Hunt, 1999; Sacchet, Byng, Marshall, & Pound, 1999), neither will I address treatmentsthat focus on impairments at an articulatory level (e.g., those treatments focusing onapraxia of speech, for review see Ballard, Granier, & Robin, 2000, and Wambaugh &Doyle, 1994), nor treatments ‘‘beyond the single word’’ (e.g., sentence processing—seeMitchum, Greenwald, & Berndt, 2000, for a review of the issues in this field). In addition,this review will not address rehabilitation primarily focused at reducing levels of handicap/disability where the rehabilitation is not impairment-based (e.g., Lesser &Algar, 1995).
Finally, this review will restrict itself to papers published in peer-reviewed journals and books (hence excluding unpublished conference papers, oral paperpresentations, and theses).
APPROACHES TO THE REMEDIATION OF WORD-RETRIEVAL IMPAIRMENTS IN APHASIA
Howard and Hatfield (1987) gave a historical review of approaches to the treatmentof aphasia—these included surgical, pharmacological (e.g., crocodile grease), andbehavioural treatments. However, the vast majority of treatments over the past 100years have been behaviourally based. It is only more recently that pharmacologicalapproaches to the treatment of aphasia have been demonstrated to show some promise,using, for example, amphetamine or piracetam (e.g., Enderby, Broeackx, Hospers,Schildermans, & Deberdt, 1994; Walker-Batson et al., 2001). However, there remainsa general consensus that these treatments are helpful primarily when paired witheffective behavioural language therapy (see Shisler, Baylis, & Frank, 2000, for areview). Hence, it is not the case that there is little point in devoting research effortto evaluating behavioural approaches to the remediation of aphasia because of thepromise of pharmacological approaches; there is little doubt that there will be a rolefor behavioural approaches for many years to come.Behavioural approaches take many forms, and in particular can be divided into thosethat aim to rehabilitate the impaired process(es) and those that attempt to provide analternative mechanism to achieve a goal (such as successful word production) usingprocesses not normally implicated. I shall discuss these latter approaches first.
Strategic, re-organisational, or compensatory approaches
One approach to treatment of word-production/retrieval impairment aims to facilitatenaming by reorganising the processes utilised, such that intact processes are used tocompensate for or support the impaired processes (Howard & Patterson; 1989). Table 1summarises the studies that have set out with the aim of taking this approach (as we willsee aims and results do not always converge).Common to most of these approaches is the use of knowledge of the written form of aword to help retrieve the spoken form. Clearly this approach will be of most benefit to
This is not meant to suggest that impairment-based approaches do not have an impact on levels of disability/handicap, far from it, underlying every clinician’s impairment-based treatment is the belief that it willhave an impact on the levels of disability and/or handicap of the individual treated. The evidence for the truth of this statement will be discussed later.
THERAPY FOR NAMING DISORDERS