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  3. A Provisional Theory Of Change And Basic Logic Model For Intensive Comprehensive Aphasia Programs.
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  3. A Provisional Theory Of Change And Basic Logic Model For Intensive Comprehensive Aphasia Programs.

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A Provisional Theory of Change and Basic Logic Model for Intensive Comprehensive Aphasia Programs.

Katie Monnelly1, Jane Marshall1, Lucy Dipper1

  • 1Centre for Language and Communication Science Research, Department of Allied Health, School of Health and Medical Sciences, City St George's, University of London, United Kingdom.

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|March 23, 2026

View abstract on PubMed

Summary
This summary is machine-generated.

Intensive Comprehensive Aphasia Programs (ICAPs) can be better understood using theory of change (TOC), logic modeling (LM), and dark logic. This methodological approach enhances ICAP design and evaluation by clarifying therapeutic input and potential risks for people with aphasia.

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Area of Science:

  • Speech and Language Therapy
  • Rehabilitation Science
  • Health Services Research

Background:

  • People with aphasia face significant challenges in daily life due to language impairments.
  • Aphasia-unfriendly environments exacerbate these difficulties, necessitating tailored speech and language interventions.
  • Intensive Comprehensive Aphasia Programs (ICAPs) offer a structured approach to address these needs.

Purpose of the Study:

  • To apply theory of change (TOC), logic modeling (LM), and dark logic to the Intensive Comprehensive Aphasia Program (ICAP) service delivery model.
  • To clarify the hypothesized mechanisms of change and potential adverse outcomes within ICAPs.
  • To provide a methodological example for enhancing the theoretical underpinning, design, and evaluation of ICAPs.

Main Methods:

  • An extensive literature review and expert discussions informed an initial TOC.
  • People with aphasia (n=8) co-constructed the TOC and explored adverse outcomes using focus groups and dark logic modeling.
  • The refined TOC was mapped onto a logic model (LM).

Main Results:

  • A provisional TOC and LM, incorporating dark logic, was developed for ICAPs.
  • The co-construction process highlighted the importance of including people with aphasia in program development.
  • Potential risks and adverse outcomes associated with ICAPs were identified.

Conclusions:

  • Applying TOC, LM, and dark logic presents challenges but offers a valuable framework for understanding and improving ICAPs.
  • This approach enhances the methodological mapping of ICAPs, clarifying theoretical foundations and evaluation strategies.
  • Further inclusion of diverse stakeholder groups is recommended for comprehensive TOC application to ICAPs.