Date of Award

Fall 12-15-2017

Degree Type


Degree Name

PhD Health Sciences


Health and Medical Sciences


Venu Balasubramanian, Ph.D.

Committee Member

Anthony Koutsoftas, Ph.D.

Committee Member

Vikram Dayalu, Ph.D.


Impairment specific approach, social functional approach, agrammatic Broca’s aphasia, Verb Network Strengthening Treatment, Script Therapy


Background/Introduction: Individuals with agrammatic Broca’s aphasia frequently are treated at single word level, verb priming, or simple sentence structure treatments. In this study, an impairment specific treatment such as Verb Network Strengthening Treatment (VNeST) was explored as well as a social functional approach such as Script Therapy. These two approaches were assessed by the outcome measures of rate of speech, subject-verb-object production, and error rates during probe tasks.

Objective: To examine the impact of two treatment approaches: Script Therapy and Verb Network Strengthening Treatment for two individuals with chronic agrammatic Broca’s aphasia.

Method: A single subject multiple baseline alternating treatment across participants’ design was implemented. Each participant received each therapy for 9 weeks and both treatments were counterbalanced. Generalization probes were administered on the second session of each treatment per week to assess pre-to-post outcome measures including rate of speech, subject- verb-object production (SVO), and error rate. Effect sizes were calculated for baseline through maintenance outcome measures. To analyze the inter-therapeutic effects of the two treatment, the Percentage of data Exceeding the Median was used.

Results: Both participants improved over the 18 weeks on rate of speech and subject verb-object (SVO) production during probe tasks. For P1, Error rates decreased from baseline to maintenance phases. Effect sizes were calculated for the baseline to maintenance phases using the Busk & Serlin’s d2 formula (1992). The effects size calculations were compared using the Beeson & Robey (2006) benchmarks for lexical and syntactic metanalyses for aphasia. For the baseline to maintenance effects, small effect sizes were found for both participants for rate of speech. For P1, a medium to large effect was noted for SVO production. P2’s effect size for SVO production revealed no effect. Error rates for P1 revealed no effect. P2’s error rate produced a small unfavorable effect.

Conclusions: Both participants benefitted from the two treatment approaches in individual ways. It is possible that the multi-modal nature of the training between VNeST and Script that engaged functional sentence production and a linguistic approach for sentence production contributed to a positive language change for these participants.