Introduction
AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) is a language impairment that typically results from damage to the left hemisphere of the brain and consequently, is a common impairment after strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. The resulting language dysfunctions are roughly classified as expressive (e.g. Broca’s aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada)) or receptive (e.g. Wernicke’s aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada)).
An individual with Broca’s aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) has a partial or total inability to speak or produce spontaneous speech. They often have no difficulty understanding others, however, thoughts and intentions are difficult to express and may be non-fluent in nature. This form of aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) can also affect written communication.
An individual with Wernicke’s aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) has a partial or total inability to understand spoken and sometimes written language. Expression of language may be fluent in nature, but can be difficult for the listener to understand.
The symptoms of global aphasiaGlobal aphasia is characterized by the complete loss of the ability to comprehend spoken or written language, as well as express language verbally or orthographically. Verbal expression is limited to words or short automatic phrases such as explicatives. Meaning can sometimes appear to be present because of the emotional content of the explicatives. Also, comprehension is totally absent even though facial expression and fleeting looks might appear that the patient comprehends. Repetition and naming are also disturbed.
are those of severe Broca’s aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) and Wernicke’s aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) combined. There is an almost total reduction of all aspects of spoken and written language, in expression as well as comprehension.
This module contains 34 studies, where 21 of them are high quality randomized clinical trials (RCTs), 11 are fair quality RCTs, and 2 are non-RCTs. The majority of interventions (18 studies) were studied among patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. (i.e. 6 months or more post-stroke).
Overall, we identified different interventions for post-stroke aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) and those include: constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy; speech language therapy-unspecified, task-oriented aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy; semantic/phonological training, action-embedded therapy, intentional gestures and visual gestural cueing, supported communication, technology-assisted training (computer and devices), behavioral aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy, cognitive linguistic therapy, and narrative aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) intervention.
Patient/Family Information
Authors: Tatiana Ogourtsova, PhD OT; Maxim Ben-Yakov, BSc PT; Nicol Korner-Bitensky, PhD OT
Contributors: Jennifer Sweeney, M.S., CCC-SLP, S-LP (C) Founder, BC AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Centre; Aura Kagan PhD – AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Institute
What is aphasia?
AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) is a problem of language and communication that makes it difficult to understand or produce speech. It may also affect reading and writing ability. AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) affects about 30% of people who have had a strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Why do people get aphasia after a stroke?
Our brain has two main areas responsible for language. One is for understanding language through reading or listening. The other is for making language by writing or speaking. The type and severity of aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) depends on the area of the brain that was damaged, and the amount of damage to the brain.
Are there different types of aphasia?
There are two types of aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada):
- Receptive aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) is when a person has difficulty understanding what he/she hears or reads.
- Expressive aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) is when a person has difficulty expressing him/herself by writing or talking.
How can I recognize aphasia?
Some people have mild aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) after a strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. and have difficulty expressing themselves. For example, they may have difficulty finding a word to describe an object. They may say the beginning of a sentence, such as:
“I would like to have a…”, and then pause, as though they are trying to think of the right word.
For instance, instead of asking:
“What do you want to eat?”
you can ask them:
“Do you want a banana?”
Some people with aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) are not able to speak, but they are able to write down what they want to say. Others may not be able to write or speak after the strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Some people with aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) no longer understand what you are saying to them. They may understand when you speak in one language (for example, the first language they learned) but not in another language that they also knew before the strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Some people with aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) may be unable to read after the strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This often comes as a shock to the person when they pick up a magazine or newspaper and the letters and words on the page have no meaning to them.
To better understand how someone with aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) is feeling, think about being alone in a foreign country where you do not understand the language. You cannot make your needs understood and when people speak to you, you don’t understand them. This can be very frustrating and isolating.
It is important to remember that someone with aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) can retain many of the cognitive and social skills he/she had before the strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. However, these skills may be hidden or masked by the language difficulties. Individuals with aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) are often incorrectly treated as though they are less capable. This can affect their social life and participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. in community activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
, which in turn can impact on their self-esteem and quality of life.
Who diagnoses and treats aphasia?
Speech-language pathologists (SLP’s), also known as speech therapists, are trained to diagnose the different types of aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) and treat individuals with aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada).
Other members of the strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. team, including nurses, psychologists or neuro-psychologists, occupational therapists, social workers, doctors/neurologists, and physical therapists also understand and can help with the difficulties caused by aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada). They will try to communicate with the person who has aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) using strategies that are known to make communication easier.
The SLP will also explain to the strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. team the specific problems that the person with aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) is having, and will suggest strategies to make communication easier.
Does Speech Language Therapy (SLT) work?
Yes, SLT works! A recent high-quality study found that SLT can improve different skills related to language and communication in individuals in the chronic phase of strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. recovery (more than 6 months after strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.).
Are there different types of SLT?
Numerous SLT approaches exist for aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada). Your SLP will help choose a suitable program according to your needs. These might include:
- Constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy: you practice having a conversation with your therapist or peers mostly without using gestures or other non-verbal communication (e.g. nodding your head).
- Task-oriented aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy: you will train to follow spoken commands that are important to your everyday activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
.
- Semantic treatment: your therapist will ask you questions about words that are difficult for you to remember, and you will answer them. For example, if you have difficulty remembering the word ‘television’, the therapist will ask you questions such as: ‘where is the object located?’ [‘living room’]; or ‘what is it used for? [‘to watch movies’].
- Action-embedded therapy: you perform actions to match a verbal request, the name of a word or something you visualise in your mind.
- Intentional gestures: you move your left hand to do a task (e.g. reaching for a box, pressing a button), while naming different objects shown on pictures.
- Supported communication: you join in group discussions or talk with a trained conversation partner using both verbal and non-verbal communication (i.e. words, gestures, writing notes, miming, role play, etc.).
- Technology-assisted training: you use computer programs or other technological devices in your treatment sessions.
- Behavioral aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy: your therapist will provide you with education, activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
and tasks to improve your mood.
- Cognitive-linguistic therapy: your therapist will work with you to practice saying words and sentences, based on logic/decision-making and organization of sounds in words.
- Narrative aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) intervention: you practice saying words and sentences while discussing a range of everyday topics (for example: shopping for an item).
- Very early intervention: you engage in various aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapies as early as possible after having a strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. and when medically stable.
You might have also heard about recent high-tech treatments. For example, computer programs for aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) can be very helpful for some people after strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. These computer programs include microphones and recording devices that allow people with aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) to practice talking. The person can hear him/herself speak and can correct their mistakes. Computer programs can also help people re-learn to read after a strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. Computer programs allow you to practice in your own home, in your own time. You can use computer programs in addition to speech language pathology to practice techniques and special skills that your SLP has taught you.
Your SLP may choose one or a combination of these different therapies when working with you, based on your individual needs.
What therapies work for aphasia?
Research has tested the effect of aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapies at different stages of strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. recovery. High and fair quality research studies show that the following interventions are useful in improving language and/or communication skills:
In the acute stage of strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. recovery
(up to 1 month after strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.):
- constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy
- very early intervention
In the subacute stage of strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. recovery
(1-6 months after strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.):
- phonological training
- semantic training
In the chronic stage of strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. recovery
(more than 6 months after strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.):
- action-embedded therapy
- speech language therapy-unspecified
- supported communication
- technology-assisted training
Studies done with patients who were across the recovery continuum (i.e. acute, subacute and/or chronic):
- cognitive-behavioral aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy
- cognitive-linguistic therapy
- speech language therapy-unspecified
What can I expect from aphasia therapies?
You can expect to work individually or in small groups with help from your SLP. The SLP might use different approaches such as cards with pictures, electronic devices, stories, video and audio supports, reading and writing material. Your SLP might also provide you with exercises and activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
to do in your room or at home, with or without a caregiver/conversational partner.
Do I need to do SLT for a long time?
Research suggests that the timing and intensity of treatment are very important. After a strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain., patients often spend a short time in hospital or a rehabilitation clinic where they receive SLT. They may not continue with SLT when they return home from hospital. However, it is very important to continue with SLT for aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada).
Research shows that both one-to-one and group therapies are effective for aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada). The goals of each type of therapy differ. One-to-one therapy may be best for improving speech, whereas group therapy helps with conversation and social skills. So, if you or your family member has aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada), consider participating in both one-to-one and group therapy if available.
Are there any side effects?
You might experience some side effects from aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapies such as mental fatigue and/or frustration. It is important for your therapist to be aware of any side effects that you might be experiencing so that your treatment regime can be adjusted to better fit your abilities and need
How does aphasia affect my recovery from stroke?
StrokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. recovery requires a lot of patience and perseverance from the person who had a strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. and their family/caregivers. If you or your loved one is experiencing aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) after strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain., the process of recovery might be more frustrating and challenging. It is important to continue with therapies, even if aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) makes it challenging.
Will my aphasia get better?
Yes. There is evidence that language and communication skills can improve after strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. with different aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapies.
There is also evidence that “higher intensity” SLT (more sessions and/or for a longer duration) can result in greater and/or faster gains.
It is important to remember that the rate at which someone improves, and whether they make a complete or a partial recovery, can vary from one person to another and depends on many individual factors
How long does it take to recover?
The recovery from aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) can take time. However, there is evidence that speech-language therapy works even in patients who have had the strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. years ago.
My family member has aphasia. How can I help?
AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) is stressful for the whole family. Research shows that education sessions are beneficial for family members and friends, as it can increase awareness and knowledge about aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada). Below are some tips on communicating with people with aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada).
