title: Vocabulary relearning in semantic dementia: Positive and negative consequences of increasing variability in the learning experience.
abstract: Anomia therapy typically aims to improve patients' communication ability through targeted practice in naming a set of particular items. For such interventions to be of maximum benefit, the use of trained (or relearned) vocabulary must generalise from the therapy setting into novel situations. We investigated relearning in three patients with semantic dementia, a condition that has been associated with poor generalisation of relearned vocabulary. We tested two manipulations designed to improve generalisation of relearned words by introducing greater variation into the learning experience. In the first study, we found that trained items were retained more successfully when they were presented in a variety of different sequences during learning. In the second study, we found that training items using a range of different pictured exemplars improved the patients' ability to generalise words to novel instances of the same object. However, in one patient this came at the cost of inappropriate over-generalisations, in which trained words were incorrectly used to name semantically or visually similar objects. We propose that more variable learning experiences benefit patients because they shift responsibility for learning away from the inflexible hippocampal learning system and towards the semantic system. The success of this approach therefore depends critically on the integrity of the semantic representations of the items being trained. Patients with naming impairments in the context of relatively mild comprehension deficits are most likely to benefit from this approach, while avoiding the negative consequences of over-generalisation.
authors.affiliation: Neuroscience and Aphasia Research Unit (NARU), University of Manchester, UK; Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh EH8 9JZ, UK. Electronic address: p.hoffman@ed.ac.uk.
authors.forename: Paul
authors.initials: P
authors.lastname: Hoffman
authors.affiliation: Research Institute for the Care of Older People (RICE), Bath, UK.
authors.forename: Natasha
authors.initials: N
authors.lastname: Clarke
authors.affiliation: Research Institute for the Care of Older People (RICE), Bath, UK.
authors.forename: Roy W
authors.initials: RW
authors.lastname: Jones
authors.affiliation: Research Institute for the Care of Older People (RICE), Bath, UK.
authors.forename: Krist A
authors.initials: KA
authors.lastname: Noonan
mesh_terms: D000849:Anomia / Q000209:etiology / Q000628:therapy*; D032882:Comprehension; D005260:Female; D057180:Frontotemporal Dementia / Q000150:complications / Q000473:pathology / Q000523:psychology / Q000628:therapy*; D005793:Generalization, Psychological; D006801:Humans; D008875:Middle Aged; D009483:Neuropsychological Tests; D010364:Pattern Recognition, Visual; D011214:Practice, Psychological; D014825:Vocabulary
keywords: Anomia therapy; Conceptual knowledge; Generalisation; Semantic dementia; Word relearning