Therapeutic effect of an intensive, comprehensive aphasia program: Aphasia LIFT

The development of intensive, comprehensive aphasia programs (ICAPs) is increasing due to evidence in favour of greater treatment intensity (Cherney, Patterson, Raymer, Frymark, & Schooling, 2008), the adoption of a broad, holistic, biopsychosocial approach in aphasia rehabilitation (Byng & Duchan, 2005; Kagan et al., 2008; Martin, Thompson, & Worrall, 2008; Simmons-Mackie & Kagan, 2007), and the desire to meet the needs of people with aphasia and their family members in therapy (Howe et al., 2012; Worrall et al., 2012). ICAPs comprise a range of therapy approaches (individual therapy, group therapy, patient/family education, technology), delivered at high intensity (minimum of three hours per day over at least two weeks), to a defined group of participants within a specified amount of time (Cherney, Worrall, & Rose, 2012). Aphasia LIFT (Language Impairment and Functioning Therapy) is a research-based ICAP that uses evidence-based therapy approaches to target language and functioning across the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) domains (WHO, 2001). The aim of this study was to determine the therapeutic effect of Aphasia LIFT on language impairment, functional communication, and communication-related quality of life (QOL)

An fMRI investigation of the effects of attempted naming on word retrieval in aphasia

In healthy controls, picture naming performance can be facilitated by a single prior exposure to the same picture ("priming"). This priming phenomenon is utilized in the treatment of aphasia, which often includes repeated picture naming as part of a therapeutic task. The current study sought to determine whether single and/or multiple exposures facilitate subsequent naming in aphasia and whether such facilitatory effects act through normal priming mechanisms. A functional magnetic resonance imaging paradigm was employed to explore the beneficial effects of attempted naming in two individuals with aphasia and a control group. The timing and number of prior exposures was manipulated, with investigation of both short-term effects (single prior exposure over a period of minutes) and long-term effects (multiple presentations over a period of days). Following attempted naming, both short-term and long-term facilitated items showed improvement for controls, while only the long-term condition showed benefits at a behavioral level for the participants with aphasia. At a neural level, effects of long-term facilitation were noted in the left precuneus for one participant with aphasia, a result also identified for the equivalent contrast in controls. It appears that multiple attempts are required to improve naming performance in the presence of anomia and that for some individuals with aphasia the source of facilitation may be similar to unimpaired mechanisms engaged outside the language network

Intensive versus distributed aphasia therapy: a nonrandomized, parallel-group, dosage-controlled trial

Background and Purpose-Most studies comparing different levels of aphasia treatment intensity have not controlled the dosage of therapy provided. Consequently, the true effect of treatment intensity in aphasia rehabilitation remains unknown. Aphasia Language Impairment and Functioning Therapy is an intensive, comprehensive aphasia program. We investigated the efficacy of a dosage-controlled trial of Aphasia Language Impairment and Functioning Therapy, when delivered in an intensive versus distributed therapy schedule, on communication outcomes in participants with chronic aphasia

Hear–communicate–remember: feasibility of delivering an integrated intervention for family caregivers of people with dementia and hearing impairment via telehealth

To evaluate the feasibility of Hear-Communicate-Remember, a training programme developed for family caregivers of people with dementia and hearing impairment that integrated hearing, communication and memory strategies, which was intended to be delivered via telehealth.Participants included six dyads consisting of adults with dementia and hearing impairment and their family caregivers. Data collection involved a combination of semi-structured interviews, self-report questionnaires and field notes.Analysis of the qualitative interviews revealed four themes: appropriateness of intervention resources, considerations for the delivery of intervention via telehealth, knowledge and application of intervention strategies, and impact of the intervention on day-to-day life. Results from the satisfaction survey indicated that caregiver participants were mostly satisfied with all aspects of the intervention except the use of some technological components. The field notes described challenges with implementation via telehealth.Future research involving a cohort comparison study with a larger cohort of dyads is needed to establish treatment efficacy

Facilitation of naming in aphasia with auditory repetition: an investigation of neurocognitive mechanisms

Prior phonological processing can enhance subsequent picture naming performance in individuals with aphasia, yet the neurocognitive mechanisms underlying this effect and its longevity are unknown. This study used functional magnetic resonance imaging to examine the short-term (within minutes) and long-term (within days) facilitation effects from a phonological task in both participants with aphasia and age-matched controls. Results for control participants suggested that long-term facilitation of subsequent picture naming may be driven by a strengthening of semantic-phonological connections, while semantic and object recognition mechanisms underlie more short-term effects. All participants with aphasia significantly improved in naming accuracy following both short- and long-term facilitation. A descriptive comparison of the neuroimaging results identified different patterns of activation for each individual with aphasia. The exclusive engagement of a left hemisphere phonological network underlying facilitation was not revealed. The findings suggest that improved naming in aphasia with phonological tasks may be supported by changes in right hemisphere activity in some individuals and reveal the potential contribution of the cerebellum to improved naming following phonological facilitation. Conclusions must be interpreted with caution, however, due to the comparison of corrected group control results to that of individual participants with aphasia, which were not corrected for multiple comparisons. (C) 2013 Elsevier Ltd. All rights reserved

Neural mechanisms underlying the facilitation of naming in aphasia using a semantic task: an fMRI study

Background: Previous attempts to investigate the effects of semantic tasks on picture naming in both healthy controls and people with aphasia have typically been confounded by inclusion of the phonological word form of the target item. As a result, it is difficult to isolate any facilitatory effects of a semantically-focused task to either lexical-semantic or phonological processing. This functional magnetic resonance imaging (fMRI) study examined the neurological mechanisms underlying short-term (within minutes) and long-term (within days) facilitation of naming from a semantic task that did not include the phonological word form, in both participants with aphasia and age-matched controls