To help the person with aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) understand what you are saying:
- Look at the person when you are speaking to them.
- Use gestures and facial expressions to help them understand what you are saying.
- Write down key words. Use a thick black marker and print letters.
- Draw a picture or symbol of what you are trying to say.
- Use objects to help get your message across (e.g. if asking the person if they want a drink, hold up a cup).
- Use yes/no questions.
- Acknowledge that the person with aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) is a competent, knowledgeable person who can make decisions, and that they usually know what they want to say, but cannot say it.
- Speak in a tone of voice appropriate for an adult. Do not sound condescending, or like you are speaking to a child.
- Communicate one idea at a time. For example, instead of saying:“I will help you get up, showered and dressed and then I am going to take you to the dining room for breakfast but first you have to take your pill.”You might try this:
- “Here is your pill” (pause and give pill).
- “First I will help you take a shower” (pause).
- “Then I will help you get dressed” (pause).
- “Then I will take you for breakfast.”
The following scenario between a care provider and a patient helps to illustrate the above strategies:
| Conversation |
Strategies used by careprovider |
| “Mrs. Jones, I want to tell you about an event we have coming up. I think you will be interested.” |
Comes prepared with a calendar, scrap paper and a black marker. |
| “This is today.” |
Points to the date on the calendar. |
| “On Tuesday…” |
Points to the date on the calendar and then writes it down. |
| “…the John Higgins Band is coming to play.” |
Writes down “John Higgins Band”. |
| “They are coming here.” |
Uses hand gestures to indicate the location. |
| “Do you want to go?” |
Writes down “Do you want to go?” and points to the resident. Writes down:
Yes / No / I don’t know
and waits for the patient to point to the response. |
To help the person with aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) to get their message across:
- Encourage the person with aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) to write down a word or draw if they can.
- Encourage the person with aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) to point to something.
- Ask questions to identify the general topic first and then move onto understanding the details. For example:
- “Are you talking about your family?”
- “Are you talking about your daughter?”
- “Are you wondering if she is coming to visit today?”
- Ask yes/no questions.
- Use a written yes/no if needed.
- If you do not have the time to communicate, explain this and give a time when you will return to finish your conversation. Make sure you do return.
- Encourage the person with aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) to use some of the words you have written down to communicate. For example:
- “I have heard you are a big fan of music?”
- “What kind of music do you like?”
- “Opera? … Classical? … Blues?”
Where can I find more information about aphasia?
For further detail about aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada), please visit these links:
Clinician Information
Note: When reviewing the findings, it is important to note that they are always made according to randomized clinical trial (
RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.) criteria – specifically as compared to a control group. To clarify, if a treatment is “effective” it implies that it is more effective than the control treatment to which it was compared. Non-randomized studies are no longer included when there is sufficient research to indicate strong evidence (level 1a) for an outcome.
This module contains 34 studies, where 21 of them are high quality randomized clinical trials (RCTs), 11 are fair quality RCTs, and two are non-RCTs. The majority of interventions (18 studies) were studied among patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. (i.e. 6 months or more post-stroke).
Overall, we identified different interventions for post-stroke aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) and those include: constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy; speech language therapy-unspecified, task-oriented aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy; semantic / phonological training, action-embedded therapy, intentional gestures and visual gestural cueing, supported communication, technology-assisted training (computer and devices), behavioral aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy, cognitive linguistic therapy, and narrative aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) intervention.
Click here to access resources from the AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Institute (Ontario, Canada).
Results Table
View results table
Outcomes
Acute phase - Constraint-induced aphasia therapy
Two high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Ciccone et al., 2016; Woldag et al., 2017) investigated the effect of constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy (CIAT) on aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) severity in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
The first high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Ciccone et al., 2016) randomized patients to receive CIAT or individual conventional speech language therapy. AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) was measured by the Western AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Battery – AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Quotient at post-treatment (4-5 weeks) and follow-up (12 and 26 weeks). No between-group differences were found at any time point.
The second high quality RCT (Woldag et al., 2017) randomized patients to receive CIAT, high-intensity conventional communication group language therapy or low-intensity individual/group speech language therapy. AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) was measured by the Aachen Aphasia Test (AAT: 50-item Token test, Repetition, Written language, Naming, Comprehension, Profile level scores) at post-treatment (2 weeks). No between-group differences were found.
Conclusion: There is strong evidence (Level 1a) from two high quality RCTs that CIAT is not more effective than comparison interventions (individual conventional speech language therapy; high-intensity conventional communication group language therapy; low-intensity individual/group speech language therapy) in improving aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with acute stroke.
Communication accuracy/efficiency
Not Effective
1B
One high quality RCT (Ciccone et al., 2016) investigated the effect of constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy (CIAT) on communication accuracy/efficiency in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive CIAT or individual conventional speech language therapy. Communication accuracy/efficiency was measured by a Discourse Analysis score (percent correct information units produced per minute) at post-treatment (4-5 weeks) and follow-up (12 and 26 weeks). No between-group differences were found at any time point.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that CIAT is not more effective than a comparison intervention (individual conventional speech language therapy) in improving communication accuracy/efficiency in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Communication quantity/quality
Effective
1B
One high quality RCT (Woldag et al., 2017) investigated the effect of constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy (CIAT) on communication quantity/quality in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive CIAT, high-intensity conventional communication group language therapy or low-intensity individual/group speech language therapy. Communication quantity/quality was measured by the Communicative Activity Log (CAL – Quality, Quantity scores) at post-treatment (2 weeks). A significant between-group difference was found on one measure (CAL – Quality score), favoring CIAT vs. high-intensity conventional communication group language therapy. No other significant between-group differences were found.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that CIAT is more effective than a comparison intervention (high-intensity conventional communication group language therapy) in improving communication quality in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Note: CIAT was not more effective than low-intensity individual/group speech language therapy in improving communication quality; CIAT was not more effective than comparison interventions (high-intensity conventional communication group language therapy) in improving communications quantity.
Quality of life
Not Effective
1B
One high quality RCT (Ciccone et al., 2016) investigated the effect of constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy (CIAT) on quality of life in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive CIAT or individual conventional speech language therapy. Quality of life was measured by the StrokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. and AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Quality of Life Scale at post-treatment (4-5 weeks) and follow-up (12 and 26 weeks). No between-group difference was found at any time point.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that CIAT is not more effective than a comparison intervention (individual conventional speech language therapy) in improving quality of life in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Acute phase - Speech language therapy-unspecified
One high quality RCT (Laska et al., 2011) and one fair quality RCT (Mattioli et al., 2014) investigated the effect of speech language therapy on aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
The high quality RCT (Laska et al., 2011) randomized patients to receive speech language therapy or no treatment. AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) was measured by the Norsk Grunntest for Afasi (NGA: AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) coefficient) at post-treatment (21 days) and at follow-up (6 months). No significant between group difference was found at either time point.
The fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Mattioli et al., 2014) randomized patients to receive speech language therapy or no treatment. AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) was measured by the Aachen AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Test (AAT: Repetition, Naming, Written language, Oral comprehension, Written comprehension, 50-item Token Test, Spontaneous language subtests) at post-treatment (2 weeks) and at follow-up (6 months). Significant between-group differences were found on only two subtests (AAT: Naming, Written language) at post-treatment, favoring speech language therapy vs. no treatment. Improvements were maintained at follow-up.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT and one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that speech language therapy is not more effective than no treatment in improving aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Carer wellbeing
Not Effective
1B
One high quality RCT (Bowen et al., 2012) investigated the effect of speech language therapy on the wellbeing of carers of patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive speech language therapy or social contact with an untrained conversation partner for 16 weeks. Carer wellbeing was measured by the Carers of Older People in Europe Index (COPE: Negative/Positive impact, Quality of support) at follow-up (6 months post-stroke). No significant between-group differences were found.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that speech language therapy is not more effective than a comparison intervention (social contact with an untrained conversation partner) in improving the wellbeing of carers of patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Functional communication ability
Not Effective
1B
One high quality RCT (Bowen et al., 2012) investigated the effect of speech language therapy on functional communication ability in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive speech language therapy or social contact with an untrained conversation partner for 16 weeks. Functional communication ability was measured by the Therapy Outcome Measure (TOM: Communicative Activity Scale) at follow-up (6 months post-stroke). No significant between-group difference was found.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that speech language therapy is not more effective than a comparison intervention (social contact with an untrained conversation partner) in improving functional communication ability in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Self-perception of communication effectiveness
Not Effective
1B
One high quality RCT (Bowen et al., 2012) investigated the effect of speech language therapy on self-perception of communication effectiveness in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients to receive speech language therapy or social contact with an untrained conversation partner for 16 weeks. Patients’ and carers’ evaluation of patients’ communication effectiveness was measured by the Communication Outcomes After StrokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. (COAST) and Carer COAST (respectively) at follow-up (6 months post-stroke). No significant between-group differences were found.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that speech language therapy is not more effective than a comparison intervention (social contact with an untrained conversation partner) in improving patients’ and carers’ perception of communication effectiveness in patients with acute stroke.
Verbal communication
Not Effective
1B
One high quality RCT (Laska et al., 2011) investigated the effect of speech language therapy on verbal communication in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients to received speech language therapy or no treatment. Verbal communication skills were measured by the Amsterdam-Nijmegen Everyday Language Test at post-treatment (21 days) and at follow-up (6 months). No significant between group difference was found at either time point.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that speech language therapy is not more effective than no treatment in improving verbal communication in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Acute phase - Very early intervention
One non-randomized design study (Godecke et al., 2014) investigated the effect of very early intervention on aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with acute stroke. This non-randomized design study allocated patients to receive a multimodal intervention or usual care (sample drawn from Godecke et al., 2012 cohort). Aphasia was measured by the Western AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Battery – AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Quotient (percentage maximum potential recovery) at post-treatment (5 weeks) and follow-up (26 weeks post-stroke). Significant between-group differences were found at post-treatment, favoring very early intervention vs. usual care. Improvements were maintained at follow-up.
