An Intensive and Comprehensive Aphasia Program Versus a Conventional Speech and Language Therapy: A Dose-Controlled,...

Aphasia, an acquired communication disorder after a stroke, negatively impacts an individual's participation and communicative exchanges in daily life. Speech and language therapy (SLT) serves to either restore or compensate for language capabilities. An intensive and comprehensive aphasia program (ICAP) that emphasizes improving an individual's abilities for daily participation and functional communication through a highly intensive schedule has accumulated substantial evidence supporting its efficacy. This study is aimed at comparing the effects of the mentioned treatment models to firstly progress the investigation of an ICAP in comparison with a conventional model, and secondly, at addressing local service gaps and identify how an ICAP could meet the needs of individuals with aphasia. A nonrandomized, dose-controlled crossover, pre-post design. The ICAP and the conventional SLT (c-SLT) were delivered alternately at a local community-based rehabilitation center in Hong Kong, with a minimum of six-month washout period between programs; treatment allocation was determined by the timing of recruitment. Twelve right-handed adults with chronic aphasia were recruited. Both the treatment models provided 39 hours of treatment, using evidence-based approaches and targeting both word and beyond-word levels. The ICAP phase was delivered over 2.5 weeks at an intensity of 3 hours/day, 5 days/week. Treatment components included individual impairment-based, participation-based, technology-based, and group therapy. The c-SLT phase was delivered at an intensity of 2 hours/week, once weekly, providing individual language-only therapy. Each participant received a total of 78 hours of treatment; no dropouts were recorded. Linguistic performance was assessed using two standardized comprehensive language-functioning tests, an individual naming test and a discourse test. Communication confidence and effectiveness were also evaluated. Overall, the ICAP condition demonstrated better linguistic and quality of life treatment outcomes at the individual and group levels. Feedback on the experiences with the two treatment models was collected through interviews, which provided insights into perceived benefits from the user perspective and insights for future participant recruitment.