Disclaimer: this resource is intended for speech and language therapists and students of this profession. If you require therapy for aphasia please contact a speech and language therapist.
Anagram and Copy Treatment (ACT)
Summary: Anagram and Copy Treatment (ACT) (Beeson, 1999; Beeson, Hirsch, &, Rewega, 2002) seeks to improve single word writing ability. Clients rearrange scrambled letters to form a target word before repeatedly copying the written form. Targeted words are typically functional. ACT bears some similarities to Copy and Recall Treatment (CART) and some clinicians have combined these approaches (Beeson et al., 2002; Helm-Estabrooks & Albert, 2004).
Example:
1) The client is provided the spoken form and/or a picture of the target word. The client is asked to write the target word.
2) If the client is successful, the therapist gives feedback and moves on to the next target.
3) If the client has difficulty writing the target, the therapist presents the individual component letters (printed in large font on thick paper) in scrambled order. The client is asked to rearrange these to form the target.
4) If the client successfully arranges the component letters, they are asked to copy the target word 3 times.
5) If the client is unsuccessful, the therapist arranges the letters correctly and the client is asked to copy this 3 times before returning to step 3.
6) The therapist then again presents the individual component letters plus 2 distractor letters (i.e. letters not in the target word) in scrambled order. The client is again asked to rearrange these to form the target.
7) If the client successfully arranges the component letters, they are asked to copy the target word 3 times.
8) If the client is unsuccessful, the therapist arranges the letters correctly and the client is asked to copy this 3 times before returning to step 6. If the client repeatedly struggles with step 6, return to step 3.
9) All written forms of the word are removed from view. The client is again provided the spoken form and/or picture of the target word and asked to write the target word.
10) If the client is successful, they are asked to write the target word in response to the spoken form and/or picture form a further 3 times before moving on to next target word.
11) If the client is unsuccessful, they are asked to copy a written model of the target word before returning to step 9. If the client repeatedly struggles with step 9, return to step 3.
Adapted from Beeson et al. (2002).
1) The client is provided the spoken form and/or a picture of the target word. The client is asked to write the target word.
2) If the client is successful, the therapist gives feedback and moves on to the next target.
3) If the client has difficulty writing the target, the therapist presents the individual component letters (printed in large font on thick paper) in scrambled order. The client is asked to rearrange these to form the target.
4) If the client successfully arranges the component letters, they are asked to copy the target word 3 times.
5) If the client is unsuccessful, the therapist arranges the letters correctly and the client is asked to copy this 3 times before returning to step 3.
6) The therapist then again presents the individual component letters plus 2 distractor letters (i.e. letters not in the target word) in scrambled order. The client is again asked to rearrange these to form the target.
7) If the client successfully arranges the component letters, they are asked to copy the target word 3 times.
8) If the client is unsuccessful, the therapist arranges the letters correctly and the client is asked to copy this 3 times before returning to step 6. If the client repeatedly struggles with step 6, return to step 3.
9) All written forms of the word are removed from view. The client is again provided the spoken form and/or picture of the target word and asked to write the target word.
10) If the client is successful, they are asked to write the target word in response to the spoken form and/or picture form a further 3 times before moving on to next target word.
11) If the client is unsuccessful, they are asked to copy a written model of the target word before returning to step 9. If the client repeatedly struggles with step 9, return to step 3.
Adapted from Beeson et al. (2002).
Evidence Base: Beeson et al. (2002) report 2 case studies where Anagram and Copy Treatment (ACT) was delivered alongside a Copy and Recall Treatment Programme (CART) homework programme and a further 2 case studies where a CART homework programme was carried out with no ACT input. All participants had significant aphasia and severe agraphia. Positive item-specific results were reported for all participants. Beeson et al. observe that a CART homework programme alone can result in similar positive outcomes to ACT delivered alongside a CART homework programme. They note, however, that each approach has features that will suit different clients. For example, ACT involves a supportive cueing heirarchy while CART may be carried out predominantly at home with less clinical support.
Ball et al. (2011) delivered a modified form of ACT and CART incorporating spoken repetition to 3 participants with severe aphasia and apraxia of speech. Following a 3 month programme, all participants showed positive results in their ability to write words targeted in the programme. However, no improvements were found in spoken naming of these targets.
Ball et al. (2011) delivered a modified form of ACT and CART incorporating spoken repetition to 3 participants with severe aphasia and apraxia of speech. Following a 3 month programme, all participants showed positive results in their ability to write words targeted in the programme. However, no improvements were found in spoken naming of these targets.
References
Ball, A.L., de Riesthal, M., Breeding, V.E., & Mendoza, D.E., 2011. Modified ACT and CART in severe aphasia. Aphasiology, 25(6-7), 836-848
Beeson, P.M., 1999. Treating acquired writing impairments: Strengthening graphemic representations. Aphasiology, 13(9-11), 767-785
Beeson, P.M., Hirsch, F.M., & Rewega, M.A., 2002. Successful single-word writing treatment: Experimental analyses of four cases. Aphasiology, 14(4-6), 473-491
Helm-Estabrooks, N. & Albert, M.L., 2004. Manual of aphasia therapy. Austin, TX: PRO-ED
Ball, A.L., de Riesthal, M., Breeding, V.E., & Mendoza, D.E., 2011. Modified ACT and CART in severe aphasia. Aphasiology, 25(6-7), 836-848
Beeson, P.M., 1999. Treating acquired writing impairments: Strengthening graphemic representations. Aphasiology, 13(9-11), 767-785
Beeson, P.M., Hirsch, F.M., & Rewega, M.A., 2002. Successful single-word writing treatment: Experimental analyses of four cases. Aphasiology, 14(4-6), 473-491
Helm-Estabrooks, N. & Albert, M.L., 2004. Manual of aphasia therapy. Austin, TX: PRO-ED
|
|
