The Effects of the Persian Writing Treatment Protocol on Communication Skills in People With Aphasia After Stroke

Aphasia is one of the most severe post-stroke deficits affecting speech, comprehension, reading, and writing modalities. In some patients, speech is severely impaired, so choosing an alternative or complementary approach for communication seems necessary. Writing has the closest characteristics to verbal language. So, it can be a substitute or facilitate speech and improve the quality of communication. Therefore, this study aimed to design a writing treatment protocol for Persian stroke patients and investigate its effect on improving communication skills.

First, the writing treatment protocol was designed by considering the characteristics of the Persian written language, and an expert panel determined its validity. Then, a single-subject study with ABA design was performed on 6 stroke patients suffering from chronic aphasia, non-fluent with limited speech. After the baseline phase, treatment sessions using the developed protocol were conducted for one hour twice weekly for 10 sessions. Finally, a follow-up was performed to evaluate the stability of the treatment.

The results showed that patients' improvement was limited to trained words, which were treated using the developed protocol, and no generalization was observed for untrained words. The effect size indices (improvement rate difference, percentage of non-overlapping data, and percentage of overlapping data) showed the acceptable effect of treatment, its effectiveness, and the very high impact of writing therapy in all patients.

Writing treatment using the developed Persian protocol can improve patients' writing performance and communication. An essential outcome of this study is introducing a writing treatment approach as a new intervention for Persian patients with limited speech.