Comparing the treatment effect of conversational and traditional aphasia treatments based on conversational outcome measures

This prospective Phase I single-subject (ABABA) study repeated across 4 participants with quasi-randomized treatment order investigated the treatment effects of conversation and traditional stimulation treatments on conversational outcomes. Treatment was administered for 10 sessions (2 one-hour weekly sessions) per treatment type. Primary conversational outcomes included 6-minute conversations coded for pragmatic behaviors and percent Correct Information Units (CIUs). Traditional stimulation probes included auditory comprehension, lexical retrieval, and syntax probe performance. Secondary outcome measures represented the domains of the ICF (WHO, 2001) model with the addition of quality of life. These included the Western Aphasia Battery (Kertesz, 2007), the American Speech Language and Hearing Association’s Functional Assessment of Communication Scale (Frattali, Holland, Thompson, Wohl, & Ferketic, 1995), the Conversation Analysis Profile for People with Aphasia (Whitworth, Perkins, & Lesser, 1997), and the Stroke and Aphasia Quality of Life Scale (Hilari, Byng, Lamping, & Smith, 2003). Results indicated there was a treatment effect for syntax abilities following traditional stimulation therapy for the participants who received this treatment first. The two participants who received traditional stimulation therapy first demonstrated improved conversational outcomes. The participant with moderate aphasia who received conversation therapy first demonstrated an effect for conversation therapy. Visual trends indicated three out of the four participants demonstrated the highest gains in conversational abilities during or following conversation therapy. Percent CIUs increased over time in three participants despite order of treatment. No significant group changes were demonstrated after traditional or conversation therapy on secondary outcome measures. These results provide a template for conducting and measuring conversational therapy