Conclusion: There is limited evidence (Level 2b) from one non-randomized design study that very early intervention is more effective than a comparison intervention (usual care) in improving aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Communication accuracy/efficiency
Effective
2B
One non-randomized design study (Godecke et al., 2014) investigated the effect of very early intervention on communication accuracy/efficiency in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This non-randomized design study allocated patients to receive a multimodal intervention or usual care (sample drawn from Godecke et al., 2012 cohort). Communication accuracy/efficiency was measured by a Discourse Analysis score at post-treatment (5 weeks) and follow-up (26 weeks post-stroke). A significant between-group difference was found at post-treatment, favoring very early intervention vs. usual care. Improvements were not maintained at follow-up.
Conclusion: There is limited evidence (Level 2b) from one non-randomized design study that very early intervention is more effective than a comparison intervention (usual care) in improving communication accuracy/efficiency in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Subacute phase - Constraint-induced aphasia therapy
One high quality RCT (Sickert et al., 2014) investigated the effect of modified Constraint Induced AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Therapy (mCIAT) on aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with subacute stroke. This high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive mCIAT or conventional aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy. AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) was measured by the Aachener AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Test (Spontaneous speech, Token Test, Repetition, Written language, Naming, Comprehension) at post-treatment (3 weeks) and follow-up (8 weeks, 1 year). No significant between-group differences were found at any time point.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that mCIAT is not more effective that a comparison intervention (conventional therapy) in improving aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Communication quantity/quality
Not Effective
1B
One high quality RCT (Sickert et al., 2014) investigated the effect of modified Constraint Induced Aphasia Therapy (mCIAT) on communication quantity/quality in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive mCIAT or conventional aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy. Communication quantity/quality was measured by the Communicative Activity Log (CAL – Quality, Quantity scores: patient/relative scores) at post-treatment (3 weeks) and follow-up (8 weeks, 1 year). No significant between-group differences were found at any time point.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that mCIAT is not more effective that a comparison intervention (conventional therapy) in improving communication quantity/quality in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Subacute phase - Semantic vs. phonological treatment approaches
Language processing
Effective
1B
One high quality RCT (Doesborgh et al., 2004a) compared the effect of semantic vs. phonological intervention approaches on language processingin patients with subacute stroke. This high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive semantic (interpretation-focused) or phonological (sound structure focused) treatment approaches. Language processing skills were measured by the Semantic Association Test [semantic measure] and the Psycholinguistic Assessment of Language Processing in AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) (PALPA: synonym judgement [semantic measure], nonword repetition, auditory lexical decision [phonological measures]) at post-treatment (10-12 months). A significant between-group difference was found on one phonological measure (PALPA: auditory lexical decision), favoring phonological vs. semantic treatment approach.
Note: A statistically-significant within-group improvement in one semantic measure (Semantic Association Test) was seen following semantic treatment, and an improvement in both phonological measures was seen following phonological treatment.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that a phonological treatment approach is more effective than a semantic treatment approach in improving phonological language processing skills in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Verbal communication
Not Efective
1B
One high quality RCT (Doesborgh et al., 2004a) compared the effect of semantic vs. phonological intervention approaches on verbal communication in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive semantic (interpretation-focused) or phonological (sound structure focused) treatment approaches. Verbal communication skills were measured by the Amsterdam Nijmegen Everyday Language Test (ANELT-A: final score, mean improvement) at post-treatment (10-12 months). No significant between-group difference was found.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that a semantic treatment approach is not more effective than a phonological treatment approach in improving verbal communication in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Subacute phase - Speech language therapy-unspecified
Carers' perception of patient's language
Not Effective
1B
One high quality RCT (Lincoln et al., 1984) investigated the effect of speech language therapy on carers’ perception of language in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive speech language therapy or no treatment. Carer’s perception of patient’s expressive and receptive language was measured by the Speech Questionnaire at mid-treatment (12 weeks) and post-treatment (24 weeks). No significant between-group difference was found at either time point.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that speech language therapy is not more effective than no treatment in improving carers’ perception of language of patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Communication
Not Effective
1B
One high quality RCT (Lincoln et al., 1984) investigated the effect of speech language therapy on communication in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients to receive speech language therapy or no treatment. Communication skills were measured by the Porch Index of Communicative Ability and the Functional Communication Profile at mid-treatment (12 weeks) and post-treatment (24 weeks). No significant between-group differences were found at either time point.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that speech language therapy is not more effective than no treatment in improving communication skills in patients with subacute stroke.
Subacute phase - Task-oriented aphasia therapy
Communication
Not Effective
1B
One high quality RCT (Hartman & Laundau, 1987) investigated the effect of task-oriented aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy in improving communication in patients with subacute stroke. This high quality RCT randomized patients to receive task-oriented aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy or nondirective counseling and conversation. Communication skills were measured by the Porch Index of Communicative Ability at post-treatment (6 months) and at follow-up (10 months post-stroke). No significant between-group difference was found at either time point.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that task-oriented aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy is not more effective than a comparison intervention (nondirective counseling and conversation) in improving communication skills in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Chronic phase - Action-embedded therapy
One high quality RCT (Stahl et al., 2016) investigated the effect of action-embedded therapy on aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality cross-over design RCT randomized patients to receive intensive language action therapy (ILAT) or naming therapy for 6 days, then the other intervention for a further 6 days; participants received no therapy for 6 days between intervention periods. Language was measured by the Aachen AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Test (AAT: mean score, production score) at post-treatment (6 days, 18 days). Significant between-group differences were found on both measures at both post-treatment time points, favoring ILAT vs. naming therapy.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that intensive language action therapy is more effective than a comparison intervention (naming therapy) in improving aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Word retrieval response time
Not Effective
2A
One fair quality RCT (Drummond & Rentschler, 1981) investigated the effect of action-embedded therapy on word retrieval response time in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This fair quality RCT randomized patients to receive visual-gestural cueing training or no gesture cueing; both groups received auditory-verbal cueing. Word retrieval response time was measured by the response time to 10 AMERIND Gestural Code nouns and 10 non-AMERIND Gestural Code nouns at post-treatment (2 weeks). No significant between-group difference was found.
Conclusion: There is limited evidence (Level 2a) from one fair quality RCT that visual-gestural cueing training is not more effective than a comparison intervention (no gesture cueing) in improving word retrieval response time in patients with chronic stroke.
Chronic phase - Communication partner program
One non-randomized study (Lyon et al., 1997) investigated the effect of a communication partner program on aphasia in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This non-randomized study assigned patients and their carers to a communication partner training program with a community volunteer. AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) was measured by the Boston Diagnostic AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Examination (BDAE: overall mean percentile) at post-treatment (20 weeks). No significant improvements from pre- to post-treatment were found.
Conclusion: There is limited evidence (Level 2b) from one non-randomized study that a communication partner training program with a community volunteer is not effective in improving aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Communication
Not Effective
2B
One non-randomized study (Lyon et al., 1997) investigated the effect of a communication partner program on communication in patients with chronic stroke. This non-randomized study assigned patients and their carers to a communication partner training program with a community volunteer. Communication skills were measured by the Communication Abilities in Daily Living (CADL) and the non-standardized Communication Readiness and Use Index (CRUI: patient, carer, communication partner scores) at post-treatment (20 weeks). Significant improvements from pre- to post-treatment were found on the CRUI.
Note: an improvement in communication readiness and use (CRUI) was also seen among patient triads whose treatment was deferred.
Conclusion: There is limited evidence (Level 2b) from one non-randomized study that a communication partner training program with a community volunteer is not effective in improving communication in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Note: However, the program was effective in improving patients, carers’ and communication partners’ reports of communication in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Participation in conversation
Effective
1B
One high quality RCT (Kagan et al., 2001) investigated the effect of a communication partner program on participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. in conversation in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to interact with a conversation partner trained in the “Supported Conversation for Adults with AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada)” program, or with an untrained volunteer. ParticipationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. in conversation was measured by the Measure of ParticipationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. in Conversation for Adults with AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) (MPCA: Interaction, Transaction scores) at post-treatment (1-day workshop). Significant between-group differences were found on both scores, favoring the “Supported Conversation for Adults with AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada)” program vs. social interactions with an untrained volunteer.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that a communication partner program is more effective than a comparison intervention (social interactions with an untrained volunteer) in improving participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. in conversation in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Well-being
Not Effective
2B
One non-randomized study (Lyon et al., 1997) investigated the effect of a communication partner program on well-being in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This non-randomized study assigned patients and their carers to a communication partner training program with a community volunteer. Well-being was measured by the Affect Balance Scale (ABS) and the non-standardized Psychosocial Wellbeing Index (PWI: patient, carer, communication partner scores) at post-treatment (20 weeks). A significant improvement from pre- to post-treatment was found on the PWI scores.
Note: an improvement in wellbeing (PWI) was also seen among patient triads whose treatment was deferred.
Conclusion: There is limited evidence (Level 2b) from one non-randomized study that a communication partner training program with a community volunteer is not effective in improving well-being in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Note: However, the program was effective in improving patients’, carers’ and communication partners’ reported perception of well-being in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Chronic phase - Constraint-induced aphasia therapy
One high quality RCT (Kurland et al., 2016) and one fair quality RCT (Maher et al., 2006) investigated the effect of constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy (CIAT) on aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with chronic stroke.
