interventions

Which of the following interventions targets syntactic simplification for people with agrammatic aphasia?

• Treatment of Underlying Forms

• Reduced Syntax Therapy

• Verb Network Strengthening Treatment

• Morphosemantic treatment

Reduced Syntax Therapy

Which intervention primarily focuses on strengthening verb-argument structures to improve sentence production?

• Verb Network Strengthening Treatment

• NARNIA/NADIIA

• CIAT

• ECoLoGiC

Verb Network Strengthening Treatment

Which of the following interventions targets narrative production within ecologically valid conversational contexts? (select all that apply)

• NARNIA/NADIIA

• CIAT

• Morphosemantic treatment

• ECoLoGiC

NARNIA/NADIIA

ECoLoGiC

Which intervention emphasizes massed practice and overcoming learned non-use of language in interactive communicative tasks?

• CIAT

• Treatment of Underlying Forms

• Verb Network Strengthening Treatment

• Reduced Syntax Therapy

CIAT

Which intervention focuses on improving verb morphology and the semantic aspects of verb use?

• Morphosemantic treatment

• Treatment of Underlying Forms

• ECoLoGiC

• CIAT

Morphosemantic treatment

Which of the following interventions targets syntactic construction abilities using the complexity effect?

• Treatment of Underlying Forms

• Morphosemantic treatment

• Reduced Syntax Therapy

• Verb Network Strengthening Treatment

Treatment of Underlying Forms

Which interventions target sentence production in situational language contexts (select all that apply)?

• NARNIA/NADIIA

• CIAT

• Morphosemantic treatment

• ECoLoGiC

NARNIA/NADIIA

CIAT

ECoLoGiC

Which treatment targets verb-centered semantic networks to support sentence generation and word retrieval?
A. PCA
B. VNeST
C. SFA
D. TUF

B

Which treatment uses repetition and melody to engage preserved singing abilities in individuals with severe nonfluent aphasia?
A. MIT
B. ORLA
C. LRC
D. REST

A

A person with pure alexia and relatively preserved writing skills would most benefit from:
A. Multiple Oral Rereading (MOR)
B. Reading Strategies
C. PCA
D. Direct Auditory Comprehension Therapy

A

Which treatment helps clients improve sentence comprehension and production by targeting complex syntax structures?
A. SPPA
B. TUF
C. REST
D. ECoLoGiC

B

Script therapy is best suited for:
A. Mild fluent aphasia with naming deficits
B. Global aphasia with no verbal output
C. Severe aphasia working on functional daily scripts
D. Semantic variant PPA

C

Mild-moderate aphasia with reading comprehension difficulty but intact decoding

• PCA

• LRC

• MIT

• ACT/CART

• Reading strategies

reading strategies

Moderate-severe aphasia with phonological paraphasias and relatively intact semantics

• PCA

• LRC

• MIT

• ACT/CART

• Reading strategies

PCA

 Nonfluent aphasia with agraphia and preserved comprehension

• PCA

• LRC

• MIT

• ACT/CART

• Reading strategies

ACT/CART

Semantic or logopenic variant of PPA

• PCA

• LRC

• MIT

• ACT/CART

• Reading strategies

LRC

Severe nonfluent aphasia with good auditory comprehension

• PCA

• LRC

• MIT

• ACT/CART

• Reading strategies

MIT

What is the main difference in therapeutic approach between REST and TUF for sentence production?

• TUF aims to restore syntactic function by training complex sentence forms, benefiting generalization to simpler ones.

• REST is compensatory, encouraging reduced grammar (e.g., content words only) to reduce cognitive load and enhance functional speech in severe agrammatism.

How does SFA strengthen word retrieval?

Strengthens word retrieval by activating a word’s semantic network (e.g., category, function, location). This spreads activation, making target words more accessible for naming.

Describe two goals of group therapy in aphasia treatment and name one advantage it offers that individual therapy may not.

• Goals: Promote pragmatic skills, encourage carryover of strategies into real life.

• Advantage: Offers peer support and more naturalistic communication opportunities than individual sessions.

Explain how ECoLoGiC facilitates more effective real-life communication.

Helps moderate-severe aphasia clients self-monitor, identify breakdowns, and use self-repair strategies during real-life conversations, enhancing autonomy in communication.

Strengthens lexical system to improve word-finding in individuals with phonological/semantic paraphasias; targets moderate-severe aphasia with intact semantic knowledge.

PCA

Enhances word retrieval by activating semantic networks; used for aphasia (especially anomic) and cognitive-communication disorders.

SFA

Preserves word retrieval in PPA by teaching self-cueing strategies; for svPPA and lvPPA.

