Effects of two treatments for aprosodia secondary to acquired brain injury.

Expressive aprosodia is an impaired ability to change one's voice to express common emotions such as joy, anger, and sadness. Individuals with aprosodia speak in a flat, unemotional voice that often results in miscommunicated emotional messages. This study investigated two conceptually based treatments for expressive aprosodia: imitative treatment and cognitive-linguistic treatment. Five women and nine men with expressive aprosodia following right-hemisphere brain damage received the treatments in two phases 1 month apart in random order. Treatment was received 3 to 4 days a week for a total of 20 sessions each phase. As the outcome measure, sentences that elicited treated (happy, angry, sad, neutral) and untreated (fear) emotional tones of voice were administered during baseline, prior to treatment sessions, following treatment termination, and at 1- and 3-month follow-ups. Effect sizes indicated that treatment effects were modest to substantial and that 12 participants responded to at least one treatment. Four responsive participants who were available for follow-up showed benefit at 1 and 3 months posttreatment. Most visual and statistical analyses were congruent.

Active treatments for aprosodia secondary to right hemisphere stroke.

This study investigates the effects of two mechanism-based treatments for expressive aprosodia. Three participants, two women and one man, had a right hemisphere cerebral infarction resulting in affective aprosodia with greater expressive than receptive deficits. Trained raters determined presence of aprosodia by judging participants' performance on two emotional communication batteries. A single-subject design with replication across three participants was employed. Sentence production with the use of treated and nontreated emotions was measured during baseline and treatment phases. Sentences were scored for accuracy by a trained rater blind to time of testing and analyzed visually and statistically. Effect sizes calculated on the resulting data for each participant and treatment confirmed modest to substantial treatment effects for both treatments in all three participants. Because of a relative paucity of treatment studies investigating expressive aprosodia, these data are among the first to suggest that aprosodia may be amenable to behavioral treatments.

Novel treatments for expressive aprosodia: a phase I investigation of cognitive linguistic and imitative interventions.

This study investigated two mechanism-based treatments for expressive aprosodia, a disturbance in emotional prosody thought to be governed by the right hemisphere. The 3 participants all suffered right CVA's resulting in expressive aprosodia. Presence of expressive aprosodia was determined by performance on two batteries of emotional communication. A single subject ABAC design was employed in which two treatments, one imitative and one cognitive linguistic, were assigned in random order. All participants in this study were randomly assigned to begin with the cognitive linguistic treatment. Probes of treated and untreated emotions were completed during baseline and therapy phases. Probe items were judged by a reliable, trained rater blind to time of testing. Visual and statistical analyses were completed. These analyses confirmed that both treatments were active. For example, effect size calculations confirmed modest to substantial treatment effects for both treatments in all 3 patients. Replication to increase confidence about treatment effect and enhance understanding of the neuromechanisms underlying aprosodia is underway.