The scripts (or scripts) are dialogues or monologues which, repeated for more or less long periods (at least 3 weeks), can lead the person with aphasia to have "islands of automatic speech" to be used in everyday life. A classic example is that of the pizzeria. A series of questions and answers is created that can lead the aphasic person to interact with the waiter and order his favorite pizza.
As you can guess, this is an activity to be carried out constantly and intensively (at least once a day until automation is complete). The fact of having to repeat these words, phrases or speeches many times led to the creation of tools to practice individually, from simple videos to real software (in the United States, for example, it exists AphasiaScripts).
One criticism of this approach concerns generalization. Does the aphasic person learn a series of phrases by heart, but will then be able to produce others, even similar ones, or will he just repeat the ones he has practiced?
I study. In 2012 Goldberg and colleagues  published an interesting study on the possible generalization of these scripts. In particular, the authors asked themselves these three questions:
- Does script treatment improve accuracy, grammar proficiency, speech fluency, and articulatory fluency in trained scripts?
- Does script treatment improve accuracy, grammar proficiency, speech fluency, and articulatory fluency in untrained scripts?
- Is remote treatment (eg videoconferencing) through scripts a valid solution, in combination with face-to-face sessions?
Two subjects were scripted on topics they considered relevant for three sessions a week (through video calls) of 60-75 minutes plus 15 minutes of self-paced home exercises.
Results. The best results were obtained on the speed of speech, but positive results were also found on the reduction of disfluences and on the use of trained words and phrases. A good one was also found generalization untrained script, with one of the two participants using a trained (political) script to introduce new topics. Finally, the remote treatment proved to be effective, despite some practical difficulties (for example, the lack of synchronization between audio and video or the connection drops that led to less defined images).
The importance of self-cueing. Finally, an important aspect turned out to be that of self-cueing, or rather being able to independently produce a word capable of recalling the target word. This aspect proved particularly useful when subjects were unable to start a sentence on their own. For example, one of the two participants could not start a sentence whose first word was "Will", but could say the name "William". Using William as a starting point, he was able to produce the phrase that began with "Will" on his own.
Conclusions. The main limitations of this study obviously concern the small number of participants. Moreover, but it is a difficulty found in all the literature on the subject, it was not possible to identify general rules for choosing the scripts to train. However, it is an interesting study because it tackles the problem of generalization for the first time, as well as providing further clues to the importance of self-cueing.
Our course. You can purchase our online course “The Treatment of Aphasia” from here. Contains several hours of videos with references to literature and practical activities (in addition to materials) for the treatment of aphasia. The cost is € 80. Once purchased, the course will be accessible forever.
Aphasia has not only an emotional but also an economic cost for the patient and his family. Some people, for economic reasons, limit their rehabilitation possibilities, despite the evidence supporting the need for intensive and constant work. For this reason, since September 2020, all our apps can be used for free online in GameCenter Aphasia and our activity sheets are all available here: https://www.trainingcognitivo.it/le-nostre-schede-in-pdf-gratuite/