Gregory_ACRT_Handout
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Apr 3, 2024
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Anagram Copy and Recall Treatment (ACRT) for Spelling Focus of the intervention
ACRT is a combination of two other evidence-based aphasia treatments, Anagram and Copy Treatment (ACT)
and
Copy and Recall Therapy (CART)
. ACRT is an evidence-based intervention that focuses on writing out single words for persons with severe aphasia and agraphia through repetition. Since this is used when verbal expression is not sufficient for the person with aphasia (PWA), it is important to work with both the PWA and family/caregiver to create a list of 25-40 words to target during therapy. These words should be functional in nature (e.g., family names, common requests, and/or recurring topics). Details of the treatment protocol
Materials: pictures of each word, letter tiles, paper, writing utensil, a helper (Tactus Therapy also has an app that can be used in lieu of the pictures and letter tiles)
Before beginning, organize the word list into sets of 5-10 to work on at a given time, and start with the shortest, most common words. 1.
Test
– Show the PWA a picture of the word (e.g., book) and say “write the word for this”
or “can you write “book”’? If the PWA is able to write the word, provide positive feedback and move to the next word. If not, continue to the next step. 2.
Anagram
– Provide the PWA letter tiles containing the letters found in the word being targeted in a random order (e.g., O-K-B-O). Tell the PWA to “put the letters in order”. If the PWA is unable to do so, arrange the letters for them. 3.
Copy
– Ensure that the correct spelling of the word is visible to the PWA and tell them to
“copy the word 3 times.” 4.
Recall
– Remove the paper and letters. Show the picture again and say “write this word” on a new piece of paper. Note: There are many variations of ACRT, and the level of difficulty can easily be increased or decreased (e.g., giving the PWA a partially spelled word and telling them to fill-in-the-blank or providing extra letter tiles for them to choose from during the Anagram stage).
Evaluation of the treatment approach
In PWA, ACRT appears to be a good treatment option. Beeson et al., (2002) reported that of the four people they studied, all showed improvement and were able to master their target words. They also discovered that while ACRT is a combination of ACT and CART, the participants who only used CART also showed success, but those that used ACRT showed the most success. Motivation also has been proven to be an important factor as the key to ACRT’s success is a repetition. However, as there is limited research and success in PWA with severe cases of agraphia, ACRT will most likely have the most success with PWA whose aphasia is more severe
than thier agraphia as the goal is to be able to use writing as a way to help communicate what they are having difficulty saying verbally. There is also limited evidence that ACRT, ACT, or CART generalizes to words outside of the target list. Overall, there appears to be a significant amount of research that shows the success of this treatment despite its limitations. Presented by: Juliette Gregory, April 13, 2022
References
Beeson, P. M., Hirsch, F. M., & Rewega, M. A. (2002). Successful single-word writing treatment: Experimental analyses of four cases. Aphasiology
, 16
(4/5/6), 473-491. https://aphasia.sites.arizona.edu/content/9
Tactus Therapy. (n.d.). Anagram Copy and Recall Treatment for Writing: A 'How To' Guide
. Tactus Therapy. Retrieved April 2, 2022, from https://tactustherapy.com/anagram-copy-
recall-treatment-writing/
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