Authors: Rogalski Y, Edmonds LA
Title: Attentive Reading and Constrained Summarisation (ARCS) treatment in primary progressive aphasia: A case study
Source: Aphasiology 2008 22(7-8): 763-775
Year: 2008
Research Design: Single Case Design

BACKGROUND: Primary progressive aphasia (PPA) is a neurodegenerative disease characterised by isolated and gradual language decline that can negatively affect discourse. Behavioural treatments for PPA have typically targeted linguistic processes at the micro-structure (word or sentence) level rather than the macro-structure (discourse) level, with minimal generalisation to discourse. There is a growing consensus that non-linguistic mechanisms such as attention are imperative for complex language execution such as discourse. Intentional language use (Nadeau, Rothi, and Rosenbek, 2008) is another mechanism thought to promote language generalisation by encouraging verbal language to the exclusion of other modalities. Attentive Reading and Constrained Summarisation (ARCS) is a novel discourse-level treatment derived from cognitive principles and operating on macro-structure and micro-structure linguistic levels. AIMS: In this case report of one participant with PPA we anticipated post-treatment discourse-level improvements in coherence, cohesion, and informativeness/efficiency with unlikely maintenance due to the neurodegenerative nature of PPA. METHODS AND PROCEDURES: 'Stanley', a 76-year-old gentleman with PPA and concomitant attention impairments, received the ARCS treatment. ARCS focuses attention during reading and promotes intentional language use by summarisation with constraints. OUTCOMES AND RESULTS: Pre- to post-treatment and maintenance improvements on coherence, cohesion, and percent correct information units were observed. CONCLUSIONS: The current findings are intriguing but must be interpreted with prudence given that this is a case study with limitations related to lack of experimental control. However, ARCS is a novel behavioural treatment for PPA and the post-treatment and 2-months maintenance results warrant consideration.

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