Lexical Retrieval Cascade (LRC)

Targets verbs and their semantic roles to improve sentence generation and word-finding; requires functional auditory comprehension and repetition.

Verb Network Strengthening Treatment (VNeST)

Nonverbal strategy using hand/body gestures to support communication in severe/global aphasia or motor speech disorders.

Gesture Therapy

Uses rhythm, pitch, and melody to facilitate verbal output in severe nonfluent aphasia (e.g., Broca’s); relies on preserved singing ability.

Melodic Intonation Therapy (MIT)

Rehearses personally relevant scripts until automatic; supports functional communication in severe/global aphasia.

Script Training

Restores sentence production by training complex syntax in agrammatic Broca’s aphasia; promotes generalization to simpler forms.

Treatment of Underlying Forms (TUF)

Compensates for agrammatism by training reduced, simplified utterances for functional communication

Reduced Syntax Therapy (REST)

Improves real-world communication by addressing word, sentence, and discourse-level processing; for post-stroke and PPA aphasia.

NARNIA/NADIIA (Narrative Intervention)

Conversation-based treatment to improve self-repair and breakdown management in moderate to severe post-stroke aphasia.

ECoLoGiC

Indirect reading comprehension treatment using visual, content, and metacognitive strategies; for mild-moderate aphasia with intact decoding.

Reading Strategies

Improves text-level reading rate/accuracy in pure alexia; emphasizes top-down processing.

Multiple Oral Rereading (MOR)

Sentence-level reading aloud to support language comprehension and pacing; for nonfluent aphasia and deep alexia.

Oral Reading for Language in Aphasia (ORLA)

 Improves single-word writing in nonfluent aphasia; requires preserved comprehension, not suitable for severe auditory deficits.

ACT/CART (Anagram/Copy Therapy)

Strengthens lexical-auditory links to improve spoken language understanding; for clients with poor auditory comprehension.

Direct Auditory Comprehension Therapy

Enhances attention and self-monitoring to support comprehension in mild-moderate aphasia with attention-related deficits.

Attention Processing Training (APT-3)

Facilitates real-world communication, peer modeling, and social connection; appropriate for mild to severe aphasia.

Group Therapy

Increases therapy intensity and access using at-home digital tools; focuses on impairment and participation levels.

Computer-Based Therapy

 Supports daily communication using multimodal strategies; aligns with Life Participation Approach to Aphasia (LPAA)

AAC

Compare and contrast ECoLoGiC and NARNIA/NADIIA in terms of their treatment focus, goals, and target populations.

• Similarities:

  • Both are functional, discourse-level interventions.

  • Each aims to improve real-life communication for people with aphasia.

  • Target populations include individuals with moderate to severe aphasia (ECoLoGiC: post-stroke; NARNIA: post-stroke and PPA).

• Differences:

  • ECoLoGiC focuses on conversational self-repair, helping clients identify and repair communication breakdowns during conversation.

  • NARNIA/NADIIA targets narrative and discourse structure, addressing multiple levels of language (word, sentence, discourse).

  • ECoLoGiC is designed specifically for post-stroke aphasia, while NARNIA is applicable to both post-stroke and primary progressive aphasia.

  • ECoLoGiC emphasizes spontaneity and interactional repair, whereas NARNIA emphasizes structured storytelling and language formulation.

A direct treatment for expressive emotional aprosodia that focuses on restoring nonverbal affective representations in the brain

cognitive-linguistic approach

A direct treatment for expressive linguistic and emotional aprosodia that works to reorganize motor pathways involved in producing vocal emotional prosody.

imitative-motor approach

Patient names a picture by analyzing 5 phonological components (rhyme, first sound, associate, final sound, syllables) and reattempts naming after cues and modeling.

PCA

Patient describes target words using a semantic feature grid (e.g., group, use, action), often with personalized items and clinician support.

SFA

Patient uses a sequence of cues (semantic, orthographic, phonemic, oral reading, written/spoken) to retrieve and name target words.

LRC

Patient generates agent-patient-verb pairs (SVO sentences), expands with wh- questions, and practices retrieval and judgment of verb usage.

VNeST

Client learns to pair gestures with target words using modeling, repetition, and practice with simultaneous verbal-gestural production.

gesture therapy

Patient intones increasingly complex phrases using high/low pitch contrast and rhythmic tapping to improve verbal expression.

MIT

Clinician and patient co-create a script, practice each line using choral reading and fading cues, aiming for independent production over time

script therapy

Patient manipulates sentence structure using word cards, identifies grammatical roles, and practices producing complex sentences independently.

TUF

Patient progresses through structured levels of increasing sentence complexity using prompts and picture/written stimuli personalized to their interests.

