Brain Injuries Clinical Trial
Official title:
Language Assessment and Treatment Following Acquired Brain Injury
People with acquired brain injury (ABI) often experience persistent language challenges that are subtle in nature and not readily observable to others. These challenges can have substantial negative effects on vocational and social endeavors despite their subtlety. Even though these challenges are prevalent in the ABI population, limited methods exist for quantifying and remediating them. The two purposes of Phase I of this research are to (a) explore methods of using event related potential (ERP) recordings to quantify language processing differences between people with and without ABI and (b) correlate behavioral observations from language tests with ERP findings. The purpose of Phase II is to explore the use of game-based, group activities as an intervention for people with ABI who experience word-retrieval challenges. The purpose of Phase III is to collect post-intervention data for comparison with Phase I data and provide evidence about the effectiveness of the intervention program.
Phase I: Phase I participants will engage in two sets of activities: (a) standardized and
informal language and cognitive measures and (b) a series of language and cognitive
activities performed during the collection of event related potential (ERP) recordings.
Standardized language measures will include the: (a) Test of Adolescent/Adult Word Retrieval,
(b) Cognitive Linguistic Quick Test, and (c) California Verbal Learning Test. Informal
measures will include a conversational interaction about a participant's language
difficulties and a topic of his/her choosing. During the conversational interaction,
participants will press a button each time they experience difficulty retrieving a word.
ERPs measure electrical signals from the brain using a soft net of woven electrodes placed on
a participant's head. Before the session, the investigators will soak a net in a saline (salt
water) solution. The recording electrodes will be placed on the participant's scalp. The
investigators will record ERPs while the participant completes the following tasks:
1. word retrieval: The participant will view a series of neutral stimuli (i.e., pictures of
familiar objects, people, or locations flashed briefly on a computer monitor). The
participant will press one of three buttons to indicate (a) recall of the name of the
depicted image, (b) knowledge of the name but inability to recall it, or (c) no
knowledge of the name of the depicted image. If a participant does not press a button
within the time limit of the stimulus presentation, a new stimulus trial will begin.
During some trials, participants will perform a second task requiring judgment about the
orientation of lines appearing after the stimulus image. Following completion of all
trials, the investigators will present the stimulus images a second time along with
three response options: (a) the correct name, (b) an incorrect name, and (c) "don't
know." The participant will again use a button press to indicate his/her response
choice.
2. stimulus categorization: The participant will view a series of objects. For each object,
he/she will categorize the stimulus semantically (e.g., Is the object a fruit or
animal?) or phonologically (e.g., Does the object start with the letter "L" or "N?").
Participants will respond by pushing a button.
3. deductive reasoning: The participant will view written word pairs. Some of the pairs
will relate to a specific word (e.g., "desert" and "humps" relate to "camel"), whereas
other pairs will not (e.g., "desert" and "bark"). The participant will press one of two
buttons to indicate whether a word pair triggers or does not trigger recall of a related
word.
Phase II: Only people with acquired brain injury (ABI) will participate in Phase II
activities. Phase II participants will attend two-hour, group intervention sessions one day
per week for eight weeks. Participants will engage in multiple word game activities
throughout each intervention session. Games will include Facts in Five, Anomia, Boggle, and
Bananagrams as well as variations on these, as appropriate. Data collection during these
sessions will be limited to a list of activities in which a participant engaged and the
duration of engagement in each activity. Game-based group activities such as these are not
typically used in intervention sessions for people with ABI who experience mild
word-retrieval challenges. In fact, because of the subtlety of word retrieval difficulties
experienced by people with relatively good recoveries from ABI--that is, the target
population for this research--most people do not receive any treatment for this problem.
Phase III: Only people with ABI who have performed both Phase I and Phase II activities will
be eligible for participation in Phase III. Following completion of the intervention
sessions, participants will perform post-testing activities. Post-testing activities will
include a subset of Phase I testing activities. Specifically, we will repeat (a) the audio
recording of a conversational interaction and (b) the ERP recording with the same tasks used
in Phase I.
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