The high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Kurland et al., 2016) randomized patients to receive interactive language action therapy – constrained (ILAT- constrained) or a modified version of Promoting Aphasic Communicative Effectiveness – unconstrained (mPACE -unconstrained). AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) was measured by the Boston Diagnostic AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Examination (BDAE: AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) severity, Auditory comprehension, Sentence repetition, Cookie Theft Description task – changes in content units) at post-treatment (2 weeks). No significant between-group difference was found.
The fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Maher et al., 2006) assigned patients to receive CIAT or mPACE. AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) was measured by the Western AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Battery – AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Quotient at post-treatment (2 weeks). No significant between-group difference was found.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. and one fair quality RCT that constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy is not more effective than a comparison intervention (Promoting Aphasic Communicative Effectiveness) in improving aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Communication
Not Effective
1B
One high quality RCT (Kurland et al., 2016) investigated the effect of constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy (CIAT) on communication in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients to receive interactive language action therapy – constrained (ILAT-constrained) or a modified version of Promoting Aphasic Communicative Effectiveness – unconstrained (mPACE-unconstrained). Communication skills were measured by the Porch Index of Communicative Abilities at post-treatment (2 weeks). No significant between-group difference was found.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy is not more effective than a comparison intervention (modified version of Promoting Aphasic Communicative Effectiveness – unconstrained) in improving communication skills in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Two high quality RCTs (Szaflarski et al., 2015; Kurland et al., 2016) and two fair quality RCTs (Maher et al., 2006; Nenert et al., 2017) investigated the effect of constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy (CIAT) on naming in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
The first high-quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Szaflarski et al., 2015) randomized patients to receive CIAT or no treatment for 10 consecutive weekdays. Naming skills were measured by the Boston Naming Test (BNT) at follow-up (1 week and 3 months post-treatment). No significant between-group difference was found.
The second high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Kurland et al., 2016) randomized patients to receive interactive language action therapy – constrained (ILAT-constrained) or a modified version of Promoting Aphasic Communicative Effectiveness – unconstrained (mPACE-unconstrained). Naming skills were measured by the Object and Action Naming Battery (objects and verbs/trained and untrained items) and BNT at post-treatment (2 weeks). No significant between-group differences were found.
The first fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Maher et al., 2006) assigned patients to receive CIAT or mPACE. Naming skills were measured by the BNT and Action Naming Test at post-treatment (2 weeks). No significant between-group differences were found.
The second fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Nenert et al., 2017) randomized patients to receive CIAT or no treatment. Naming skills were measured by the BNT at post-treatment (10 days). No significant between-group difference was found.
Conclusion: There is strong evidence (Level 1a) from two high quality RCTs and two fair quality RCTs that constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy is not more effective than comparison interventions (no treatment, Promoting Aphasic Communicative Effectiveness) in improving naming skills in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Noun recall
Not Effective
2a
One fair quality RCT (Nenert et al., 2017) investigated the effect of constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy (CIAT) on noun recall in patients with chronic stroke. This fair quality RCT (Nenert et al., 2017) randomized patients to receive CIAT or no treatment. Noun recall was measured by a noun recall task at post-treatment (10 days). No significant between-group difference was found.
Conclusion: There is limited evidence (Level 2a) from one fair quality RCT that constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy is not more effective than no treatment in improving noun recall in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Receptive language
Not Effective
1B
One high quality RCT (Szaflarski et al., 2015) and one fair quality RCT (Nenert et al., 2017) investigated the effect of constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy (CIAT) on receptive language in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
The high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Szaflarski et al., 2015) randomized patients to receive CIAT or no treatment for 10 consecutive weekdays. Receptive language skills were measured by the Boston Diagnostic Aphasia Examination (BDAE: Complex ideation subtest) and the Peabody Picture Vocabulary Test III (PPVT-III) at follow-up (1 week and 3 months post-treatment). No significant between-group differences were found.
The fair quality RCT (Nenert et al., 2017) randomized patients to receive CIAT or no treatment. Receptive language skills were measured by the PPVT-IV at post-treatment (10 days). No significant between-group difference was found.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. and one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy is not more effective than no treatment in improving receptive language skills in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Subjective communication
Not Effective
1B
One high quality RCT (Szaflarski et al., 2015) and one fair quality RCT (Nenert et al., 2017) investigated the effect of constraint-induced aphasia therapy (CIAT) on subjective communication in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
The high quality RCT (Szaflarski et al., 2015) randomized patients to receive CIAT or no treatment for 10 consecutive weekdays. Subjective communication skills (fluency, frequency of use, frequency of misunderstandings) were measured by the Mini-Communicative ActivitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
Log (Mini-CAL) at follow-up (1 week and 3 months post-treatment). A significant between-group difference was found at follow-up (3 months post-treatment), favoring CIAT vs. no treatment.
The fair quality RCT (Nenert et al., 2017) randomized patients to receive CIAT or no treatment. Subjective communication skills were measured by the Mini-CAL at post-treatment (10 days). No significant between-group difference was found.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. and one fair quality RCT that constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy is not more effective than no treatment in improving subjective communication skills in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Note: However, CIAT was more effective than no treatment in the long term.
Verbal function/fluency
Not Effective
1b
One high quality RCT (Szaflarski et al., 2015) and one fair quality RCT (Nenert et al., 2017) investigated the effect of constraint-induced aphasia therapy (CIAT) on verbal function and fluency in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
The high quality RCT (Szaflarski et al., 2015) randomized patients to receive CIAT or no treatment for 10 consecutive weekdays. Verbal function/fluency was measured by the Semantic Fluency Test (SFT) and the Controlled Oral Word Association Test (COWAT) at follow-up (1 week and 3 months post-treatment). No significant between-group difference was found.
The fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Nenert et al., 2017) randomized patients to receive CIAT or no treatment. Verbal function/fluency was measured by the SFT and the COWAT (raw score) at post-treatment (10 days). No significant between-group difference was found.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. and one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy is not more effective than no treatment in improving verbal function/fluency.
Chronic phase - Group communication
One high quality RCT (Elman & Burnstein-Ellis, 1999) investigated the effect of group communication on aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with chronic stroke. This high quality RCT randomized patients to receive group communication treatment or delayed group communication treatment (no treatment). AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) was measured by the Western Aphasia Battery-Aphasia Quotient (WAB-AQ) at post-treatment (4 months) and follow-up (5 months). A significant between-group difference was found at post-treatment, favoring group communication treatment vs. no treatment. This between-group difference was not maintained at follow-up.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that group communication is more effective than a comparison intervention (no treatment) in improving aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with chronic stroke.
One high quality RCT (Elman & Burnstein-Ellis, 1999) investigated the effect of group communication on functional communication in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients to receive group communication treatment or delayed group communication treatment (no treatment). Communication skills were measured by the Communicative Abilities in Daily Living Test (CADL) and the Shortened Porch Index of Communicative Ability (SPICA) at post-treatment (4 months) and follow-up (5 months). A significant between-group difference was found on one measure (CADL), favoring group communication treatment vs. no treatment. This between-group difference was not maintained at follow-up.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that group communication is more effective than a comparison intervention (no treatment) in improving communication skills in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Chronic phase - Intentional gestures
One fair quality RCT (Altmann et al., 2014) investigated the effect of intentional gestures on aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with chronic stroke. This fair quality RCT randomized patients to receive intensive anomia treatment using intentional left-hand gestures or intensive anomia treatment without gestures. AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) was measured by the Western AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Battery – AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Quotient at post-treatment (3 weeks) and follow-up (3 months). No significant between-group difference was found at either time point.
Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that intentional gestures is not more effective than comparison interventions without gestures (intensive anomia treatment) in improving aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Discourse quantity/quality
Not Effective
2A
One fair quality RCT (Altmann et al., 2014) investigated the effect of intentional gestures on discourse quality/quantity in patients with chronic stroke. This fair quality RCT randomized patients to receive intensive anomia treatment using intentional left-hand gestures or intensive anomia treatment without gestures. Discourse quantity/quality was measured according to Discourse Quantity (Utterances, Words, Verbs, Nouns) and Discourse Quality (Grammatical, Correct information units, Propositions, Utterances with new information) at post-treatment (3 weeks) and follow-up (3 months). A significant between-group difference was found on only one measure (Discourse Quantity: Words) at follow-up, favoring intentional left-hand gestures + intensive anomia treatment vs. intensive anomia treatment alone.
Conclusion: There is limited evidence (Level 2a) from one fair quality RCT that intentional gestures is not more effective than comparison interventions without gestures (intensive anomia treatment) in improving discourse quantity/quality in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Naming and retrieval
Not Effective
2A
Two fair quality RCTs (Altmann et al., 2014; Benjamin et al., 2014) investigated the effect of intentional gestures on naming and retrieval skills in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
The first fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Altmann et al., 2014) randomized patients to receive intensive anomia treatment using intentional left-hand gestures or intensive anomia treatment without gestures. Naming and retrieval skills were measured by the Picture Naming probes, Category-Generation probes, and the Boston Naming Test at post-treatment (3 weeks) and follow-up (3 months). No significant between-group differences were found at either time point.
The second fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Benjamin et al., 2014) randomized patients to receive picture naming and category-member generation training using intentional left-hand gestures or picture naming and category-member generation training without gestures. Naming and retrieval skills were measured by the Picture Naming and Category-Generation probes at post-treatment (6 weeks) and follow-up (3 months). No significant between-group differences were found at either time point.
