Constraint-Induced Language Therapy

Many aphasia treatments encourage people with aphasia to use alternative means to get their message across. This might include gesturing, drawing, or using augmentative and alternative communication (AAC) devices.

Constraint-Induced Language Therapy (CILT) takes the opposite approach. CILT is an intense treatment choice for people who only want to work on speaking. It is also known as Constraint-Induced Aphasia Therapy. CILT requires the person with aphasia to communicate only by speaking. It does not allow any means of communicating other than verbally.

Three Principles of Constraint-Induced Language Therapy

• Constraint: avoiding the use of any compensatory strategies (for example, drawing or pointing)
• Forced use: talking is the only means of communication
• Massed practice: therapy must last for a sufficient amount of time

CILT is based on the principles of Constraint-Induced Movement Therapy. This is a type of therapy used by physical therapists for people with limb weakness. It requires that they do not use their good limb at all in order to build the strength of the weak limb. For instance, if someone has weakness in their left arm, the physical therapist might physically constrain the right arm. This forces the person to use their left (weak) arm for everything.

Physical therapists may recommend using Constraint-Induced Movement Therapy at all times, that is, not just during a physical therapy session. Because CILT is an intense treatment option involving communication, it is not recommended for use all day, every day. It is typically used for a few hours a day, ideally every day.

The goal of CILT is improved verbal speech. It is typically used with people who do have some functional verbal speech. People with severe impairments who do not have any verbal speech might experience frustration with this treatment technique.

As with other therapy techniques, there are pros and cons to using CILT. Your speech-language pathologist (SLP) can help decide if it is an appropriate treatment for you or your loved one.