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NSW Adult Communication and Dysphagia Group

CAT In patients with aphasia post stroke, does constraint induced aphasia therapy assist language production?. NSW Adult Communication and Dysphagia Group. CIAT. Application in Speech Pathology; Intensity: 30hr over 2weeks

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NSW Adult Communication and Dysphagia Group

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  1. CATIn patients with aphasia post stroke, does constraint induced aphasia therapy assist language production? NSW Adult Communication and Dysphagia Group

  2. CIAT • Application in Speech Pathology; • Intensity: 30hr over 2weeks • Shaping; language tasks of increasing complexity embedded in communicative language games within a group setting (max 2-3 people) • Constraint: constraint of non-verbal or compensatory strategies. (Taub, et al 2002 cited in Meinzer et al 2006)

  3. CAP#1:Pulvermueller et al (2001) Constraint induced therapy of chronic aphasia after stroke. Stroke. 32: 1621-1626 CAP#2: Meinzer et al(2005). Long term stability of improved language functions in chronic aphasia after constrain inducedaphasia therapy. Stroke. 37(6):1464 –1466. CATSearch produced two articles for appraisal.

  4. CAPS

  5. CAP Cont’d

  6. Massed-practice CIAT performed intensely over a short period of time with chronic aphasics resulted in improved language performance. It is difficult to determine whether CIAT was more effective than other conventional therapies. Clinical Bottom LineCAP#1 & #2

  7. Conventional Therapies • Chronic aphasics usually receive the option of gp or individual therapy. • Individual therapy 1hr/wk • Offered in blocks –particularly if students placements available and if caseload permitting. • Goal oriented therapy • Gp therapy: 2hr a week/fortnight for a period of 10-12 weeks. Total communication approach. • Transport and staffing

  8. Conventional Therapy • Therapies used in individual and gp sessions include: • Strategies • Impairment • Family Education • Functional Therapy

  9. Is CIAT an alternative model to service delivery for aphasia?

  10. Participants • Recruit 30 participants • Confirmed diagnosis of stroke and aphasia • Have functional comprehension at a single sentence level • 12 mth post onset • Outpatients

  11. Methodology • Blinding assessors • Concealed and quasi-randomised • Control gp • 2 participants in the control or both treatment gps • Therapy conducted 2hr/day for 2 weeks with carer education

  12. Treatment Gp 1- CIAT • Therapy tasks could include go-fish game, other barrier task games plus general conversation on current affairs topics.

  13. Treatment Gp 2 – Functional Therapy • Social communication tasks • Total communication approach utilised • Education to carers provided

  14. Control • Wait list gp • Treatment not withheld

  15. How? • Big exercise • At a smaller level • Utilise clients as their own control while they are on the waiting list • Compare CIAT with current functional therapy approach that focuses on total communication • Increase intensity at sub acute level of rehab (inpatients)

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