Comprehensive, high-dose aphasia treatment (Dignam et al., 2025)

<p dir="ltr"><b>Purpose: </b>Intensive comprehensive aphasia programs (ICAPs) are a novel service delivery model incorporating best practice principles in aphasia rehabilitation. Despite increased evidence, adoption of this model into health care services remains limited. This study evaluated the feasibility and effectiveness of the comprehensive, high-dose aphasia treatment (CHAT) program, a modified-ICAP, when implemented by a public rehabilitation facility in Brisbane, Australia.</p><p dir="ltr"><b>Method:</b> A nonrandomized, Type II hybrid clinical implementation and effectiveness study design was employed. The CHAT program includes 50 hr of goal-directed aphasia rehabilitation, delivered over 8 weeks. Sixty-seven adults with poststroke aphasia consented to the study. Feasibility was evaluated using service statistics (i.e., referrals, adherence, dose) and analyzed using descriptive statistics. Effectiveness evaluated changes in participants’ language impairment, communication activity and participation, and quality of life at posttherapy and 3-month follow-up. Group-level data were analyzed using linear mixed models and Cohen’s <i>d</i> effect sizes. Minimal detectable change (MDC₉₀) was used to determine changes at the individual participant level.</p><p dir="ltr"><b>Results: </b>Fourteen cohorts of CHAT were delivered from February 2021 to December 2023. Sixty-five participants completed CHAT, with an average dose of 46.6 hr of therapy. Group-level analyses revealed significant improvements in participants’ language impairment, communication activity and participation, and quality of life (<i>p</i> < .05) at posttherapy and 3-month follow-up. Most participants (89%) demonstrated significant improvements on at least one outcome measure.</p><p dir="ltr"><b>Conclusions: </b>The CHAT program was feasibly delivered within a public, health care context and resulted in positive and enduring changes in participants’ language impairment, communication function, and quality of life.</p><p dir="ltr"><b>Supplemental Material S1. </b>STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist.</p><p dir="ltr"><b>Supplemental Material S2. </b>Individual participant demographic and stroke-related data at baseline.</p><p dir="ltr"><b>Supplemental Material S3. </b>Individual participant data for language domains (T-scores) on the Comprehensive Aphasia Test at baseline.</p><p dir="ltr"><b>Supplemental Material S4. </b>Example CHAT weekly therapy timetable.</p><p dir="ltr"><b>Supplemental Material S5. </b>Template for Intervention Description and Replication (TIDieR) for the comprehensive, high-dose aphasia treatment.</p><p dir="ltr"><b>Supplemental Material S6. </b>Minimal detectable change₉₀ for the Communication Confidence Rating Scale for Aphasia.</p><p dir="ltr"><b>Supplemental Material S7. </b>Individual participant data for dose of intervention received.</p><p dir="ltr"><b>Supplemental Material S8. </b>Individual participant change scores on clinical outcome measures at post-therapy and 3-month follow-up.</p><p dir="ltr">Dignam, J., Burfein, P., Campbell, J., Coleman, A., Fraser, C., Halpin, J., Hill, A., O'Brien, K., O'Neill, E., Roxas, K., Short, K., Shrubsole, K., Stuckey, R., Wedley, H., & Copeland, D. A. (2025). Clinical effectiveness of the comprehensive, high-dose aphasia treatment program for people with poststroke aphasia. <i>Journal of Speech, Language, and Hearing Research, </i><i>68</i>(12), 5938–5949. <a href="https://doi.org/10.1044/2025_JSLHR-25-00336" rel="noreferrer" target="_blank">https://doi.org/10.1044/2025_JSLHR-25-00336</a></p>