Treatment of Working Memory in a Patient with Moderate Aphasia

Working memory (WM) is the cognitive system that functions for the temporary storage, activation, and manipulation of information in support of complex, goal-directed behavior (Baddeley, 2003; Kane, Conway, Hambrick, & Engle, 2007). This system is limited in capacity, and it includes an attentional or central executive component that serves to block interference, resolve conflict, and flexibly manage its capacity limitations (Baddeley, 2003; Just & Carpenter, 1992; Kane et al., 2007). It has been suggested that WM deficits may contribute to language performance impairments in aphasia (Caspari, Parkinson, LaPointe, & Katz, 1998; Friedmann & Gvion, 2003; Wright, Downey, Gravier, Love, & Shapiro, 2007; Wright & Shisler, 2005). Accordingly, clinical researchers have begun to study whether aphasia treatment targeted at WM or related processes may be efficacious

Description of an Intensive Residential Aphasia Treatment Program: Rationale, Clinical Processes, and Outcomes

Purpose: The purpose of this article is to describe the rationale, clinical processes, and outcomes of an intensive comprehensive aphasia program (ICAP). Method: Seventy-three community-dwelling adults with aphasia completed a residentially based ICAP. Participants received 5 hr of daily 1:1 evidence-based cognitivelinguistically oriented aphasia therapy, supplemented with weekly socially oriented and therapeutic group activities over a 23-day treatment course. Standardized measures of aphasia severity and communicative functioning were obtained at baseline, program entry, program exit, and follow-up. Results were analyzed using a Bayesian latent growth curve model with 2 factors representing (a) the initial level and (b) change over time, respectively, for each outcome measure. Results: Model parameter estimates showed reliable improvement on all outcome measures between the initial and final assessments. Improvement during the treatment interval was greater than change observed across the baseline interval, and gains were maintained at follow-up on all measures. Conclusions: The rationale, clinical processes, and outcomes of a residentially based ICAP have been described. ICAPs differ with respect to treatments delivered, dosing parameters, and outcomes measured. Specifying the defining components of complex interventions, establishing their feasibility, and describing their outcomes are necessary to guide the development of controlled clinical trials