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An Enhanced Protocol for Constraint-Induced Aphasia Therapy II (Johnson et al., 2014)

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journal contribution
posted on 01.02.2014, 00:00 by Margaret L. Johnson, Edward Taub, Leslie H. Harper, Jamie T. Wade, Mary H. Bowman, Staci Bishop-McKay, Michelle M. Haddad, Victor W. Mark, Gitendra Uswatte
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.

Funding

This study was supported by a grant from the National Institutes of Health (1 R01 HD0 53750).

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