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Abstract
Background: Studies of intensive aphasia treatments vary widely in terms of treatment focus, in patient population and, in particular, in definition of what is considered “intensive”. Variability makes it difficult to compare among studies and to definitively determine whether more treatment is actually better. Constraint-induced language therapy (CILT) is one treatment that has been successfully replicated at approximately the same dosage with generally positive results.
Aims: The current study used a modified multiple baseline design across participants to investigate the administration of CILT at the standard intensive dosage of 30 hours over 2 weeks (CILT-I) compared to a more distributed dosage of 30 hours over 10 weeks (CILT-D).
Methods & Procedures: Eight participants with chronic aphasia participated in either CILT-I or CILT-D. Standardised and discourse measures were taken pre- and post-treatment and also 4 weeks after the completion of treatment. Discourse probes were administered after every 6 hours of treatment to assess change in productivity and efficiency over time.
Outcomes & Results: All of the participants who received CILT-I and CILT-D showed either an increased effect size on a discourse measure, a clinically significant change on a standardised battery or both. Gains were maintained in nearly all cases.
Conclusions: CILT administered in both intensive and distributed dosages resulted in positive changes in aphasia severity and discourse. This study adds evidence to the still inconclusive role of intensity to CILT.
Notes
1. A recent 100 participant randomised study designed to treat the subacute population (~1 month post) demonstrated an equally positive response to intensive CILT and intensive traditional group therapy for all participants (Sickert et al., Citation2014).
2. Dosage parameters (session duration, session frequency, intervention duration, and number of sessions) are those proposed by Warren and colleagues (Citation2007) for investigations of treatment dosage in children with intellectual delays. These parameters were modified by Cherney (Citation2012) for use in the aphasia literature. Reporting these parameters in each study will allow for easier comparison among studies claiming to provide intensive therapy.