The effect of combining working memory training with naming treatment on word retrieval and the generalization to discourse in individuals with aphasia: The mediating role of working memory.

Given the interdependence of working memory (WM) and language processing, mitigating cognitive "bottlenecks" remains a critical objective in aphasia rehabilitation to promote functional recovery. This study investigated the comparative efficacy of a language treatment (Phonological Component Analysis; PCA) versus a combined approach integrating PCA and WM training, specifically examining their effects on lexical retrieval and discourse performance. A 65-year-old male with chronic non-fluent aphasia (participant [HY]) was recruited for this single-subject ABAC experimental design, comprising an initial three-session baseline (A1), a phase of PCA-only treatment (B), a secondary three-session baseline (A2), and a phase of combined PCA+WM intervention (C). Primary outcome measures encompassed naming accuracy, WM capacity, and connected speech indices (including lexical, grammatical, and communicative indices). Data analysis was conducted via visual inspection and the Percentage of Non-overlapping Data (PND) metric. Visual analysis revealed that both intervention protocols yielded clinical gains relative to baseline performance. While naming abilities exhibited consistent enhancement across both treatment phases, a notable augmentation in WM capacity was observed specifically during the second phase. Notably, discourse outcomes-incorporating grammatical, semantic, and communicative parameters-demonstrated significant improvement during the initial PCA-only phase, with more modest gains observed during the subsequent combined treatment phase. Post-intervention follow-up indicated that therapeutic gains were either maintained or exhibited marginal continued progress. These findings suggest that integrating WM training into traditional anomia therapy may augment naming and discourse outcomes, Further large-scale research is warranted to elucidate the precise mechanisms by which WM contributes to the remediation of discourse deficits in aphasia.