Treatment Outcomes Following Script Training for Two Women with Broca’s Aphasia

Empirical evidence from hundreds of research studies support the general effectiveness of aphasia therapy, however, it is not known what therapy works best for which client. Aphasia treatments may be generally classified as one of two approaches: traditional aphasia treatment, which attempts to restore linguistic abilities, or functional communication treatment, which focuses on restoring aspects of communicative functioning. This study furthers investigation of a treatment method that combines aspects of both traditional and functional methods with principles of instance theory of automatization; specifically, script training. This approach attempts to restore automatic, effortless, and natural context-specific expressive language production for individuals with Broca’s aphasia.

The purpose of this treatment study was to examine treatment outcome in relation to participant performance and to explore implications for establishing a script training protocol. Four primary research questions were posed. Does script training result in the fluent production of target scripts? Does fluent speech production generalize to conversational contexts? Do words contained in trained scripts transfer to non-trained narratives? What types of script errors are observed during script learning?

A single-subject multiple baseline design across behaviors was used to examine the acquisition of scripts for two adult females with chronic Broca’s aphasia. Both participants showed strong, positive responses to script training. They mastered their trained scripts in monologue form over the course of four to six treatment sessions. As a result of script training, the verbal communication of both participants on all trained script topics improved from halting, ineffective, and impaired at baseline to fluid, competent speech, that was produced flexibly in conversation. Participants reported generalization of script use to functional contexts, and context specific modifications initiated by the participants. Additionally, participants made the same types of errors while learning their scripts; these errors were analyzed to better understand the development of automaticity.

The results of this study suggest script training has the potential to be an effective treatment for improving the speech of people who have Broca’s aphasia from both a functional and linguistic perspective.