Conference Contribution Details
Mandatory Fields
Salis, C., Kelly, H. & Code, C.
16th International Aphasia Rehabilitation Conference
The role of short-term and working memory in the assessment and treatment of aphasia: a systematic review
The Hague
Poster Presentation
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Background: Historically, definitions of aphasia, the language impairments that occur after stroke, have acknowledged concomitant memory impairments, specifically, verbal short-term and working memory (STM/WM). These memory systems impact on the ability to encode, retain and manipulate verbal information, and are often impaired in aphasia (Murray, 2012). While some aphasia treatments are effective (Brady et al., 2012), the treatment of aphasia on the whole remains a challenge to rehabilitation professionals. Evidence from diverse research paradigms reports associations between STM/WM and language functioning in aphasia. This evidence leads to the hypothesis that treatment of such memory impairments would improve language functioning. Despite long-standing links, and contemporary neuropsychological and neurolinguistic evidence, clinical practice has not considered seriously the relevance of STM/WM to the treatment of aphasia. We carried out a systematic literature review in order to outline assessment and treatment methods of STM/WM impairments in aphasia. Methods: Using a range of relevant search terms, published treatments were sourced by systematically searching relevant databases. We reviewed studies that included STM and/or WM approaches in the treatment of post-stroke aphasia. We focused on studies where participants were adults and were described as presenting with post-stroke aphasia. We included studies that quantified STM/WM impairments in terms of test data and provided a description of the STM or WM treatment. We excluded studies where participants presented with acquired brain injuries other than stroke. We also excluded mixed aetiology group studies where it was not possible to identify the treatment outcomes for participants with aphasia. Finally, we excluded studies that involved related tasks and principles, e.g. attention, but did not report STM/WM abilities, e.g., Coelho (2005), Fridriksson et al. (2005). Results: Eight studies fulfilled the inclusion criteria. Table 1 summarises the studies, main treatment tasks and outcomes. These studies are not included in the reference list. Discussion: In all studies improvements were noted in terms of STM/WM functioning measures as well as other language functioning measures. Only two studies included outcome measures of psychosocial functioning (Vallat et al., 2005; Murray et al., 2006). Apart from Vallat et al. (2005), which was replicated in mixed acquired brain injury (not included in this review), none of the reported treatments have been replicated. All studies reported were single cases. We describe assessment and treatment principles and approaches that were used in these studies in order to aid transfer of this small corpus of literature to a wider audience. The supportive evidence for treatment of STM/WM is gradually growing and suggests some indication of the benefits of treating STM/WM, not only in terms of improved STM/WM functioning but also other language functions. Aiming to influence clinical research and practice (cf. Martin & Reilly, 2012), but mindful of the small evidence base, we make a case for aphasia therapists adopting protocols of STM/WM assessment and treatment as part of the rehabilitation in post-stroke aphasia. References Brady, M.C., et al. (2012). Cochrane Database of Systematic Reviews, Issue 5. Art. No.: CD000425. Coelho, C. (2005). Aphasiology, 19, 275-283. Fridriksson, J., et al. (2005). Aphasiology, 19, 99-109. Martin, N., & Reilly, J. (2012). Aphasiology, 26, 253-257. Murray, L. L. (2012). Aphasiology, 26, 317-337.