U.S. researchers at Temple University (Philadelphia) and Boston University have studied effects of group conversation treatment delivered in contrasting circumstances on outcome assessments in persons with chronic aphasia.The goals of the research were to determine: (a) whether interventions in either setting – or both – led to significantly improved outcomes over no treatment; (b) if so, whether particular associations were found between treatment circumstances and outcome improvement domains; and (c) were benefits maintained long-term.

The study participants were randomly assigned to one of three conditions, namely: (i) treatment in groups of six or more (n = 14); (ii) treatment in dyads, (n = 16); or (iii) control subjects, whose intervention was delayed (n = 14).  Individual goals were developed by participants themselves, who engaged in thematically oriented conversations.  The hour-long treatment sessions occurred twice a week over ten weeks.  Standardized tests were administered before and after the 10-week intervention period, and — to probe maintenance — at 11 months for those in the intervention groups.

At the end of intervention, both of the treatment groups showed significantly improved outcome assessment scores in various domains, while the control group did not significantly change. Comparison of the two treatment regimens reveals that their domains of improvement did not overlap.  Thus, the dyad participants improved their posttreatment impairment-level assessment scores specifically in naming and repetition; the group participants significantly improved non-impairment outcome scores, namely, self-reported Aphasia Communication Outcome Measures, and production of connected speech.  In two instances – one per setting – significant gains were still found after 11 months.

The findings show that conversation treatment is an efficacious method for significantly improving communicative performance among persons in chronic aphasia, whether delivered in the context of groups or in of dyads, at least for a time.  The results indicate further that treatment group size may influence outcome benefit patterns.  Dyad participants improved certain of their impairment test scores; participants in the group settings self-reported improved performance and were observed to produce connected speech better.  Questions for follow-on research include: (i) whether some combination of dyadic treatment plus larger-group conversation therapy can produce more evenly-distributed benefits; and (ii) if so, whether such benefits are more robustly maintained in the 11-month maintenance probe.

For further reading:  G. DeDe, E. Hoover, & E. Maas.  2019.  Two to Tango or the More the Merrier? A Randomized Controlled Trial of the Effects of Group Size in Aphasia Conversation Treatment on Standardized Tests.  Journal of Speech, Language, and Hearing Research, 62:1437–1451, https://doi.org/10.1044/2019_JSLHR-L-18-0404

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