs), have been inserted for the group mean scores.

Figure 9

Percent change from pre- to post-treatment on comprehension of trained object relative (OR) and untrained object cleft (OC) and object wh-question (OWH) structures derived from clinician-delivered TUF and Sentactics®. Error bars, which represent standard errors (SEs), have been inserted for the group mean scores.

Figure 10

Number of sessions required to reach criterion for Sentactics® and clinician-delivered TUF. Error bars, which represent standard errors (SEs), have been inserted for the group mean scores.