REST

Patient builds and narrates stories using visual sequences, mind mapping, verb generation, sentence combining, and self-rating tools.

NARNIA/NADIIA

Alternates between Therapeutic Conversation (TC) and Repair (TR), using supported conversation strategies and a feedback hierarchy to build communicative independence

ECoLoGiC

Patient reads, rereads, summarizes, and recalls sentences from a passage in a repeated pattern to strengthen reading comprehension.

reading strategies

Patient repeatedly reads a passage aloud, tracking fluency and errors, with home practice to build automaticity and accuracy.

MOR

Uses repeated oral reading at the sentence level (silent reading, choral reading, word identification, independent reading) to improve fluency.

ORLA

Writing-based approach:

uses repeated copying and recall of written models.

involves assembling letters from an anagram to write words;

CART

ACT

Uses clinician-judged tasks (e.g., yes/no, commands, discrimination) with multimodal feedback to build auditory comprehension.

direct auditory comprehension treatment

Focuses on tasks for auditory comprehension and attention, adjusted in intensity based on clinician judgment and tailored to client goals.

APT-3

Focuses on emotion vocabulary, matching emotions to vocal tone, explaining reasoning, practicing with emotional intonation, and educating family. Targets patients without severe cognitive deficits.

cognitive -linguistic approach

Client imitates clinician’s emotional tone with visual/kinesthetic cues (e.g., pitch movement via hand gesture) and practices sentences in emotional tones. Not suitable for clients with motor deficits.

imitative-motor approach

A compensatory treatment for unilateral spatial neglect that aims to improve spatial attention by systematically training individuals to scan their neglected side. Based on attentional retraining

VST (Visual Scanning Training)

To gently increase a person’s recognition of their deficits, not through confrontation but through guided self-reflection and internal motivation. Uses principles of motivational interviewing and self-determination theory

MET (Motivational Enhancement Therapy)

Uses reflective prompts and self-assessment tasks to increase awareness through empathetic dialogue, discrepancy development, and support for self-efficacy; avoids confrontation to reduce defensiveness.

MET (Metacognitive Executive Therapy)

Involves structured visual tasks like symbol cancellation with real-time feedback; patient is seated for optimal visual access; stimuli include spatial cues delivered via screen or paper-based formats.

VST (Visual Scanning Training)

Non-invasive brain stimulation that modulates neural activity using mild scalp currents; based on the stimulation-dependent model to enhance neuronal depolarization. Target Clients are individuals with non-fluent aphasia or semantic variant PPA (svPPA)

tDCS (Transcranial Direct Current Stimulation)

Non-invasive technique using electromagnetic induction to modulate brain activity; It has been studied to improve naming in nonfluent aphasia by altering interhemispheric interaction. Target Clients are post-stroke or chronic stroke patients with nonfluent aphasia; individuals with depression.

TMS (Transcranial Magnetic Stimulation)

Applies fixed electrical currents via scalp electrodes; patients remain seated and relaxed while clinicians localize stimulation site, monitor for skin integrity, and assess for adverse effects post-treatment.

tDCS (Transcranial Direct Current Stimulation)

Magnetic coil placed on the scalp delivers focused pulses to stimulate targeted brain areas; most common for aphasia recovery, using repetitive pulses to modulate language-related neural circuits

TMS (Transcranial Magnetic Stimulation)

tDCS vs TMS

• Both are non-invasive brain stimulation techniques used in aphasia rehabilitation.

• tDCS delivers low electrical currents through scalp electrodes to modulate neural activity,

• TMS uses magnetic pulses via a scalp-placed coil to stimulate specific brain areas.

• tDCS is portable and less focal, suited for broader modulation

• TMS (especially rTMS) is more targeted and often used to improve naming in nonfluent aphasia.

• tDCS is generally more accessible

• TMS offers stronger spatial precision but requires specialized equipment.

Direct treatment to improve narrative comprehension in RHD by reducing activation of irrelevant meanings using context-supported sentence processing; based on the suppression deficit hypothesis.

suppression treatment

Uses auditory presentation of contextually strong or moderate sentences followed by ambiguous probe sentences; client evaluates target words as relevant or not to practice suppressing inappropriate meanings and enhance discourse comprehension.

suppression treatment

Direct approaches that strengthen interpretation of ambiguous language and main ideas using visual cues and context; grounded in suppression deficit hypothesis and holistic processing theory.

Other Suggested Treatments for Discourse in RHD

Uses picture-based discussions, homograph exploration, and ambiguous word interpretation tasks to support awareness of meaning through context and promote flexible language processing

Other Suggested Treatments for Discourse in RHD