Dyslexia, Acquired, Stroke
Conditions
Keywords
reading, computational model, treatment, therapy
Brief summary
This study is a low-risk, early phase 1, multicenter trial to test the use of a computational (neural network) cognitive model of reading to simulate acquired dyslexia and its treatment. The aim is to determine whether there is an advantage to receiving the treatment the model predicts to be advantageous compared to the alternative treatment. All participants will receive two full rounds of treatment. A round of treatment will consist of either phonomotor treatment (PMT) or semantic feature analysis (SFA) for 60 hours, distributed over 5 days a week for 2 hours a day.
Interventions
BEHAVIORALPhono-Motor Therapy
Orthographic stimuli (letters) are introduced from the beginning as each phoneme is being trained. This maintains the focus on phonology, while emphasizing its relevance to reading. PMT consists of an initial phase focused on training of individual phonemes and phoneme sequences in spoken language, followed by written language tasks. English phonemes are first trained in isolation, followed by phoneme sequences in words and pseudowords. They are trained multi-modally through emphasis on auditory, motor, tactile-kinesthetic, visual, and orthographic representations for each consonant and vowel. When sequences are introduced, focus on phonology is maintained by training on pseudowords first before real words are introduced. Participants work on identifying, repeating, parsing, blending, and manipulating phonemes that make up the pseudoword and word stimuli. To maintain focus on phonology, pictures and definitions of the stimuli are never shown or discussed.
BEHAVIORALSemantic Feature Analysis
SFA activates semantic features of the target word to help retrieve the spoken form of the word. To target reading, a modified SFA is used with written words rather than pictures as the primary materials. Pictures are instead included for each word as a semantic feature. Stimuli will consist of 80 highly imageable nouns with a range of word frequencies. During treatment the therapist will present a written noun and ask the participant a series of questions about the features of that noun. For example, if the presented noun is "juice", the therapist would have the participant select the corresponding picture from an array of pictures. The therapist then would ask, "what do you do with it?" (eliciting a feature from the "function" category) and "where do you store it in your home?" (eliciting a feature from the "context" category). This is done for a total of 6 categories of semantic features. The process is repeated until the participant reads the noun correctly three times in a row.
Sponsors
Rutgers, The State University of New Jersey
National Institute on Deafness and Other Communication Disorders (NIDCD)
Study design
Allocation
NON_RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Intervention model description
The study model is a partial crossover design in that participants receiving model-matched therapy will continue with the same therapy in the 2nd half of the study, while those receiving the non-model-matched therapy will be switched in the 2nd half to the other therapy.
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Fluent in English as a first language pre-stroke by self report. * Normal or corrected-to-normal vision. * Normal or aided hearing. * Left hemisphere ischemic or hemorrhagic stroke (as verified by a structural brain scan). * Impaired reading as confirmed by significant impairment in the Basic Skills cluster of the Woodcock Reading Mastery Test - III.
Exclusion criteria
* Diagnosed pre-stroke neurological disease affecting the brain other than left hemisphere stroke. * Severe apraxia of speech (determined by consensus judgment among speech-language pathologists). * History of learning disabilities such as developmental dyslexia or current self-reported major psychiatric disorders. * Inability to undergo, or provide a copy of, a post-stroke brain imaging scan.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Woodcock Reading Mastery Test - III | Baseline, following the first 60 hours of therapy, and following the final 60 hours of therapy. | The WRMT-III is a standardized measure of reading skills. |
| Test words and pseudowords | Baseline, following the first 60 hours of therapy, and following the final 60 hours of therapy. | Change in accuracy of reading 120 test words and 80 pseudowords |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Western Aphasia Battery - Revised | Baseline, following the first 60 hours of therapy, and following the final 60 hours of therapy. | The WAB - R is a standard measure of aphasia severity. It determines both the degree of aphasia and whether treatment has any impact on aspects of aphasia other than acquired dyslexia. |
| Comprehensive Aphasia Test - Disability Quotient | Baseline, following the first 60 hours of therapy, and following the final 60 hours of therapy. | The CAT - DQ is a self-report measure of subjectively perceived degree of disability. |
Countries
United States
Contacts
CONTACTWilliam W Graves, PhD
CONTACTOlga Boukrina, PhD
PRINCIPAL_INVESTIGATORWilliam W Graves, PhD
Rutgers, The State University of New Jersey
Outcome results
None listed