Faculty in the Communication Sciences and Disorders Departments at the University of Montana (UMT) and Utah State University have published a study of cognitive and linguistic outcomes of intensive comprehensive aphasia programs (ICAPs) for people with aphasia (PWA) in the chronic stage, implemented by graduate student in Speech-Language Pathology (SLP). Using graduate students lowers ICAP costs to participants, an important financial consideration for many PWA. The clinical research goals of this this study were: (a) to probe the therapeutic effectiveness of student-run ICAPs; and (b) to investigate relationships between individual and treatment variables, regarding outcome changes observed in cognitive-linguistic functioning.

Between 2014-2019, successive groups of SLP graduate students at UMT implemented 8 such programs with groups of 4-8 PWA each, for a total of 53 participants. The mean age of participants was 65 y/o, and the mean time post-onset was 34 months. Successive programs varied slightly in duration and intensity, but typically ran a few weeks, meeting several hours per day on most workdays. Interventions included individual sessions, small and large group sessions, community outings, and care partner wellness training. Participants were assessed at intake and discharge using the Western Aphasia Battery – Revised (WAB-R), the Boston Naming Test – Second Edition (BNT-2), and Ravens Progressive Colored Matrices (RPCM). Analyses included paired t-tests to characterize changes in assessment scores by magnitude, direction, and statistical significance, and calculation of Pearson’s ρ correlation coefficients to characterize relationships between measures.

In the mean, by discharge participants improved scores on all three pf the assessment instruments modestly. Mean WAB AQ scores improved +6.1 (p < .001), mean BNT scores improved +2.7 (p < .001), and mean Ravens scores improved +2.3 (p = .005). Calculation of Cohen’s d shows the associated clinical effect sizes to be small (WAB, RCPM) to none (BNT). Calculation of Pearson’ ρ shows that improvements on the WAB and RPCM were significantly correlated with previous participation in an ICAP; but no other variables significantly predicted any documented changes. Results of this Phase I study argue for that the completion of follow-on studies with greater sample sizes, more rigorous design, and a focus on consistent implementation. Such work will help clarify intrinsic advantages and challenges of this approach, while giving investigators additional opportunities to refine students’ implementation methods.

For further reading: J. Griffin-Musick, D. Jakober, Amanda Sallay, et al., 2021

Cognitive-linguistic outcomes from an intensive comprehensive aphasia program implemented by graduate student clincians. Aphasiology, 15 pp.

https://doi.org/10.1080/02687038.2021.1937920

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