Are you on the lookout for a new aphasia therapy approach? AbSANT, or Abstract Semantic Associative Network Training, is a promising technique devised by Dr. Chaleece W. Sandberg and colleagues. AbSANT stands out by focusing on abstract rather than concrete words, aiming to capitalize on the way our brains process intangible concepts. Here you’ll learn what AbSANT is, who might benefit, and how to do it. You can find instructional videos, a thorough tutorial, and all the materials on the SANDLab page at Penn State.
Free DIRECT download: AbSANT for anomia (cheat sheet). (Email subscribers get free access to all the resources in the Free Subscription Library.)
Outline:
- What is AbSANT therapy?
- Who is AbSANT for?
- What materials does AbSANT require?
- The first session.
- Preparing the materials.
- How to do the AbSANT protocol.
- Learn more: AbSANT tutorial and training video.
- Try AbSANT with your aphasia patients.
- Related Eat, Speak, & Think posts.
What is AbSANT therapy?
AbSANT stands for Abstract Semantic Associative Network Training. AbSANT is the work of Chaleece W. Sandberg, PhD, CCC-SLP and colleagues.
You can find free access to the SIG 2 tutorial, videos, and materials on the SANDLab‘s page at Penn State.
Just as a reminder, abstract words refer to intangible ideas, such as love, time, beauty, science, care, community, and weddings.
Unlike other treatment approaches to anomia, AbSANT focuses on abstract words. Research has shown that PWA trained with AbSANT generally showed generalization to related, untrained words. Generalization to untrained words is one desired outcome of therapy.
As Dr. Sandberg writes in her tutorial, abstract words are processed differently than concrete words. Concrete concepts are activated strongly, with limited spread to neighboring concepts.
Abstract concepts, on the other hand, are activated less strongly but have a wider spread of activation to semantically-related words.
AbSANT seeks to take advantage of this difference in activation, aiming for generalization to untrained concepts for lexical retrieval. This is appealing for aphasia therapy, since abstract words are often more impaired but they are so important for everyday conversation.
Who is AbSANT for?
Dr. Sandberg reports in her tutorial that 20 PWA participated in rigorous single-subject experiments. Of these, 14 of 20 showed improvement in both trained and untrained items, 2 of 20 only showed improvement in trained items, and 4 of 20 did not benefit. The researchers have been unable to determine any shared characteristics of those who did and did not benefit in terms of age, time since diagnosis, or type of aphasia.
This means that we may consider AbSANT for any adult who has anomia. Good candidates may include adults with aphasia who:
- Can read single words/phrases (with or without assistance).
- Understand verbal speech at the single word/phrase level.
- Have some ability for semantic processing.
What materials does AbSANT require?
AbSANT requires printed stimuli cards and data collection sheets. The good news is that the materials are all available on Dr. Sandberg’s site, including templates to individualize the stimuli.
Here are the materials you’ll use:
- Personalized target category: 15 abstract and 15 concrete words.
- A distractor category: 15 abstract and 15 concrete words.
- Pre-made general feature cards (15) and distractor feature cards (15).
- Protocol to brainstorm 15 personalized features with your patient.
- Data sheets:
- AbSANT probe template.
- AbSANT Steps 3 and 4 template.
- AbSANT Step 5 template.
The first session
I highly recommend you read the freely-available tutorial and watch the video on the SANDLab site.
If you’re working with a patient who seems like a candidate for AbSANT, and your goal is to improve word retrieval of abstract words for conversation, then you may try something like this during the first session:
- Select a category/context that is relevant to their patient’s life.
- Measure baseline performance: Ask your patient to name concrete and abstract words in the target category for 2 minutes.
- Work together to generate 10 concrete and 10 abstract words that fit the target category/context.
- Using each of the 10 abstract words to stimulate conversation, identify up to 15 semantic features to use in therapy.
- Select a “distractor” category: one that is significantly different from the target category. Work together to select 10 concrete and 10 abstract words. If you use one of the categories from the SANDLab, you’ll have long word lists to choose from.
We may have to provide significant assistance in choosing the 40 words. Realistically speaking, we may have to make some of the choices outside of a clinical session. If we pick a word that doesn’t make sense to them, we can take a moment to find a better word and just write it on the flashcard.
Preparing the materials
Download the “template for word cards” and type in your 40 abstract and concrete words. (10 of each for the target category and the distractor category). Print on card stock and cut the cards apart.
