Training and generalization of expressive syntax in nonfluent aphasia

Generalization of treatment effects remains a consistent goal of clinicians who treat aphasic adults. Specifically, various types of stimulus/response generalization designs are available, depending on the level of generalization desired. We have reviewed training matrices designed to elicit gestural subject-plus-verb targets and treatment studies designed to answer more global questions regarding treatment efficacy. As Kearns (1989) so eloquently states, "clinical accountability cannot, in fact, be fully achieved without documentation of communication skills trained in the clinic generalized to other settings and situations." Although the studies cited and data reviewed in this article did not meet this standard specifically, an attempt was made to provide a brief prelude to the data now emerging in the aphasiology literature. Additionally, with an increasing data base in the literature specific to generalization, more efficacious treatment paradigms will be made available. Clinicians treating aphasic adults thus should have the opportunity to choose the treatments shown to be most effective for a specific type and severity of aphasia.