Abstract
The study reported in this dissertation sought to provide an answer to the question as to whether compensation therapy improves functional communication in chronic agrammatism when restoration therapy has failed. More specifically, it was investigated whether a Dutch version of the Reduced Syntax Therapy (REST, Schlenck, Schlenck, & Springer, 1995, see also Springer, Huber, Schlenck, & Schlenck, 2000) leads, after a period of restoration therapy, to the overuse of ellipses and consequently to an increase in functional communication in chronic agrammatism. The REST therapy is compensatory in nature as it teaches agrammatic speakers to overuse ellipses. Ellipses are syntactic frames in which slots for grammatical morphology tend to be lacking, such as Everybody inside or Two beers, please. The listener has to compensate for the blanks by deriving the missing words from the conversational or situational context. Since the linguistic impairment is, at least partially, circumvented when elliptical style is overused, it was hypothesized that this compensatory style of speech increases communicative efficacy and efficiency in chronic agrammatism. Although compensation therapy can be considered to be the best solution to the underlying language impairment in the chronic phase, it has some serious pitfalls. Compensation asks for new speech behaviour and might, for several reasons, sincerely challenge stroke patients. These reasons, which relate to cognitive and socio-emotional factors, were also investigated. The main results of the present study suggest that, if restoration of sentence production fails, REST therapy may improve functional efficiency in chronic agrammatic speakers. It is important to note that there is no reason to assume that communicative efficiency improved at the expense of communicative efficacy: The agrammatic speakers got faster in getting their messages across and they nevertheless provided the listener with (at least) the same amount of information necessary to reconstruct their messages from their speech.
