Using Masked Repetition Priming in Treatment of Anomia – A Phase 2 Study

Silkes, JoAnn (2014) Using Masked Repetition Priming in Treatment of Anomia – A Phase 2 Study. [Clinical Aphasiology Paper]

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Abstract

Individuals with anomia often demonstrate preserved lexical knowledge, even when they are unable to produce a lexical item. An interactive spreading activation model of lexical processing explains this dichotomy by suggesting that impaired lexical access can result from deficits in the spread of activation between levels of processing or from the maintenance of activation of target representations long enough for them to be selected [1]. In either case, impaired spreading activation is implicated in lexical retrieval impairments. Spreading activation is a fundamental component of the implicit (unconscious) processing system that supports the rapid, accurate use of language. Implicit and explicit (conscious) processes and representations interact in language production [2], and there is some evidence that the interaction between them may also be impaired in aphasia. For instance, many people with aphasia demonstrate implicit lexical knowledge and/or implicit lexical processing even if they cannot explicitly produce those same items. Most established methods of treatment for anomia are highly explicit, having clients consciously consider a word’s meaning, use, or form. If the implicit processing system and/or the interface between explicit and implicit systems is impaired, however, anomia treatment could benefit from finding ways to also address the implicit system more directly. All treatment approaches recruit both implicit and explicit processes to some extent, due to the highly integrated, interactive nature of the language processing system. The treatment approach described here, however, shifts the therapeutic target from the explicit to the implicit end of the spectrum. We do this by using visual masking to make prime items implicit, and presenting them several times before asking for a naming response to pictures that are presented. While the naming response is an explicit response, the intent of the masked primes is to pre-activate the appropriate implicit lexical representation adequately so that the target word is more readily available when an explicit response is required. This has been demonstrated in principle by a study conducted with a single individual with anomia [3], which showed improved naming when masked primes were presented. The single-subject, multiple baseline study reported here for two participants extends this idea to investigate the effects of masked priming over repeated exposures on 1) trained items; 2) untrained items in the same semantic category; and 3) untrained items across semantic categories. This is an ongoing project. At this time, data have been collected and analyzed for two participants, reported here. Additional participants will be enrolled in the project in early 2014, with those data included in the conference presentation, as well.

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