Purpose: Response Elaboration Training (RET) is a treatment program for increasing the amount of information contained in the speech of individuals with aphasia. This study employed a sentence production task (SPT) to examine whether RET will (1) generalize to a task not worked on in treatment and (2) affect syntactic performance. Methods and Procedures: Three adults with chronic non-fluent Broca’s aphasia received RET in this prospective, repeated case study. The dependent variable was a SPT requiring the participant to put a verb in a sentence. Changes in the syntactic performance of the participant’s sentence productions were classified across three parameters: (1) syntactic structure, (2) grammatical completeness, and (3) semantic appropriateness. Results: Findings of this study indicate that RET improves the syntactic performance of individuals with chronic Broca’s aphasia and generalizes to a task not worked on in treatment. Participant responses to the SPT showed increased complexity in syntactic structures, improved grammaticality, and improved topic relevancy. In addition, qualitative improvements were seen in 5 randomly selected verbs for each participant. These improvements included increased length of sentences and fewer false starts, interjections, and disfluencies. Finally, improvements on the Western Aphasia Battery and two picture description tasks were evinced for two participants.

Perceived self-efficacy has been shown to be an accurate predictor of one's performance capabilities (Zimmerman, 2000). Low levels of perceived self-efficacy have been found to correlate with negative performance outcomes; while high levels of perceived self-efficacy correlate with positive performance outcomes. This construct has also been found to influence an individual's motivation level, goal setting ability, and risk for depression (Resnick, 2002; Phillips & Gully, 1997; Blazer, 2002). Therefore, perceived levels of self-efficacy may predict and influence performance of individuals with aphasia during a treatment program. However, the influence of self-efficacy on treatment for aphasia has not been sufficiently studied. The present study examined the differences between Response Elaboration Training (Kearns, 1985) and a modified version of Response Elaboration Training, incorporating the four sources of self-efficacy. First, it was hypothesized that the individual's level of perceived self-efficacy would predict performance during treatment. Also, it was hypothesized that a treatment incorporating self-efficacy would result in increased levels of self-efficacy, thereby promoting more positive therapeutic outcomes. A single-subject, cross-over design was employed; two individuals with Broca type aphasia received both types of treatment at alternating intervals. A relationship between perceived self-efficacy levels and performance outcomes was suggested. Participant one, with a high level of perceived self-efficacy for communicative tasks, experienced a general trend of improvement for effective communication. Participant two's use of effective communication revealed minimal change throughout the study; he also reported low to moderate levels of perceived self-efficacy in all modalities of communication throughout the study. Participant two's performance revealed slight improvements in self-efficacy, however, as well as improvements on a standardized aphasia assessment; this finding may suggest a relationship between increased self-efficacy and increased performance on the assessment. Results suggest that a treatment incorporating the four sources of self-efficacy may promote more positive treatment outcomes for individuals with aphasia.

The effects of a multimodality treatment were investigated using a single subject experimental design across behaviors in two patients with different severity levels of Broca's aphasia. We hypothesized that Response Elaboration Training and an oral reading task would improve accuracy of sentence production, information content, and mean length of utterance. Results indicated that this treatment approach elicited significant improvement in the accuracy of sentence production and information content in the participant with very mild Broca's aphasia. Furthermore, the participant with severe Broca's aphasia demonstrated a very significant improvement in information content and mean length of utterance. The improvements support the idea that the same treatment may be used for individuals with various levels of ability as long as appropriate aspects of language are monitored for each client.