Picture and spoken word presentation in repetition training for anomia: does stimulus order matter? Evidence obtained from 12 individuals with chronic aphasia using a computer based telemedicine approach

Background: Presenting pictures accompanied by the corresponding spoken words to be repeated is a commonly used method for treating naming impairments in aphasic people. Aims: In this study, we investigated whether the presentation order of pictures and words in repetition training affects treatment outcome. Methods & Procedures: We administered a computer-based word repetition protocol at a distance to 12 individuals with chronic pure anomia. The words to be repeated were presented with the corresponding pictures. We manipulated the timing of word and picture presentation. In one condition Picture-Word condition (Pic-Wd), the picture onset preceded that of the corresponding spoken word; in the other condition Word-Picture (Wd-Pic), the presentation order was reversed. Data were analyzed at the group and the single subject level to determine the relative efficacy of the two experimental conditions and the cognitive features predicting therapy success. Outcomes & Results: The study demonstrates the substantial equivalence of the two presentation orders at the group level. At the single subject level in a minority of cases, there are hints of an asymmetrical response favoring either the Pic-Wd or the Wd-Pic treatment. Non-word repetition skills were the only feature in the participants’ cognitive profile that was reliably linked to therapy outcome. Conclusions: When pictures are presented alongside the corresponding word in repetition training, stimuli presentation order seems to have only a minor effect on therapy outcome. Potential advantages of both treatments are discussed with reference to the cognitive profile of treated patients.