Changes in Complete Utterances Following Communication-Based Group Treatment for Chronic Aphasia

ABSTRACT

Background

Evidence suggests that communication-based aphasia group treatment may increase formal assessment scores and improve features of discourse production. The real-life interactions which occur during group treatment may increase use of grammatically complete and relevant utterances.

Aims

To examine the effects of communication-based group treatment on production of complete utterances during structured and conversational discourse in adults with chronic aphasia.

Methods & Procedures

We analyzed structured and conversational discourse samples from 23 adults with chronic aphasia originally collected by Elman and Bernstein-Ellis (1999a). Bayesian generalized linear mixed-effects models were used to evaluate changes in use of complete utterances and its two components, syntactic completeness and relevance, at treatment exit and 4-6 weeks post-treatment.

Outcomes & Results

Results are presented with reference to the region of practical equivalence (ROPE, i.e., the range of effect sizes small enough to ignore) and in terms of the probability, derived from Bayesian model posterior distributions, that the effect in question exceeded, fell within, or fell below the ROPE. At the group level, syntactic completeness improved in structured discourse, but syntactic completeness, relevance, and complete utterances did not change during conversational discourse. Individual response to treatment varied and participants with mild aphasia and without concomitant apraxia of speech were more likely to demonstrate post-treatment change in complete utterances.

Conclusions

Use of syntactically complete utterances during structured discourse increased at treatment exit and follow-up. Participants, especially those with severe aphasia and apraxia of speech, may have changed in ways not revealed by the complete utterance measure.

KEYWORDS:

• aphasia
• group treatment
• discourse

Acknowledgments

We thank Ellen Bernstein-Ellis, M.A., CCC-SLP and the people with aphasia who participated in the study. Thanks also to the following students who contributed to various phases of this project: Alexa Bergenfeld, Alexandra Buchanan, Abby Cohen, Anne DeCaro, Sophia Hendrix, Sara Manzon, and Carly Truglio.

Declaration of Interest

The original RCT was partially funded by a grant from the National Easter Seals Research Program (awarded to Roberta J. Elman). This study was partially funded by the Aphasia Center of California Research Fund.

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/02687038.2024.2311949

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.