The Effect of Combining Attention Training Program into Language-based Treatment of Anomia on Word Retrieval: A Case Report

  • Amin Modarres Zadeh Department of Speech Therapy, School of Rehabilation, Tehran University of Medical Sciences, Tehran, Iran.
  • Azar Mehri ORCID Department of Speech Therapy, School of Rehabilation, Tehran University of Medical Sciences, Tehran, Iran.
  • Shohreh Jalaie ORCID Department of Physical Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
  • Vahid Nejati Department of Psychology, Faculty of Education and Psychology, Shahid Beheshti University, Tehran, Iran.
  • Ahmad Reza Khatoonabadi Mail Department of Speech Therapy, School of Rehabilation, Tehran University of Medical Sciences, Tehran, Iran.
Stroke, Aphasia, Attention, Naming, Treatment


Introduction: The present study is a case report of a 50-year-old man (SM) with aphasia whose word retrieval was severely impaired. The aim of the study was to compare the effect of a combined treatment program (attention training and language treatment) and a single program (language treatment alone) on the naming picture materials.
Materials and Methods: This case was affected by a hemorrhagic cerebrovascular accident in the territory of Middle Cerebral Artery branches of the left hemisphere. Two naming treatments, i.e. the single and combined treatments sequentially, were provided for SM; during each of them a 50-item wordlist was practiced (Lists A and B). 12 treatment sessions were implemented for him during each treatment program. These two lists along with another list (List C), left for assessment of generalization of treatments to untrained items, were probed 6 times during and after each program. The whole picture set was normalized in another study described in the text.
Results: Our patient’s naming ability progressed during the treatment programs. However, this progression was more salient in combined treatment program. More specifically, List B had the mean score of 34.25 in combined treatment program that was higher than mean of List A in single treatment program (14.5). The slope of List B scores was also higher than that of List A (3.7 vs 1.2). List C showed more generalization of combined treatment to untrained items than single treatment based on its mean scores (27 vs 18.5).
Conclusion: the observed improvements of naming ability were felt to be the result of combining attention training into the language treatment which is lead to sustained attention, less distraction and more concentration.


Murray LL, Ramage AE, Hopper T. Memory impairments in adults with neurogenic communication disorders. Seminars in Speech and Language 2001; 22(2): 129-138. [DOI:10.1055/s-2001-13937] [PMID]

Caspari I, Parkinson SR, LaPointe LL, Katz RC. Working memory and aphasia. Brain and Cognition. 1998; 37(2):205-23. [DOI:10.1006/brcg.1997.0970] [PMID]

Mayer JF, Murray LL. Measuring working memory deficits in aphasia. Journal of Communication Disorders. 2012; 45(5):325-39. [DOI:10.1016/j.jcomdis.2012.06.002] [PMID]

Murray LL. Review attention and aphasia: Theory, research and clinical implications. Aphasiology. 1999; 13(2):91-111. [DOI:10.1080/026870399402226]

Murray LL. The effects of varying attentional demands on the word retrieval skills of adults with aphasia, right hemisphere brain damage, or no brain damage. Brain and Language. 2000; 72(1):40-72. [DOI:10.1006/brln.1999.2281] [PMID]

Murray LL. Attention and other cognitive deficits in aphasia: Presence and relation to language and communication measures. American Journal of Speech-Language Pathology. 2012; 21(2):S51-64. [DOI:10.1044/1058-0360(2012/11-0067)]

Borod JC, Carper M, Goodglass H. WAIS Performance IQ in aphasia as a function of auditory comprehension and constructional apraxia. Cortex. 1982; 18(2):199-210. [DOI:10.1016/S0010-9452(82)80003-8]

Purdy M. Executive function ability in persons with aphasia. Aphasiology. 2002; 16(4-6):549-57. [DOI:10.1080/02687030244000176]

Glosser G, Goodglass H. Disorders in executive control functions among aphasic and other brain-damaged patients. Journal of Clinical and experimental Neuropsychology. 1990; 12(4):485-501. [DOI:10.1080/01688639008400995] [PMID]

Gordon-Pershey M, Wadams A. The relationship of language and attention in elders with nonfluent aphasia. Cogent Medicine. 2017; 4(1):1356063. [DOI:10.1080/2331205X.2017.1356063]

Murray LL, Keeton RJ, Karcher L. Treating attention in mild aphasia: Evaluation of attention process training-II. Journal of Communication Disorders. 2006; 39(1):37-61. [DOI:10.1016/j.jcomdis.2005.06.001] [PMID]

Helm-Estabrooks N, Connor LT, Albert ML. Treating attention to improve auditory comprehension in aphasia. Brain and Language. 2000; 74(3):469-72.

Treiman R, Clifton Jr C, Meyer AS, Wurm LH. Language comprehension and production. In Alice F. Healy, Robert W. Proctor (Eds). Comprehensive Handbook of Psychology.

Tahanzadeh B, Soleymani Z, Jalaie S. Parallel Picture-Naming Tests: Development and psychometric properties for farsi-speaking adults. Applied Neuropsychology: Adult. 2017; 24(2):100-7. [DOI:10.1080/23279095.2015.1107562] [PMID]

Kalbe E, Reinhold N, Brand M, Markowitsch HJ, Kessler J. A new test battery to assess aphasic disturbances and associated cognitive dysfunctions-German normative data on the aphasia check list. Journal of Clinical and Experimental Neuropsychology. 2005; 27(7):779-94. [DOI:10.1080/13803390490918273] [PMID]

Demeyere N, Riddoch MJ, Slavkova ED, Bickerton WL, Humphreys GW. The Oxford Cognitive Screen (OCS): Validation of a stroke-specific short cognitive screening tool. Psychological Assessment. 2015; 27(3):883-94. [DOI:10.1037/pas0000082] [PMID]

Nejati V. Cognitive rehabilitation in children with attention deficit-hyperactivity disorder: Transferability to untrained cognitive domains and behavior. Asian Journal of Psychiatry. 2020; 49:101949. [DOI:10.1016/j.ajp.2020.101949] [PMID]

McNeil MR, Odell K, Tseng CH. Toward the integration of resource allocation into a general theory of aphasia. Clinical Aphasiology. 1991; 20:21-39.

Sinotte MP, Coelho CA. Attention training for reading impairment in mild aphasia: A follow-up study. NeuroRehabilitation. 2007; 22(4):303-10. [DOI:10.3233/NRE-2007-22408] [PMID]

Coelho C. Direct attention training as a treatment for reading impairment in mild aphasia. Aphasiology. 2005; 19(3-5):275-83. [DOI:10.1080/02687030444000741]

How to Cite
Modarres Zadeh A, Mehri A, Jalaie S, Nejati V, Khatoonabadi AR. The Effect of Combining Attention Training Program into Language-based Treatment of Anomia on Word Retrieval: A Case Report. jmr. 14(4):253-260.
Case Report(s)