The novel cognitive flexibility in aphasia therapy (CFAT): A combined treatment of aphasia and executive functions to improve communicative success

Abstract

Purpose

Over and above language deficits, persons with aphasia can present with impairments in executive functions, including deficits in cognitive flexibility. Cognitive flexibility constitutes the ability to update behaviour quickly and flexibly in a changing environment. Its deficits can restrict communicative ability, e. g. the ability to change a topic. To date, these deficits have been neglected in aphasia therapy, even though their consideration regarding language treatment may be beneficial for the persons affected. The present study aimed to evaluate whether aphasia therapy including cognitive flexibility leads to more improvement than conventional aphasia therapy.

Method

A pilot group study with ten patients was conducted. The patients received both the novel Cognitive Flexibility in Aphasia Therapy (CFAT) and conventional aphasia therapy in a cross-over design. Each therapy method was delivered for 20 sessions within two weeks. An assessment battery was applied five times, including language skills, communicative ability and verbal/nonverbal cognitive flexibility.

Result

Patients profited from CFAT regarding language skills, communicative ability and verbal cognitive flexibility. Furthermore, compared to conventional therapy, CFAT was more effective for verbal cognitive flexibility.

Conclusion

This pilot study indicates that CFAT offers a novel opportunity to directly train cognitive flexibility in communicative settings and complements conventional therapy for optimal patient outcome.

Keywords:

• aphasia
• communication
• executive function
• speech therapy
• language

Acknowledgement

The authors thank all cooperating private practices and rehabilitation centres for their support in patient recruitment and all persons who participated in our study. Furthermore, we thank the Neuroscience and Aphasia Research Unit (NARU) group at the University of Manchester for their feedback during a short visit of the first author in Manchester. We also thank the reviewer and the editor for their very helpful comments.

Declaration of interest

The authors report no declarations of interest.

Supplementary material

Supplemental data for this article can be accessed at https://doi.org/10.1080/17549507.2020.1757152

Additional information

Funding

This work was supported by the German Academic Scholarship Foundation.