Conclusion: There is limited evidence (Level 2a) from two fair quality RCTs that intentional gestures is not more effective than comparison interventions without gestures (intensive anomia treatment, picture naming and category-member generation) in improving naming and retrieval skills in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Chronic phase - Speech language therapy-unspecified
One high quality RCT (Breitenstein et al., 2017) investigated the effect of speech language therapy on aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with chronic stroke. This high quality RCT randomized patients to receive intensive speech language therapy or no treatment. AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) was measured by the Sprachsystematisches APhasieScreening (SAPS: Total, Phonology, Lexicon, Syntax, Language comprehension, Language production scores) at post-treatment (3 weeks) and follow-up (6 months). Significant between-group differences in change scores from baseline to post-treatment were found (SAPS: Total, Lexicon, Syntax, Language comprehension, Language production). A significant difference was found on one measure at follow-up (SAPS: Phonology).
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that intensive speech language therapy is more effective than no treatment in improving aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Functional communication
Not Effective
1B
One high quality RCT (Breitenstein et al., 2017) investigated the effect of speech language therapy on functional communication in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients to receive intensive speech language therapy for 3 weeks or no treatment. Functional communication was measured by the Communication Effectiveness Index at follow-up (6 months). No significant between-group difference was found.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that intensive speech language therapy is not more effective than no treatment in improving long-term functional communication in patients with chronic stroke.
Nonverbal learning
Not Effective
1B
One high quality RCT (Breitenstein et al., 2017) investigated the effect of speech language therapy on nonverbal learning in patients with chronic stroke. This high quality RCT randomized patients to receive intensive speech language therapy or no treatment. Nonverbal learning was measured by the Nonverbal Learning Test at post-treatment (3 weeks) and follow-up (6 months). No significant between-group difference was found at either time point.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that intensive speech language therapy is not more effective than no treatment in improving nonverbal learning in patients with chronic stroke.
Quality of life
Effective
1B
One high quality RCT (Breitenstein et al., 2017) investigated the effect of speech language therapy on quality of life in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients to receive intensive speech language therapy or no treatment. Quality of life was measured by the StrokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. and AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Quality of Life Scale-39 (SAQoL-39 – Total, Physical, Communication, Psychosocial, Energy scores) at post-treatment (3 weeks) and follow-up (6 months). A significant between-group difference in change scores from baseline to post-treatment was found on only one measure (SAQoL-39 – Total score).
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that intensive speech language therapy is more effective than no treatment in improving quality of life in patients with chronic stroke.
Stroke severity
Not Effective
1B
One high quality RCT (Breitenstein et al., 2017) investigated the effect of speech language therapy on stroke severity in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients to receive intensive speech language therapy or no treatment. StrokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. severity was measured by the modified Rankin Scale at post-treatment (3 weeks) and follow-up (6 months). No significant between-group difference was found at either time point.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that intensive speech language therapy is not more effective than no treatment in reducing strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. severity in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Verbal communication
Effective
1B
One high quality RCT (Breitenstein et al., 2017) investigated the effect of speech language therapy on verbal communication in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive intensive speech language therapy or no treatment. Verbal communication skills were measured by the Amsterdam Nijmegen Everyday Language Test (ANELT: A-scale, B-scale) at post-treatment (3 weeks) and follow-up (6 months). A significant between-group difference in change scores from baseline to post-treatment was found (ANALT: A-scale).
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that intensive speech language therapy is more effective than no treatment in improving verbal communication skills in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Visual attention and executive function
Not Effective
1B
One high quality RCT (Breitenstein et al., 2017) investigated the effect of speech language therapy on visual attention and executive function in patients with chronic stroke. This high quality RCT randomized patients to receive intensive speech language therapy or no treatment. Visual attention and executive function were measured by the Trail Making Test A and B at post-treatment (3 weeks) and follow-up (6 months). No significant between-group differences were found at either time point.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that intensive speech language therapy is not more effective than no treatment in improving visual attention and executive function in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Chronic phase - Technology-assisted training
Two fair quality RCTs (Katz & Wertz, 1992; Katz & Wertz, 1997) investigated the effect of technology-assisted training on aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
The first fair quality RCT (Katz & Wertz, 1992) randomized patients to receive computer reading, non-language computer stimulation or no treatment. AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) was measured by the Western AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Battery – AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Quotient (WAB-AQ) at post-treatment (6 months). No significant between-group difference was found.
The second fair quality RCT (Katz & Wertz, 1997) randomized patients to receive computer reading, non-language computer stimulation, or no treatment. AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) was measured by the WAB-AQ at post-treatment (6 months). Comparison of computer reading vs. non-language computer stimulation revealed a significant difference favoring computer reading. Comparison of computer reading vs. no treatment revealed a significant difference favouring computer reading.
Note: Comparison of non-language computer stimulation vs. no treatment revealed no significant between-group difference.
Conclusion: There is conflicting evidence (Level 4) from two fair quality RCTs regarding the effect of technology-assisted training on aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. While one fair quality RCT found that computer reading was not more effective than comparison interventions (non-language computer stimulation, no treatment); another fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. found that computer reading was more effective than comparison interventions (non-language computer stimulation, no treatment) in improving aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Note: The larger sample size in the second study might explain the found differences that were not detected in the first study.
One high quality RCT (Nobis-Bosch et al., 2011) investigated the effect of technology-assisted training on cognition in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality cross-over design RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive intensive language training using the B.A.Bar electronic learning device or nonlinguistic cognitive training for 4 weeks, before crossing over to receive the other intervention for a further 4 weeks. Cognition was measured at post-treatment (4 weeks, 8 weeks) and follow-up (3 months) and included: auditory memory, measured by the Wechesler Memory Scale (auditory digit span); visual memory, measured by the Corsi Block Tapping Test; attention, measured by the Test of Attentional Performance (visual scanningDuring this intervention the person with USN is encouraged to conduct voluntary eye movements toward the neglected visual field (usually the left side) by performing a task in that hemispace. The treatment often includes a visual target that the patient uses as an anchor to direct voluntary gaze control while scanning.
subtest); and pattern recognition, measured by the Thurstone’s Primary Mental Ability Test (pattern recognition from subtest 10). No significant between-group differences were found at any time point.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that intensive language training using the B.A.Bar electronic learning device is not more effective than a comparison intervention (nonlinguistic cognitive training) in improving cognition in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Communication
Not Effective
1B
One high quality RCT (Nobis-Bosch et al., 2011) and two fair quality RCTs (Katz & Wertz, 1992; Katz & Wertz, 1997) investigated the effect of technology-assisted training on communication in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
The high quality cross-over design RCT (Nobis-Bosch et al., 2011) randomized patients to receive intensive language training using the B.A.Bar electronic learning device or nonlinguistic cognitive training for 4 weeks, before crossing over to receive the other intervention for a further 4 weeks. Communication skills were measured by a non-standardized dialogue test (linguistic score – trained/untrained items; communitive score – trained/untrained items), at post-treatment (4 weeks, 8 weeks) and follow-up (3 months). There were no significant between-group differences at either post-treatment timepoint. Significant between-group differences were found (communicative score – trained/untrained items) at follow-up, favoring the group that received nonlinguistic cognitive training followed by intensive language training using the B.A.Bar electronic learning device.
The first fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Katz & Wertz, 1992) randomized patients to receive computer reading, non-language computer stimulation or no treatment. Communication skills were measured by the Porch Index of Communicative Ability (PICA: Overall score, Reading, Writing, Verbal modalities) at post-treatment (6 months). Comparison of computer reading vs. non-language computer stimulation showed significant between-group differences (PICA: Overall, Writing, Verbal scores), favouring computer reading. Comparison of computer reading vs. no treatment revealed significant differences (PICA: Overall, Verbal scores), favouring computer reading.
Note: Comparison of non-language computer stimulation vs. no treatment revealed no significant differences.
The second fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Katz & Wertz, 1997) randomized patients to receive computer reading, non-language computer stimulation, or no treatment. Communication skills were measured by the PICA (Overall score, Auditory, Verbal, Pantomime, Visual, Reading, Copying, Writing scores) at post-treatment (6 months). Comparison of computer reading vs. non-language computer stimulation revealed significant differences (PICA: Overall, Verbal scores), favoring computer reading. Comparison of computer reading vs. no treatment revealed significant differences (PICA: Overall, Verbal, Pantomime scores), favouring computer reading.
Note: Comparison of non-language computer stimulation vs. no treatment revealed significant between-group differences (PICA: Pantomime score), favouring non-verbal computer stimulation.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that technology-assisted training is not more effective than comparison interventions (nonlinguistic cognitive training) in improving communication skills in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Note: However, two fair quality RCTs found that technology-assisted training is more effective than a comparison intervention (non-language computer stimulation) and no treatment in improving communication skills in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. Differences in findings could be attributed to the differences in interventions, study design/duration and/or outcome measures used.
Comprehenstion
Conflicting
4
Two fair quality RCTs (Katz & Wertz, 1997; Thompson et al., 2010) investigated the effect of technology-assisted training on comprehension in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
The first fair quality RCT (Katz & Wertz, 1997) randomized patients to receive computer reading, non-language computer stimulation, or no treatment. Comprehension was measured by the Western AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Battery – Comprehension subtest at post-treatment (6 months). No significant between-group difference was found.
