Semin Speech Lang 2020; 41(01): 099-124
DOI: 10.1055/s-0039-3401030
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Can Script Training Improve Narrative and Conversation in Aphasia across Etiology?

H. Isabel Hubbard
1  Department of Communication Sciences and Disorders, University of Kentucky, Lexington, Kentucky
,
Lori A. Nelson
2  Department of Speech and Hearing Sciences, University of New Mexico, Albuquerque, New Mexico
,
Jessica D. Richardson
2  Department of Speech and Hearing Sciences, University of New Mexico, Albuquerque, New Mexico
› Author Affiliations
Further Information

Publication History

Publication Date:
23 December 2019 (online)

Abstract

Script training is an effective treatment of stable (e.g., stroke-induced) and progressive aphasia of varying severities and subtypes. The theoretical underpinnings of script training are discussed and include fluency-inducing conditions, speech shadowing, principles of neuroplasticity, and automatization. Script training outcomes are reviewed, with a focus on discourse in persons with stable aphasia (PWSAs) and in persons with primary progressive aphasia (PWPPAs). PWSAs and PWPPAs are able to acquire and maintain short scripted monologues or conversational dialogues, with some evidence of generalization to untrained topics and settings. Advances in both technology and access have enriched script training protocols, so they now range from no-tech written script approaches to high-tech audiovisual support and avatars. Advances in audio and/or visual support promote large amounts of practice of less errorful whole-message language processing during a fluent language inducing condition. With enough practice, users decrease reliance on supports and independently produce scripted content. Script training can be delivered in a variety of settings (individual, group, telepractice), lends itself well to homework programs, and is in accordance with the principles of neuroplasticity for neurorehabilitation. Incorporating script training into therapy programming is advantageous throughout aphasia recovery following brain injuries such as stroke. It is also beneficial for persons with progressive disease for prophylaxis, remediation, and compensation. Recommendations for implementing script training in clinical practice and future research directions are presented.

Disclosures

H.I.H. receives a salary from the University of Kentucky. She has no other financial or nonfinancial disclosures.


L.A.N. receives a salary from the University of New Mexico. She has no other financial or nonfinancial disclosures.


J.D.R. receives a salary from the University of New Mexico and grant support through an Institutional Development Award (IDeA) from the National Institute of General Medical Sciences of the National Institutes of Health under grant number P20GM109089. She also serves as co-chair of the Research Committee at the Triangle Aphasia Project. She has no other financial or nonfinancial disclosures.