Authors: Bilda K
Title: Video-based conversational script training for aphasia: A therapy study
Source: Aphasiology 2011 25(2): 191-201
Year: 2011
Research Design: Case Series

Background: Chronic aphasia is a lifelong handicap that often leads to social isolation, loss of autonomy, and restricted social activities. Hence it is essential to develop cost-effective therapeutic approaches that enable people with aphasia to practise language skills in reallife contexts. Over the last several years there has been a shift from impairment-oriented language therapy to functional approaches that train language skills in more realistic contexts. Studies performed in the cognitive neurosciences have produced evidence that massed practice and forced use are essential for achieving sustained learning success in patients with aphasia. Conversational script training is based on the theory that massed practice of a whole task is likely to result in automatic and effortless language output that may facilitate participation in everyday life activities. To enhance automatisation of script use cue-based massed drilling is required. Computers are an ideal and cost-effective medium for the implementation of this massed practice and drill. Several studies have documented the positive effects of computer treatment for people grappling with the effects of long-lasting aphasia. Aims: The study involved the development of a video-based script training programme. The objective was to show the positive effects and usefulness of the programme. Methods & Procedures: The study is a case series consisting of a pre-test, 10 days of computer-based therapy with 3 hours of daily training, and two follow-up evaluations at 4 weeks and 6 months respectively. The material included 50 conversational scripts that were presented in video scenes filmed at original locations. The baseline and posttreatment scripts were audio taped, transcribed, and compared with the target scripts on the point scale of the subtest "classification of sentences" of the Aachener Aphasia Test (AAT). Additionally, language skills were tested with the AAT and various questionnaires were filled out together with the participants and their partners to evaluate the effects of the training in the patients' everyday lives. Five participants with chronic aphasia took part in the study. All were German speakers aged 45 and upwards. They exhibited a variety of types and degrees of severity of aphasia. Word-finding difficulties accounted for a significant part of their aphasia. Outcomes & Results: The quality and quantity of production of script-related words improved in every patient. Three positive themes were identified from the questionnaires and interviews: increased verbal communication skills, improvement in communication skills evident in various everyday situations, and increased confidence. Conclusions: Video-based script training was found to be an effective treatment for chronic aphasia.

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