The second fair quality RCT (Thompson et al., 2010) randomized patients to receive computer-automated Treatment of Underlying Forms (TUF), clinician-administered TUF or no treatment. Comprehension was measured by the Comprehension Probe (CP: Object relatives, Object clefts, Object wh-questions) and the Northwestern Assessment of Verbs and Sentences – Sentence Comprehension Test (NAVS-SCT: Object relatives, Object wh-questions, Subject relatives, Subject wh-questions) at post-treatment (5 weeks). Significant between-group differences were seen (CP – Object relatives; NAVS-SCT: Objects relatives), favoring the computer-automated TUF vs. no treatment. There were no significant differences between computer-automated and clinician-administered TUF.
Note: Differences between clinician-administered TUF and no treatment were not reported.
Conclusion: There is conflicting evidence (Level 4) from two fair quality RCTs regarding the effects of technology-assisted training on comprehension in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. While one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. found that computer reading is not more effective than comparison interventions (non-language computer stimulation, no treatment), another fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. found that a computer-automated Treatment of Underlying Forms program is more effective than no treatment in improving comprehension in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Note: Differences in findings could be attributed to the difference in the interventions, study design/duration and/or outcome measures used.
Two high quality RCTs (Doesborgh et al., 2004b; Palmer et al., 2012) and one fair quality RCT (investigated the effect of technology-assisted training on naming skills in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
The first high quality RCT (Doesborgh et al., 2004b) randomized patients to receive a multicue computer training program or no treatment. Naming skills were measured by the Boston Naming Test at post-treatment (2 months). No significant between group difference was found.
The second high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Palmer et al., 2012) randomized patients to receive computer treatment or no treatment; all patients received usual care. Naming skills were measured by the Object and Action Naming Battery at post-treatment (5 months) and follow-up (8 months). A significant between-group difference was found at post-treatment, favoring computer treatment vs. no treatment. Results did not remain significant at follow-up.
The fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Katz & Wertz, 1997) randomized patients to receive computer reading, non-language computer stimulation, or no treatment. Word finding and semantic retrieval processes were measured by the Western AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Battery – Naming scores at post-treatment (6 months). No between-group difference was found.
Conclusion: There is conflicting evidence (Level 4) regarding the effect of technology-assisted training on naming skills in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. While one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. and one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. found that computer training programs were not more effective than comparison interventions (no treatment, non-language computer stimulation), another high quality RCT found that a computer program was more effective than no treatment.
Note: The differences in findings may be attributed to the differences in the interventions, design study/duration (2 vs. 5 months), and/or outcome measures used.
Reading comprehension
Not Effective
2A
One fair quality RCT (Katz & Wertz, 1992) investigated the effect of technology-assisted training on reading comprehension in patients with chronic stroke. This fair quality RCT randomized patients to receive computer reading, non-language computer stimulation or no treatment. Reading comprehension was measured by the C-CAT (a non-standardized assessment comprising 232 items from the computer reading program) at post-treatment (6 months). No significant between-group difference was found.
Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that computer reading is not more effective than comparison interventions (non-language computer stimulation, no treatment) in improving reading comprehension in patients with chronic stroke.
One fair quality RCT (Katz & Wertz, 1997) investigated the effect of technology-assisted training on repetition in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This fair quality RCT randomized patients to receive computer reading, non-language computer stimulation, or no treatment. Repetition was measured by the Western AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Battery – Repetition score at post-treatment (6 months). Comparison of computer reading vs. non-language computer stimulation revealed a significant difference, favoring computer reading. Comparison of computer reading vs. no treatment revealed a significant difference, favouring computer reading.
Note: Comparison of non-language computer stimulation vs. no treatment revealed a significant between-group difference, favouring non-verbal computer stimulation.
Conclusion: There is limited evidence (Level 2a) from one fair quality RCT that computer reading is more effective than comparison interventions (non-language computer stimulation, no treatment) in improving repetition in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Sentence production
Not Effective
2A
One fair quality RCT (Thompson et al., 2010) investigated the effect of technology-assisted training on comprehension in patients with chronic stroke. This fair quality RCT randomized patients to receive computer-automated Treatment of Underlying Forms (TUF), clinician-administered TUF or no treatment. Comprehension was measured by the Production Probe (PP: Object relatives, Object clefts, Object wh-questions), the Northwestern Assessment of Verbs and Sentences – Sentence Production Priming Test (NAVS-SPPT: Object relatives, Object wh-questions, Subject relatives, Subject wh-questions), and the Cinderella narratives (CN: Mean length of utterance, Words per minute, Complex to simple sentence ratio, Noun to verb ratio, Open to closed class ratio, % grammatical sentences, % verbs with correct arguments) at post-treatment (5 weeks). Comparison of computer-automated TUF vs. no treatment revealed significant between-group differences (PP: Object relatives, Object clefts; NAVS-SPPT – Objects relatives), favoring computer-automated TUF. There were no significant differences between computer-automated and clinician-administered TUF.
Note: Differences between clinician-administered TUF and no treatment were not reported.
Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that computer-automated Treatment of Underlying Forms is not more effective than no treatment in improving sentence production in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Note: significant between-group differences were seen in only 2/3 of 7/14 measures
Spontaneous speech
Not Effective
1B
One high quality RCT (Nobis-Bosch et al., 2011) and one fair quality RCT (Katz & Wertz, 1997) investigated the effect of technology-assisted training on spontaneous speech in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
The high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Nobis-Bosch et al., 2011) randomized patients to receive intensive language training using the B.A.Bar electronic learning device or nonlinguistic cognitive training for 4 weeks, before crossing over to receive the other intervention for a further 4 weeks. Spontaneous speech was measured by a semi-standardized interview at post-treatment (4 weeks, 8 weeks) and follow-up (3 months). No significant between-group differences were found at any time point.
The fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Katz & Wertz, 1997) randomized patients to receive computer reading, non-language computer stimulation, or no treatment. Spontaneous speech was measured by the Western AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Battery – Spontaneous speech score at post-treatment (6 months). No significant between-group difference was found.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. and one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that technology-assisted training is not more effective than comparison interventions (nonlinguistic cognitive training, non-language computer stimulation, no treatment) in improving spontaneous speech in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Verbal communication
Not Effective
1A
Two high quality RCTs (Doesborgh et al., 2004b; Nobis-Bosch et al., 2011) investigated the effect of technology-assisted training on verbal communication in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
The first high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Doesborgh et al., 2004b) randomized patients to receive a multicue computer training program or no treatment. Verbal communication was measured by the Amsterdam Nijmegen Everyday Language Test – Scale A at post-treatment (2 months). No significant between group difference was found.
The second high quality cross-over design RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Nobis-Bosch et al., 2011) randomized patients to receive intensive language training using the B.A.Bar electronic learning device or nonlinguistic cognitive training for 4 weeks, before crossing over to receive the other intervention for a further 4 weeks. Verbal communication was measured by the Amsterdam Nijmegen Everyday Language Test at post-treatment (4 weeks, 8 weeks) and follow-up (3 months). No significant between-group difference was found at any time point.
Conclusion: There is strong evidence (Level 1a) from two high quality RCTs that technology-assisted training is not more effective than comparison interventions (no treatment, nonlinguistic cognitive training) in improving verbal communication in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Verbal fluency
Not Effective
1B
One high quality RCT (Nobis-Bosch et al., 2011) investigated the effect of technology-assisted training on verbal fluency in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients to receive intensive language training using the B.A.Bar electronic learning device or nonlinguistic cognitive training for 4 weeks, before crossing over to receive the other intervention for a further 4 weeks. Verbal fluency was measured by the Word Fluency Test (Food, Animals) at post-treatment (4 weeks, 8 weeks) and follow-up (3 months). No significant between-group difference was found at any time point.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that intensive language training using the B.A.Bar electronic learning device is not more effective than a comparison intervention (nonlinguistic cognitive training) in improving verbal fluency in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Phase not specific to one period - Cognitive behavior language therapy
One high quality RCT (Akabogu et al., 2019) investigated the effect of cognitive behavior language therapy (CBLT) on communication in patients with stroke. This high quality RCT randomized patients (stage of strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. recovery not specified) to receive CBLT or no treatment. Communication skills were measured by the Porch Index of Communicative Ability at post-treatment (10 weeks) and follow-up (3 months). Significant between-group differences were found at both time points, favoring CBLT vs. no treatment.
Note: In this study, CBLT principles were combined with targeted, conventional speech therapy aimed to reduce aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) by helping patients to use their remaining language abilities; restore language abilities; and learn alternative communication ways (e.g. gestures, pictures, or use of electronic devices).
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that CBLT is more effective than no treatment in improving communication skills in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Unhelpful thoughts and beliefs
Effective
1B
One high quality RCT (Akabogu et al., 2019) investigated the effect of cognitive behavior language therapy (CBLT) on unhelpful thoughts and beliefs in patients with stroke. This high quality RCT randomized patients (stage of strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. recovery not specified) to receive CBLT or no treatment. Speech-language unhelpful thoughts and beliefs were measured by Speech-Language Unhelpful Thoughts and Beliefs Scale at post-treatment (10 weeks) and follow-up (3 months). Significant between-group differences were found at both time points, favoring CBLT vs. no treatment.
Note: In this study, CBLT principles were combined with targeted, conventional speech therapy aimed to reduce aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) by helping patients to use their remaining language abilities; restore language abilities; and learn alternative communication ways (e.g. gestures, pictures, or use of electronic devices).
