The Aphasiology Archive
University Library System, University of Pittsburgh

Integrating the message level into treatment for agrammatism using story retelling

Peach, Richard K. and Wong, Patrick C. M.
Integrating the message level into treatment for agrammatism using story retelling. Aphasiology, 18(5-7), 2004, pages 429-441.


Background: Treatments for agrammatic production generally target sentence forms, inflectional morphology, verb retrieval, thematic roles, or underlying grammatical forms. Reviews of these and related methods suggest that they address Garrett's functional and positional levels of sentence processing. Such reviews also demonstrate that little attention has been given to developing treatments that emphasise the message level of sentence production. Message-level representations appear to have robust potential for influencing sentence-level processes following aphasia, since varying levels of language representation are thought to influence their downstream counterparts.

Aims: The study aimed to determine whether functional and positional-level syntactic training applied in a context requiring structuring of message-level representations would improve expressive syntax in a patient with agrammatism.

Methods & Procedures: A 10-week programme was divided into two 5-week phases requiring story retelling of three fables in each phase with critical oral and written feedback. Story retellings were analysed along three dimensions: grammaticality, complexity, and content. The programme was evaluated using a multiple-baseline across behaviours single-subject design.

Outcomes & Results: Overall, this treatment programme appeared to produce highly beneficial outcomes with regard to improved expressive syntax. Substantial generalisation of treatment effects was observed in post-treatment testing, while long-term maintenance of the gains achieved in treatment was observed.

Conclusions: The story-retelling procedure, with oral and written feedback, stimulated and improved the participant's expressive syntax. Unlike treatment approaches that simply target surface grammar, the story retelling approach appears to be rich with regard to stimulating conceptual syntax as well as lower-level syntactic processes. Functional communication also benefited by treating discourse-level behaviours to improve linguistic processing.

EPrint Type:Journal (Paginated)
ID Code:1491
Conference:Clinical Aphasiology Conference: Clinical Aphasiology Conference (2003 : 33rd : Orcas Island, WA : May 2003)
Publisher:Taylor & Francis
Alternative Locations:,,
Additional Information:Access to Full Text is subject to the Publisher's access restrictions.