Academic literature on the topic 'Constraint-induced language therapy'

Objective The authors compared the effectiveness of 2 intensive therapy methods: Constraint-Induced Aphasia Therapy (CIAT; Pulvermüller et al., 2001) and semantic therapy (BOX; Visch-Brink & Bajema, 2001). Method Nine patients with chronic fluent aphasia participated in a therapy program to establish behavioral treatment outcomes. Participants were randomly assigned to one of two groups (CIAT or BOX). Results Intensive therapy significantly improved verbal communication. However, BOX treatment showed a more pronounced improvement on two communication—namely, a standardized assessment for verbal communication, the Amsterdam Nijmegen Everyday Language Test (Blomert, Koster, & Kean, 1995), and a subjective rating scale, the Communicative Effectiveness Index (Lomas et al., 1989). All participants significantly improved on one (or more) subtests of the Aachen Aphasia Test (Graetz, de Bleser, & Willmes, 1992), an impairment-focused assessment. There was a treatment-specific effect. BOX treatment had a significant effect on language comprehension and semantics, whereas CIAT treatment affected language production and phonology. Conclusion The findings indicate that in patients with fluent aphasia, (a) intensive treatment has a significant effect on language and verbal communication, (b) intensive therapy results in selective treatment effects, and (c) an intensive semantic treatment shows a more striking mean improvement on verbal communication in comparison with communication-based CIAT treatment.

Thesis (M.A.) -- University of Maryland, College Park, 2008.<br>Thesis research directed by: Dept. of Hearing and Speech Sciences. Title from t.p. of PDF. Includes bibliographical references. Published by UMI Dissertation Services, Ann Arbor, Mich. Also available in paper.

Intensive Language Action Therapy (ILAT) is a short-term aphasia therapy that emphasises massed-practise of language, where communication is framed through language action games that approximate everyday interactions. Despite increasing interest in ILAT, a comprehensive description of its methods has thus far been missing. Furthermore due to inconsistent results, further exploration of cortical reorganisation of language functions following ILAT is warranted. The underlying principles and practical features of ILAT methods and of language-action games are fully described, including the structure and materials for two specific games. 14 English speaking patients with chronic aphasia underwent two weeks of ILAT utilising the methods outlined. Pre and post measures of language performance were collected through standardised clinical assessments, along with functional Magnetic Resonance Imaging scans from a subset of 8 patients. Accuracy and response times for speech output and comprehension during language-action games were also recorded to measure success during the therapy interval. Data analysis showed significant improvements in clinical assessments of naming and comprehension, but not in auditory or syntactic processing tasks. Significant increases were also seen in patients’ self-ratings of quality of communication following therapy. Video and voice recordings during therapy sessions demonstrated significantly faster response times in production and comprehension of language, alongside an increase in the complexity of patients’ spoken output. Cortical activation was recorded whilst patients heard low-level noise, sentences containing ambiguous words and low-ambiguity sentences. Although the results showed no changes in cortical activation in the group of patients whilst processing low-level noise or low ambiguity sentences, increases in language-induced activation were seen in single-subject analyses in both the left and right hemispheres. Furthermore the group of patients recruited the right hemisphere significantly more than the left hemisphere following ILAT when processing complex sentences containing ambiguous words. iii Clinical assessments and measures of everyday communication showed undergoing two weeks of ILAT significantly improved speech output and comprehension in patients with chronic aphasia. Gains made in communicative performance during therapy highlight the importance of recording therapy sessions for additional assessment of therapy efficacy. Although conclusions regarding cortical reorganisation are not entirely clear, they indicate the important role of the right hemisphere in reorganisation of language after stroke.

Abstract Background: Individuals with nonfluent aphasia may have significant difficulties with functional spoken communication tasks in their daily life. Aphasia treatment held in a group setting may provide an enriched communicative context wherein the requirements of spoken language are similar to those within functional day-to-day communicative situations. Thus engaging in a spoken language activity in a group setting may directly target generalization of trained skills to those required in real-life, social communication situations. The present study is concerned with an aphasia group treatment that requires focused practice of spoken language during a social-functional communication task. Intensive Language Action Therapy (ILAT) has demonstrated positive communication outcomes in some individuals with chronic aphasia. However, it remains to be seen which clinical measures best index outcomes for ILAT. The purpose of the current study was to determine the effectiveness of ILAT in individuals with nonfluent aphasia by exploring multiple, potential ILAT outcomes. The outcomes included change in performance on assessments of directly trained spoken social-functional communication abilities (proximal outcomes), untrained social-functional communication abilities and language abilities (primary outcomes), and cognitive-communication abilities (secondary outcome). Additionally, the project aimed to explore the participants' perceptions of ILAT (secondary outcome). Methods and Procedures: ILAT was implemented with four individuals with nonfluent aphasia, using a single-subject multiple baseline design. The treatment was conducted daily for 10 consecutive week days, totaling 25 hours of treatment. Treatment probes (i.e., using trained and untrained picture cards and an unrelated control-task of nonword repetition), a pre/post assessment battery, and a post-treatment survey/interview were administered to assess performance on the treatment task, generalization to other potential ILAT outcomes, and participants' perceptions. Outcomes & Results: Increased accuracy was observed for trained and untrained items. However, two of the four participants were not able to reach a criteria determined a priori for treatment performance. Performance on items that were untrained resulted in some improvements in performance for all participants. Three of the four participants demonstrated small effect sizes in response to ILAT. One participant who demonstrated a medium effect size in response to ILAT also demonstrated a clinical significant change in discourse abilities, a measure of spoken social-functional communication abilities. All participants demonstrated improvements on at least one primary outcomes measure. Two participants, however, demonstrated a decline. All participants, however, perceived a positive experience with ILAT on a qualitative posttreatment survey/interview. Conclusions: Patterns were found between skills directly trained during ILAT, proximal outcomes, and performance on primary and secondary outcome measures of language, social-functional communication, and cognitive-communication, meant to assess generalization of trained skills to similar or potentially related untrained skills. A substantial amount of change (e.g., at least a medium effect size) on proximal outcome measures may be required in order for improvements to occur in primary and secondary outcome measures. Participants' perceptions of a positive treatment experience associated with the ILAT program further supports the value of the treatment. Future research should aim to further examine the influence of ILAT treatment components and participants' characteristics.

This report investigates the efficacy of using constraint-induced language therapy (CILT) for treating acquired apraxia of speech (AOS). CILT is a treatment method used with individuals with aphasia in which communication is restricted to verbal output in order to isolate the damaged language areas of the brain and reactivate impaired neural connections (Pulvermuller et al., 2001). CILT employs repetitive, massed practiced stimuli and structured shaping of expressive output within the confines of verbal expression (Pulvermuller et al., 2001). Kirmess and Maher (2010) indirectly discovered that two patients with aphasia and apraxia of speech made gains in both language output and articulatory accuracy after receiving intensive CILT, suggesting possible efficacy for the use of CILT with patients with AOS.<br>text