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that CBLT is more effective than no treatment in reducing unhelpful thoughts and beliefs in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Phase not specific to one period - Cognitive-linguistic training
Communication (understandability)
Not Effective
1B
One high quality RCT (de Jong-Hagelstein et al., 2011) investigated the effect of cognitive-linguistic training on communication (understandability) in patients with acute/subacute stroke. This high quality RCT randomized patients to receive cognitive-linguistic training or communicative treatment (compensatory strategies and use of residual language skills). Communication (understandability) was measured by the Amsterdam-Nijmegen Everyday Language Test Scale A: Understandability (ANELT-A: Final score, Mean improvement, Severity category) at mid-treatment (3 months) and post-treatment (6 months). No significant between-group differences were found at either time point.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that cognitive-linguistic training is not more effective than a comparison intervention (communicative treatment) in improving communication (understandability) in patients with stroke.
One high quality RCT (de Jong-Hagelstein et al., 2011) investigated the effect of cognitive-linguistic training on fluency in patients with acute/subacute stroke. This high quality RCT randomized patients to receive cognitive-linguistic training or communicative treatment (compensatory strategies and use of residual language skills). Fluency was measured by the Letter Fluency Task (LFT), Semantic Association Test (SAT), Semantic Word Fluency (SWF) at mid-treatment (3 months) and post-treatment (6 months). A significant between-group difference was found in one measure at mid-treatment (SWF) and in one measure (LFT) at post-treatment, favoring cognitive-linguistic training vs. communicative treatment.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that cognitive-linguistic training is more effective than a comparison intervention (communicative treatment) in improving fluency in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Language processing
Not Effective
1B
One high quality RCT (de Jong-Hagelstein et al., 2011) investigated the effect of cognitive-linguistic training on language processing in patients with acute/subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients to receive cognitive-linguistic training or communicative treatment (compensatory strategies and use of residual language skills). Language processing skills were measured by the Psycholinguistic Assessment of Language Processing in Aphasia (PALPA: Semantic association with low imageability words, Nonword repetition, Auditory lexical decision) at mid-treatment (3 months) and post-treatment (6 months). mid-treatment (3 months) and post-treatment (6 months). No significant between-group differences were found at either time point.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that cognitive-linguistic training is not more effective than a comparison intervention (communicative treatment) in improving language processing skills in patients with stroke.
Phase not specific to one period - Narrative aphasia intervention
Discourse abilities
Not Effective
1B
One high quality RCT (Whitworth et al., 2014) investigated the effect of narrative aphasia intervention on discourse abilities in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive Novel Approach to Real-life communication – Narrative Intervention in AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) (NARNIA) or usual care. Discourse abilities were measured at (i) word-level by the Pyramid and Palmtrees Test, Kissing and Dancing Test, the Object and Action Naming Battery (Noun retrieval, Verb retrieval), and the Northwestern Assessment of Verbs and Sentences (NAVS – Verb comprehension, Verb naming); (ii) sentence-level by the NAVS (Sentence Comprehension Test, Argument Structure Production Test) and the Sentence Generation Test; and (iii) discourse level by the Curtin University Discourse Protocol – Everyday Discourse (Overall Input: number of utterances; Single Word Level: heavy verbs, light verbs, mental verbs; Sentence Level: two arguments, three arguments, thematic; Discourse: orientation, body, conclusion) at post-treatment (5 weeks). A significant between-group differences was found in only one measure (Everyday Discourse -Discourse: orientation), favoring NARNIA vs. usual care.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that narrative aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) intervention is not more effective than a comparison intervention (usual care) in improving discourse abilities in patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Phase not specific to one period - Speech language therapy-unspecified
Abstract reasoning
Effective
2A
One fair quality RCT (Lincoln et al., 1982) investigated the effect of speech language therapy (SLT) on abstract reasoning in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This fair quality cross-over design RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive (i) SLT or (ii) operant training or attention placebo for 4 weeks; participants then crossed over to receive the other intervention for a further 4 weeks (see group assignment below). Abstract reasoning was measured by the Raven’s Progressive Matrices at post-treatment (4 weeks). A significant between-group difference was found, favoring SLT vs. attention placebo. There were no significant differences between SLT and operant conditioning.
Note: Participants were assigned to 1 of 4 groups – Group A (SLT then attention placebo), Group B (attention placebo then SLT), Group C (SLT then operant conditioning), Group D (operant conditioning then SLT).
Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that speech language therapy is more effective than a comparison intervention (attention placebo treatment) in improving abstract reasoning in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Note: SLT was not more effective than operant conditioning.
One fair quality RCT (Lincoln et al., 1982) investigated the effect of speech-language therapy (SLT) on aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This fair quality cross-over design RCT randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive (i) SLT or (ii) operant training or attention placebo for 4 weeks; participants then crossed over to receive the other intervention for a further 4 weeks (see group assignment below). AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) was measured by the Token Test – short version at post-treatment (4 weeks). No significant between-group differences were found.
Note: Participants were assigned to 1 of 4 groups – Group A (SLT then attention placebo), Group B (attention placebo then SLT), Group C (SLT then operant conditioning), Group D (operant conditioning then SLT).
Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that speech language therapy is not more effective than comparison interventions (attention placebo treatment, operant conditioning) in improving aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Communication
Not Effective
2A
Two fair quality RCTs (David et al., 1982; Lincoln et al., 1982) investigated the effect of speech language therapy (SLT) on communication in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
The first fair quality RCT (David et al., 1982) randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive SLT or language stimulation by untrained volunteers. Communication skills were measured by the Functional Communication Profile at different treatment intervals (1, 2, 3, 4 weeks of treatment) and at post-treatment (15-20 weeks). No significant between-group difference was found at any time point.
The second fair quality cross-over design RCT (Lincoln et al., 1982) randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive (i) SLT or (ii) operant training or attention placebo for 4 weeks; participants then crossed over to receive the other intervention for a further 4 weeks (see group assignment below). Communication skills were measured by the Porch Index of Communicative Ability at post-treatment (4 weeks). No significant between-group differences were found.
Note: Participants were assigned to 1 of 4 groups – Group A (SLT then attention placebo), Group B (attention placebo then SLT), Group C (SLT then operant conditioning), Group D (operant conditioning then SLT).
Conclusion: There is limited evidence (Level 2a) from two fair quality RCTs that speech language therapy is not more effective than comparison interventions (stimulation and support by untrained volunteers, operant conditioning, non-specific attention placebo treatment) in improving communication skills in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
One fair quality RCT (Lincoln et al., 1982) investigated the effect of speech language therapy (SLT) on fluency in patients with stroke. This fair quality cross-over design RCT randomized patients with subacute/chronic stroke to receive (i) SLT or (ii) operant training or attention placebo for 4 weeks; participants then crossed over to receive the other intervention for a further 4 weeks (see group assignment below). Fluency was measured by the Fluency (Food/Countries) and Picture Description tasks at post-treatment (4 weeks). No significant between-group differences were found.
Note: Participants were assigned to 1 of 4 groups – Group A (SLT then attention placebo), Group B (attention placebo then SLT), Group C (SLT then operant conditioning), Group D (operant conditioning then SLT).
Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that speech language therapy is not more effective than comparison interventions (attention placebo treatment, operant conditioning) in improving fluency in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Functional speech
Not Effective
2A
One fair quality RCT (Lincoln et al., 1982) investigated the effect of speech language therapy (SLT) on functional speech in patients with stroke. This fair quality cross-over design RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive (i) SLT or (ii) operant training or attention placebo for 4 weeks; participants then crossed over to receive the other intervention for a further 4 weeks (see group assignment below). Functional Speech was measured by the Speech Questionnaire at post-treatment (4 weeks). A significant between-group difference in change scores was found, favoring attention placebo vs. SLT. There were no significant differences between SLT and operant conditioning.
Note: Participants were assigned to 1 of 4 groups – Group A (SLT then attention placebo), Group B (attention placebo then SLT), Group C (SLT then operant conditioning), Group D (operant conditioning then SLT).
Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that speech language therapy is not more effective than a comparison intervention (attention placebo treatment, operant conditioning) in improving functional speech in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
One fair quality RCT (Lincoln et al., 1982) investigated the effect of speech language therapy (SLT) on functional speech in patients with stroke. This fair quality cross-over design RCT randomized patients with subacute/chronic stroke to receive (i) SLT or (ii) operant training or attention placebo for 4 weeks; participants then crossed over to receive the other intervention for a further 4 weeks (see group assignment below). Functional Speech was measured by the Speech Questionnaire at post-treatment (4 weeks). A significant between-group difference in change scores was found, favoring attention placebo vs. SLT. There were no significant differences between SLT and operant conditioning.
Note: Participants were assigned to 1 of 4 groups – Group A (SLT then attention placebo), Group B (attention placebo then SLT), Group C (SLT then operant conditioning), Group D (operant conditioning then SLT).
Conclusion: There is limited evidence (Level 2a) from one fair quality RCT that speech language therapy is not more effective than a comparison intervention (attention placebo treatment, operant conditioning) in improving functional speech in patients with stroke.
Phase not specific to one period - Technology-assisted training
One high quality RCT (Kesav et al., 2017) investigated the effect of technology-assisted training on aphasia in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients with acute/subacute stroke to receive computer-based language rehabilitation therapy or no additional treatment; both groups received conventional speech language therapy. Aphasia was measured by the Western AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Battery – AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Quotient at post-treatment (4 weeks) and follow-up (3 months). A significant between-group difference was found at both time points, favoring no additional treatment vs. computer-based language rehabilitation therapy.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that technology-assisted training is not more effective than a comparison intervention (conventional speech language therapy alone) in improving aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) in patients with stroke.
Note: The high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. found that computer-based language rehabilitation therapy + conventional speech language therapy was less effective than speech language therapy alone.