Next, download and print out the “general feature cards” and the “distractor feature cards” on card stock. Cut the cards apart.
Then, download the “template for personalized feature cards“. Type in your 5 – 15 personalized semantic features. Print on card stock and cut the cards apart.
Alternatively, you could cut index cards into thirds and write one word per piece.
I printed the 40 word cards on blue stock paper and the 45 semantic features on yellow stock paper. This way, they will be easy to keep separate, and hopefully no one will throw them away.
Next, download the “AbSANT Steps 3 and 4 template.” Type in your 5-15 features to use for yes/no questions. Print it out.
The final form to download and print from the SANDLab is “AbSANT Step 5 template.”
I also recommend you download and print my cheat sheet, which walks you through AbSANT, step-by-step. I updated it to include a handy 1-page chart for selecting words and features.
How to do the AbSANT protocol
AbSANT asks patients to sort and verify features, with a final task for freely generating category members. Please read the tutorial for more details, which includes FAQ.
Step 1: Category sorting
At the start of each session, set out the labels for target category and the distractor category on the table. Shuffle the 40 word cards together, then ask your patient to sort them under the appropriate heading. You can read the word aloud, if needed. Give feedback on accuracy and allow them to correct any mistakes.
Step 2: Feature selection
Select one of the ten target abstract words, move all of the other word cards aside. Set out the 45 feature cards in a stack. Ask your patient to go through them and select the first 5-6 features that relate to the abstract word you’re working on. Provide assistance as needed. Once your patient has identified 5-6 features, ask them to read the features aloud, creating a sentence with the target word each time.
Step 3: Yes/no questions
Remove all the cards. Tell your patient “Now I’m going to ask you some questions about the word ____ (e.g., care). Please answer yes or no for each of these questions.” Ask your patient a total of 15 questions from the list of 45 features: 5 that are acceptable semantic features, 5 that are unacceptable semantic features from the same category, and 5 semantic features from the distractor category. Avoid saying the target word.
Step 4: Type, synonym, and recall
After you ask the yes/no questions, ask your patient if you’re working on a concrete or abstract word. Ask them to come up with a synonym. And finally, ask them to name the word you’re currently working on.
Repeat steps 2-4 for each of the 10 target abstract words.
Step 5: Free generative naming
Near the end of the session, ask your patient to name as many words as they can think of that are associated with their target category. They may name abstract or concrete words. There is no time limit. Provide feedback for each response.
Learn more: AbSANT tutorial and training video
On the SANDLab’s page at Penn State, you can find an instructional video and a written tutorial. The 8-minute video gives a good description, with demonstrations.
The tutorial is the preprint version of their manuscript that was published in the ASHA Perspectives for SIG 2.
The materials page also includes a how-to video and detailed instructions, with access to all the materials/templates you’ll need.
Try AbSANT with your aphasia patients
In conclusion, AbSANT is a research-based aphasia intervention that focuses on training abstract concepts, which are so important for normal conversation. Dr. Sandberg has made the tutorial, videos, and materials freely available.
I’d love to hear if you try AbSANT with your aphasia patients. How did it go? What modifications to the protocol did you make? Did you patient improve in their ability to talk about the target category? Please leave a comment below or contact me directly.
Related Eat, Speak, & Think posts
- How to shape words from numbers to improve speech.
- Improve aphasia outcomes by creating intensive home exercise programs.
- Attentive Reading and Constrained Summarization tutorial.
Free DIRECT download: AbSANT for anomia (cheat sheet). (Email subscribers get free access to all the resources in the Free Subscription Library.)
Featured image by maciej326 from Canva.com.
Lisa earned her M.A. in Speech-Language Pathology from the University of Maryland, College Park and her M.A. in Linguistics from the University of California, San Diego.
She participated in research studies with the National Institute on Deafness and other Communication Disorders (NIDCD) and the University of Maryland in the areas of aphasia, Parkinson’s Disease, epilepsy, and fluency disorders.
Lisa has been working as a medical speech-language pathologist since 2008. She has a strong passion for evidence-based assessment and therapy, having earned five ASHA Awards for Professional Participation in Continuing Education.
She launched EatSpeakThink.com in June 2018 to help other clinicians be more successful working in home health, as well as to provide strategies and resources to people living with problems eating, speaking, or thinking.
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