Discourse processing treatment for adults with aphasia.

The general goal of treatment for people with aphasia (PWA) is to improve their ability to communicate, which involves the discourse level. Treatment at this level is not a new concept, and there are many well-established procedures that utilize the discourse approach. Deficits that PWA exhibit during conversation are often undetectable by standardized testing. Although these deficits may not be detectable by standardized measures, they significantly impact the PWA's ability to maintain social relationships and engage in everyday communication. Multi-level analyses can identify strengths and weaknesses in PWA's discourse that relate to functional aspects of language processing and structural linguistics. Multi-level discourse analyses have revealed a more productive investigation of discourse production by more thoroughly documenting linguistic abilities in PWA. The purpose of this study was to determine if using an intensive discourse processing treatment improved discourse production in adults with aphasia. Study aims included a) determining if the discourse processing treatment improved performance on measures of micro- and macro- linguistic processes for individuals with aphasia for trained and untrained discourse productions, and b) determining if treatment effects were maintained. Participants included four PWA who met study criteria. The study included three phases: baseline, treatment, and maintenance. Baseline took place during week one of the study, treatment was during weeks two, three, and four, and the maintenance phase included data collection one week after treatment and one month post-treatment. Treatment involved twelve sequential picture stimuli and was administered in a four-step procedure. A multi-level discourse analyses was applied to analyze changes in PWA communication. Results indicated that the discourse processing treatment resulted in improvements in participant's discourse for trained and untrained productions. The multi-level analysis was more beneficial than standardized measures for analyzing discourse and documenting change in response to treatment