Differential effects of context- and skill-based treatment approaches: Preliminary findings

Context- and skill-based treatment approaches, as embodied by functional and cognitive neuropsychological interventions, predict different patterns of acquisition and transfer of skill based on their theoretical foundations. This project was designed to compare the relative outcomes of these two treatment approaches on a comprehensive set of functional and psycholinguistic measures among aphasic adults. Twelve subjects with chronic, nonfluent aphasia were randomly assigned to each of the two treatments, and their performance compared to that of a baseline group consisting of five nonfluent aphasic subjects. Context-based training focused on role-plays of a functional task, and skill-based training focused on a naming intervention divorced from a functional context. Preliminary findings suggested that patterns of improvement and transfer at post-treatment testing were generally consistent with predictions. The results are a preliminary step towards making empirically based clinical decisions about what treatment type is appropriate for which individual.