Authors: Johnson ML, Taub E, Harper LH, Wade JT, Bowman MH, Bishop-McKay S, Haddad MM, Mark VW, Uswatte G
Title: An Enhanced Protocol for Constraint-Induced Aphasia Therapy II: A Case Series
Source: American Journal of Speech Language Pathology 2014 23: 60-72
Year: 2014
Research Design: Case Series

Purpose: The initial version of Constraint-Induced Aphasia Therapy (CIAT I) consisted of a single exercise. This study sought to evaluate the feasibility for future trials of an expanded and restructured protocol designed to increase the efficacy of CIAT I. Method: The subjects were 4 native English speakers with chronic stroke who exhibited characteristics of moderate Broca's aphasia. Treatment was carried out for 3.5 hr/day for 15 consecutive weekdays. It consisted of 3 components: (a) intensive training by a behavioral method termed shaping using a number of expressive language exercises in addition to the single original language card game, (b) strong discouragement of attempts to use gesture or other nonverbal means of communication, and (c) a transfer package of behavioral techniques to promote transfer of treatment gains from the laboratory to real-life situations. Results: Participation in speech in the life situation improved significantly after treatment. The effect sizes (i.e., d′) in this domain were ≥ 2.2; d′ values ≥ 0.8 are considered large. Improvement in language ability on a laboratory test, the Western Aphasia Battery—Revised (Kertesz, 2006), did not achieve statistical significance, although the effect size was large—that is, 1.3 (13.1 points). Conclusion: These pilot results suggest in preliminary fashion that CIAT II may produce significant improvements in everyday speech.

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