Benefits of a targeted rehabilitation of number transcoding in secondary acalculia: A single‐case experimental design

• Published in: International journal of language & communication disorders 2024-01, Vol.59 (1), p.255-275
• Main Authors: Lemanissier, Maureen, Riboulot, Camille, Weill‐Chounlamountry, Agnès, Dehollain, Charlotte, Pradat‐Diehl, Pascale, Bayen, Eléonore, Villain, Marie
• Format: Article
• Language: English
• Subjects: acalculia; Brain damage; Cognition; Dyscalculia; Female; Humans; Language; Memory, Short-Term; Numbers; numerical transcoding; Patients; Rehabilitation; Research Design; Short term memory; single‐case experimental design; Speech-language pathologists; Stroke
• ISSN: 1368-2822; 1460-6984
• DOI: 10.1111/1460-6984.12942

Background Despite its potentially significant functional and emotional impact, acalculia is still too rarely assessed and managed by speech and language therapists. Research on the rehabilitation of numerical transcoding remains scarce in the literature and, despite positive results, presents a low level of evidence. Aims The present study aims to evaluate the effectiveness of a targeted rehabilitation of numerical transcoding in two patients suffering from a chronic secondary acalculia. Methods & Procedures Two post‐brain injury females with secondary acalculia took part in a single‐case experimental design with multiple baseline across subjects according to a three‐phase experimental protocol: baseline involving global cognitive rehabilitation (5–7 measurements with randomized sequential introduction); targeted intervention (10 measurements); follow‐up (2 immediate measurements and 1 month after the end of the intervention). Repeated outcome measures consisted of six lists composed of numbers of equivalent difficulty that were used alternately to assess numerical transcoding. We used a reverse digit span as a control measure to assess the specificity of the intervention. Rehabilitation lasted 5 weeks and consisted of errorless learning with colour cues, tables and number–words cards. Outcomes & Results During baseline period involving global cognitive rehabilitation, transcoding scores remained unchanged. In contrast, there was a significant improvement in scores for both patients during the intervention phase targeting transcoding and maintenance of benefits 1‐month post‐intervention. Conclusions & Implications This study demonstrates that a specific rehabilitation targeting numerical transcoding following chronic secondary acalculia can be effective in improving transcoding skills. WHAT THIS PAPER ADDS What is already known on the subject Transcoding difficulties in patients with acalculia can cause a significant disability in everyday life activities. In secondary acalculia, rehabilitation of cognitive functions associated with number processing (attention, working memory, language) is not sufficient for improvement of transcoding. What this paper adds to existing knowledge An intervention specifically targeting numerical transcoding significantly and durably improves the skills of patients with chronic secondary acalculia. What are the potential or actual clinical implications of this work? Procedural error‐free intervention using colour cueing, tab