References
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- Szaflarski, J. P., Ball, A. L., Vannest, J., Dietz, A. R., Allendorfer, J. B., Martin, A. N., … & Lindsell, C. J. (2015). Constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person's ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person's intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy for treatment of chronic post-stroke aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person's ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person's intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada): a randomized, blinded, controlled pilot trial. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 21, 2861.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4588672/
- Sickert, A., Anders, L. C., Münte, T. F., & Sailer, M. (2014). Constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person's ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person's intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy following sub-acute strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain.: a single-blind, randomised clinical trial of a modified therapy schedule. J Neurol Neurosurg Psychiatry, 85(1), 51-55.https://jnnp.bmj.com/content/85/1/51.short
- Thompson, C. K., Choy, J. J., Holland, A., & Cole, R. (2010). Sentactics®: Computer-automated treatment of underlying forms. Aphasiology, 24(10), 1242-1266.https://www.tandfonline.com/doi/abs/10.1080/02687030903474255
- Whitworth, A., Leitao, S., Cartwright, J., Webster, J., Hankey, G. J., Zach, J., … & Wolz, V. (2015). NARNIA: A new twist to an old tale. A pilot RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. to evaluate a multilevel approach to improving discourse in aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person's ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person's intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada). Aphasiology, 29(11), 1345-1382.https://www.tandfonline.com/doi/abs/10.1080/02687038.2015.1081143
- Woldag, H., Voigt, N., Bley, M., & Hummelsheim, H. (2017). Constraint-induced aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person's ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person's intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) therapy in the acute stage: What is the key factor for efficacy? A randomized controlled study. Neurorehabilitation and Neural Repair, 31(1), 72-80.https://journals.sagepub.com/doi/abs/10.1177/1545968316662707
Excluded Studies:
Bonifazi, S., Tomaiuolo, F., Altoè, G., Ceravolo, M. G., Provinciali, L., & Marangolo, P. (2013). Action observation as a useful approach for enhancing recovery of verb production: new evidence from aphasia. Eur. J. Phys. Rehabil. Med, 49, 473-481.
Reason for exclusion: Not a RCT.
Brady, M. C., Kelly, H., Godwin, J., & Enderby, P. (2012). Speech and language therapy for aphasia following stroke. Cochrane database of systematic reviews, (5).
Reason for exclusion: Review; all references of this review were verified for inclusion/exclusion in the present module.
Cherney, L. R. (2010). Oral reading for language in aphasia (ORLA): Evaluating the efficacy of computer-delivered therapy in chronic nonfluent aphasia. Topics in Stroke Rehabilitation, 17(6), 423-431.
Reason for exclusion: Both groups received therapy; mode of delivery differed (computer vs. therapist).
Crerar, M. A., Ellis, A. W., & Dean, E. C. (1996). Remediation of sentence processing deficits in aphasia using a computer-based microworld. Brain and Language, 52(1), 229-275.
Reason for exclusion: Both groups received therapy, no control group.
Des Roches, C. A., & Kiran, S. (2017). Technology-based rehabilitation to improve communication after acquired brain injury. Frontiers in neuroscience, 11, 382
Reason for exclusion: Review; all references of this review were verified for inclusion/exclusion in the present module.
Dignam, J., Copland, D., McKinnon, E., Burfein, P., O’brien, K., Farrell, A., & Rodriguez, A. D. (2015). Intensive versus distributed aphasia therapy: a nonrandomized, parallel-group, dosage-controlled study. Stroke, 46(8), 2206-2211.
Reason for exclusion: Both groups received therapy, only intensity varied.
Ferguson, N. F., Evans, K., & Raymer, A. M. (2012). A comparison of intention and pantomime gesture treatment for noun retrieval in people with aphasia. American Journal of Speech-Language Pathology, 21(2), S126-S139.
Reason for exclusion: Not a RCT.
Hinckley, J. J., Patterson, J. P., & Carr, T. H. (2001). Differential effects of context-and skill-based treatment approaches: Preliminary findings. Aphasiology, 15(5), 463-476.
Reason for exclusion: All groups received therapy; no control group.
Humphreys, I., Thomas, S., Phillips, C., & Lincoln, N. (2015). Cost analysis of the Communication and Low Mood (CALM) randomised trial of behavioural therapy for stroke patients with aphasia. Clinical rehabilitation, 29(1), 30-41
Reason for exclusion: Cost-effectiveness report, no outcome of interest.
Godecke, E., Hird, K., Lalor, E. E., Rai, T., & Phillips, M. R. (2012). Very early poststroke aphasia therapy: a pilot randomized controlled efficacy trial. International Journal of Stroke, 7(8), 635-644.
Reason for exclusion: Both groups received therapy, only intensity differed.
Godecke, E., Armstrong, E. A., Rai, T., Middleton, S., Ciccone, N., Whitworth, A., … & Cadilhac, D. A. (2016). A randomized controlled trial of very early rehabilitation in speech after stroke.
Reason for exclusion: Study protocol.
Latimer, N. R., Dixon, S., & Palmer, R. (2013). Cost-utility of self-managed computer therapy for people with aphasia. International journal of technology assessment in health care, 29(4), 402-409.
Reason for exclusion: Cost-analysis report, no outcome of interest.
Martins IP, Leal G, Fonseca I, Farrajota L, Aguiar M, Fonseca J, et al. A randomized, rater-blinded, parallel trial of intensive speech therapy in sub-acute post-stroke aphasia: the SP-IR-IT study. International Journal of Language and Communication Disorders, 48(4), 421-31.
Reason for exclusion: Both groups received therapy, only intensity varied.
Rochon, E., Laird, L., Bose, A., & Scofield, J. (2005). Mapping therapy for sentence production impairments in nonfluent aphasia. Neuropsychological Rehabilitation, 15(1), 1-36.
Reason for exclusion: Not a RCT (n=5 patients).
Thomas, S. A., Walker, M. F., Macniven, J. A., Haworth, H., & Lincoln, N. B. (2013). Communication and Low Mood (CALM): a randomized controlled trial of behavioural therapy for stroke patients with aphasia. Clinical rehabilitation, 27(5), 398-408.
Reason for exclusion: Study included in the Depression module.
Szelag, E., Lewandowska, M., Wolak, T., Seniow, J., Poniatowska, R., Pöppel, E., & Szymaszek, A. (2014). Training in rapid auditory processing ameliorates auditory comprehension in aphasic patients: a randomized controlled pilot study. Journal of the neurological sciences, 338(1-2), 77-86.
Reason for exclusion: Both groups received computerized training; no control group.
Smith, D. S., Goldenberg, E., Ashburn, A. E., Kinsella, G., Sheikh, K., Brennan, P. J., … & Reeback, J. S. (1981). Remedial therapy after stroke: a randomised controlled trial. Br Med J (Clin Res Ed), 282(6263), 517-520.
Reason for exclusion: No outcome of interest.
Van der Meulen, I., van de Sandt-Koenderman, W. M. E., Heijenbrok-Kal, M. H., Visch-Brink, E. G., & Ribbers, G. M. (2014). The efficacy and timing of melodic intonation therapy in subacute aphasia. Neurorehabilitation and neural repair, 28(6), 536-544.
Reason for exclusion: Study included in the “Music Therapy” module.
Varley, R., Cowell, P. E., Dyson, L., Inglis, L., Roper, A., & Whiteside, S. P. (2016). Self-administered computer therapy for apraxia of speech: two-period randomized control trial with crossover. Stroke, 47(3), 822-828.
Reason for exclusion: The intervention was designed for apraxia of speech and not aphasia.
Wan, C. Y., Zheng, X., Marchina, S., Norton, A., & Schlaug, G. (2014). Intensive therapy induces contralateral white matter changes in chronic stroke patients with Broca’s aphasia. Brain and language, 136, 1-7.
Reason for exclusion: Study included in the “Music Therapy” module.
Wenke, R., Lawrie, M., Hobson, T., Comben, W., Romano, M., Ward, E., & Cardell, E. (2014). Feasibility and cost analysis of implementing high intensity aphasia clinics within a sub-acute setting. International journal of speech-language pathology, 16(3), 250-259.
Reason for exclusion: Not a RCT.
Wilssens, I., Vandenborre, D., van Dun, K., Verhoeven, J., Visch-Brink, E., & Mariën, P. (2015). Constraint-induced aphasia therapy versus intensive semantic treatment in fluent aphasia. American Journal of Speech-Language Pathology, 24(2), 281-294.
Reason for exclusion: Both groups received therapy.
Whiteside, S. P., Inglis, A. L., Dyson, L., Roper, A., Harbottle, A., Ryder, J., … & Varley, R. A. (2012). Error reduction therapy in reducing struggle and group behaviours in apraxia of speech. Neuropsychological Rehabilitation, 22(2), 267-294.
Reason for exclusion: The intervention was designed for apraxia of speech and not aphasia.
Woolf, C., Caute, A., Haigh, Z., Galliers, J., Wilson, S., Kessie, A., … & Marshall, J. (2016). A comparison of remote therapy, face to face therapy and an attention control intervention for people with aphasia: a quasi-randomised controlled feasibility study. Clinical Rehabilitation, 30(4), 359-373
Reason for exclusion: Both groups received therapy; mode of delivery was different.
Zhang, J., Yu, J., Bao, Y., Xie, Q., Xu, Y., Zhang, J., & Wang, P. (2017). Constraint-induced aphasia therapy in post-stroke aphasia rehabilitation: A systematic review and meta-analysis of randomized controlled trials. PloS one, 12(8), e0183349.
Reason for exclusion: Review; all references of this review were verified for inclusion/exclusion in the present module.
