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.
Response Elaboration Training (RET)
Summary: An approach that involves structured elaboration of a client’s utterances in order to support word retrieval and increase the number of content words used (Conley & Coelho, 2003). Although predominantly used for clients with nonfluent aphasia, Response Elaboration Training (RET) has also been successful used in the treatment of clients with fluent aphasia (Kearns & Scher, 1989) and clients with apraxia of speech (Wambaugh & Martinez, 2000).
Example:
1) The therapist prompts a response from the client (e.g. describing a picture of a man running for a bus) and gives feedback:
Client: “Man...run”
Therapist: “Yes. The man is running”
2) Using wh- questions the therapist prompts the client to elaborate on their initial response:
Therapist: “Why is the man running?”
Client: “Bus”
3) The therapist combines and shapes the client’s responses to make a longer, coherent statement:
Therapist: “Good. The man is running for the bus”
4) The therapist repeats this longer statement and asks the client to repeat it.
5) The therapist asks the client to recall the longer statement after a delay.
Adapted from Davis (2007).
1) The therapist prompts a response from the client (e.g. describing a picture of a man running for a bus) and gives feedback:
Client: “Man...run”
Therapist: “Yes. The man is running”
2) Using wh- questions the therapist prompts the client to elaborate on their initial response:
Therapist: “Why is the man running?”
Client: “Bus”
3) The therapist combines and shapes the client’s responses to make a longer, coherent statement:
Therapist: “Good. The man is running for the bus”
4) The therapist repeats this longer statement and asks the client to repeat it.
5) The therapist asks the client to recall the longer statement after a delay.
Adapted from Davis (2007).
Evidence Base: Numerous single-subject studies have been carried out into the effects of RET. The majority of these studies indicate that RET results in longer and more varied utterances in picture description tasks. For example, Kearns’ study (1985) into the use of RET with a client who had chronic nonfluent aphasia and apraxia of speech indicates that the treatment resulted in increased verbal information in the participant’s utterances. Additionally, there was a moderate degree of generalisation to untrained targets.
Conley & Coelho (2003) studied the effects of a combined Semantic Feature Analysis and RET approach for improving word retrieval of nouns in a participant with chronic Broca’s aphasia. Findings indicated that this approach resulted in improved naming of words targeted in therapy as well as untreated words.
Wambaugh et al.’s study (2012) suggests that maintenance and generalisation of gains may be poorer for clients with fluent aphasia.
Conley & Coelho (2003) studied the effects of a combined Semantic Feature Analysis and RET approach for improving word retrieval of nouns in a participant with chronic Broca’s aphasia. Findings indicated that this approach resulted in improved naming of words targeted in therapy as well as untreated words.
Wambaugh et al.’s study (2012) suggests that maintenance and generalisation of gains may be poorer for clients with fluent aphasia.
References
Conley, A., & Coelho, C.A., 2003. Treatment of word retrieval impairment in chronic Broca’s aphasia. Aphasiology, 17, 203-211
Davis, G.A., 2007. Aphasiology: Disorders of Clinical Practice. Boston: Pearson
Kearns, K.P., 1985. Response elaboration training for patient initiated utterances. In: Brookshire, R.H. ed. Clinical Aphasiology Conference Proceedings. Minneapolis, MN: BRK Publishers, 196-204
Kearns, K.P. & Scher, G., 1989. The generalization of response elaboration training effects. Clinical Aphasiology, 18, 223-238
Wambaugh, J.L. & Martinez, A.L., 2000. Effects of modified response elaboration Training with apraxic and aphasic speakers. Aphasiology, 14(5/6), 603-617
Wambaugh, J.L., Wright, S., & Nessler, C., 2012. Modified response elaboration training: A systematic extension with replications. Aphasiology, 26(12), 1407-1439
Conley, A., & Coelho, C.A., 2003. Treatment of word retrieval impairment in chronic Broca’s aphasia. Aphasiology, 17, 203-211
Davis, G.A., 2007. Aphasiology: Disorders of Clinical Practice. Boston: Pearson
Kearns, K.P., 1985. Response elaboration training for patient initiated utterances. In: Brookshire, R.H. ed. Clinical Aphasiology Conference Proceedings. Minneapolis, MN: BRK Publishers, 196-204
Kearns, K.P. & Scher, G., 1989. The generalization of response elaboration training effects. Clinical Aphasiology, 18, 223-238
Wambaugh, J.L. & Martinez, A.L., 2000. Effects of modified response elaboration Training with apraxic and aphasic speakers. Aphasiology, 14(5/6), 603-617
Wambaugh, J.L., Wright, S., & Nessler, C., 2012. Modified response elaboration training: A systematic extension with replications. Aphasiology, 26(12), 1407-1439
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