Further explorations and an overview of errorless and errorful therapy for aphasic word-finding difficulties: The number of naming attempts during therapy affects outcome

TLDR

Errorless learning is a debated rehabilitation strategy, yet emerging evidence indicates it is as effective as errorful learning for treating aphasic word‑finding difficulties. This study aimed to replicate prior findings and further examine whether withholding feedback and varying the number of naming attempts influence therapy outcomes. Seven participants underwent a multiple‑baseline, crossover case‑series design to compare errorless and errorful therapy with and without feedback across sessions. Results showed equivalent immediate and follow‑up gains for both therapy types, no benefit from feedback, executive/problem‑solving skills predicted improvement, and increased naming attempts enhanced learning.

Abstract

Background: Errorless learning continues to be much debated in rehabilitation literature. Emerging data suggest that errorless learning is as effective as errorful learning when applied to the treatment of aphasic word-finding difficulties (Fillingham, Hodgson, Sage, & Lambon Ralph, 2003; Fillingham, Sage, & Lambon Ralph, in press; Fillingham, Sage, & Lambon Ralph, 2005).Aims: This paper presents a third investigation, which was designed to replicate this result and also to explore and extend other important and interesting findings from the previous empirical studies: (1) that withdrawing feedback during therapy (not giving information about whether a patient's response was correct or not) does not prevent learning; (2) that frontal executive skills are a predictor of therapy outcome but not language skill. We also used this third study to explore whether the number of naming attempts during therapy affects outcome.Methods & Procedures: Seven of the original eleven participants took part in a multiple baseline, crossover, case-series design.Outcomes & Results: The previous results were replicated: errorless and errorful therapy produced equivalent results immediately post-therapy and at follow-up. There was no effect of omitting feedback—the participants learned equally well without therapists' feedback. Also, executive/problem-solving skills and monitoring ability again predicted immediate naming improvements not language ability. In addition, we found that increasing the number of naming attempts during therapy affected learning outcome.Conclusions: The final section of the paper draws together the results of all three studies, and their implications for the treatment of aphasic word-finding difficulties are discussed.