Treatment effects: Regular use of SentenceShaper can improve spontaneous speech

Below is a brief summary of research studies about SentenceShaper as a language therapy tool, conducted at two sites: the University of Maryland School of Medicine in Baltimore, MD, and Moss Rehabilitation Research Institute in Philadelphia, PA.

SentenceShaper treatment studies at Moss Rehabilitation Research Institute

The first study to show treatment effects – that is, the positive impact of SentenceShaper use on spontaneous, unaided speech -- was reported in Linebarger, Schwartz, & Kohn (2001). Two people with non-fluent aphasia participated in an extended treatment program in which the system was used alternately (but not concurrently) with another language therapy program. As indicated in Linebarger et al. (2001: Tables 7 and 9), the first 15 hours of home use of SentenceShaper (after several hours of training in the lab) had a marked impact on the quality of these participants’ unaided retellings of silent videos viewed before and after (but never during) training. For example, both participants showed changes in Median Length of Utterance; one participant increased from a median 2 words per utterance pre-training to 4 words per utterance post-training, and the other participant increased from a median 3 words per utterance pre-training to 5 words post-training.

These gains are particularly encouraging because they were achieved through largely independent home use of the system. After learning how to operate the program effectively, participants were provided with computers in their homes and asked to use the system to create narratives – describing life events, expressing opinions, or retelling movies and television shows.

In a subsequent project, SentenceShaper was used in the context of aphasia groups. In this project, participants met weekly in supported conversation groups and also underwent weekly training on the system, which was used for two “offline” functional purposes: email (productions on the system were emailed to friends and fellow group members as sound file attachments) and a group web site (photographs and other images were accompanied by spoken comments created on the system). In the second half of the study, participants were instructed to engage in regular homework constructing narratives on SentenceShaper. For six of the 10 participants in this phase of the study, treatment gains were observed (Schwartz, Linebarger, Brooks, & Bartlett, 2007; some results reported in Linebarger & Schwartz, 2005:Table 1) across a variety of unpracticed narrative tasks, ranging from Cinderella story retellings to the less demanding task of describing wordless picture books; and across a number of different structural measures.

SentenceShaper treatment studies at the University of Maryland School of Medicine

SentenceShaper treatment effects were studied in a recent project at the University of Maryland School of Medicine.  As reported in Linebarger, McCall, & Berndt (2004), Linebarger, McCall, Virata, & Berndt (2007), and McCall, Virata, Linebarger, & Berndt (in press), largely independent home use of SentenceShaper led to treatment gains reflected in structural measures (such as utterance/sentence length, proportion of words that occur in sentences, grammatical well-formedness), measures of informativeness, and/or speech rate.. Perhaps the most striking treatment outcome to date is the case study reported in McCall et al. (2008). After using SentenceShaper at home for a period of 27 hours (over a five month period), the participant, who has nonfluent aphasia, increased his Mean Sentence Length from 3.6 words per sentence to 8.12 words per sentence; after a second treatment in which the software was used to train subordinate clauses, his unaided sentence length increased further to 11.56 words per sentence. In addition, his utterances became more structured and well-formed; after the first treatment, for example, the proportion of his words that were in sentences rather than isolated fragments increased from 44% to 91%; the proportion of sentences that were well-formed increased from 7% to 76%. Below we illustrate the qualitative impact of these changes with excerpts from McCall et al. (2008; Table 4), comparing the first few utterances of this participant’s spontaneous, unaided retelling of a wordless picture book before and after the first treatment. This particular story was never practiced during treatment, of course; for a fuller sample of these pre-post narratives, please see McCall et al. (2008; Table 4).

The participant in this study was two years post-stroke, well past the 6-month period traditionally cited as the phase of spontaneous recovery. All participants in these SentenceShaper studies have been at least one year post-onset, in order to make sure that any treatment effects do not reflect spontaneous recovery.

More information about these research studies and the scientists and clinicians involved may be found on the grants page; full references to articles cited below are on the publications page. This page is derived from our Research Report, which is in PDF format; click here to view the entire report, or right-click the link and then select "Save target as..." to download it to your computer. You may also wish to read the page describing research on the effectiveness of SentenceShaper as a communication aid.