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Linguistic Specific Treatment: Just for Broca's aphasia?

Background: Several studies have documented the efficacy of Linguistic Specific Treatment (LST) for addressing sentence production deficits associated with agrammatism (e.g., Ballard & Thompson, 1999; Thompson, Shapiro, Kiran, & Sobecks, 2003). LST is based on the proposition that training production of complex, noncanonical sentence structures should produce generalisation to syntactically related, and less complex, sentence structures. Because empirical support for LST has been established via research that has exclusively involved patients with agrammatic production with or without asyntactic comprehension, it is not yet known whether this treatment is suitable for patients with other clinical aphasia types. Aims: Four adults who represented a variety of clinical aphasia types were provided with LST to determine whether (a) these patients would show acquisition of trained sentences with generalisation to untrained but syntactically related sentence forms; (b) LST would enhance written sentence production if only spoken production was directly treated and writing was indirectly stimulated through a home work programme; (c) treatment of spoken sentence production would assist comprehension of trained and untrained sentence forms; and (d) LST would facilitate spoken narrative skills in terms of informativeness, syntactic accuracy or complexity, or both. Methods & Procedures: Single subject, multiple baseline design across behaviours methodology was used to examine acquisition and generalisation of trained (object‐ and subject‐extracted embedded questions) and untrained sentence structures (object‐ and subject‐extracted matrix questions, passives) in four participants representing a spectrum of nonfluent and fluent aphasia types. They received individual, weekly 60–90 minute sessions of LST, and were asked to complete written sentence production homework practice. Outcomes & Results: Variable response patterns were observed across the participants in terms of changes in their spoken production or comprehension of trained and untrained sentence forms, written production of trained forms, and narrative discourse. Generally, LST was less helpful to participants with poorer comprehension and concomitant cognitive deficits. Conclusions: LST may provide some benefit not only to patients with nonfluent or agrammatic aphasia, but also to some patients with fluent aphasia profiles. Further investigation of LST is needed to delineate further the clinical populations for whom this treatment approach is most appropriate, and to evaluate LST procedural modifications that might foster production and comprehension generalisation effects.