Conversation Therapy for Aphasia

Recruiting in Palo Alto (17 mi)

+2 other locations

Overseen by Elizabeth Hoover, PhD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: Boston University Charles River Campus

No Placebo Group

Approved in 3 Jurisdictions

Trial Summary

What is the purpose of this trial?

The proposed research will test the efficacy of group conversation treatment for people with aphasia and explore whether the effects of treatment differ as a result of the following factors: 1. Group size: Do large groups of 6-8 people with aphasia or dyads of 2 people with aphasia demonstrate different levels of improvement with this treatment? 2. Group composition: Do effects of conversation group treatment differ if the groups include members with similar or different types of aphasia? 3. Aphasia severity: Do effects of conversation group treatment differ if the individuals within the group have mild-moderate or moderate-severe profiles of aphasia? Treatment sessions will occur in groups of 6-8 people with aphasia or with 2 people with aphasia. During treatment sessions, discourse will be facilitated on a focused set of every day topics, such as current events or travel. Linguistic and multi modal cueing hierarchies will be tailored to individual client goals and used to maximize communication success. The prediction is that conversation treatment is an effective method for improving communication in people with aphasia, but that specific benefits may differ based on variables such as group size, group composition, and aphasia severity. The results will help inform best practices for aphasia treatment and refine a hypothesized model about the mechanisms underlying conversation treatment.

Do I have to stop taking my current medications for the trial?

The trial protocol does not specify whether you need to stop taking your current medications. However, you must abstain from any concurrent speech language treatment.

What data supports the idea that Conversation Therapy for Aphasia is an effective treatment?

The available research shows that Conversation Therapy for Aphasia is effective in improving communication skills. One study found that participants who received group communication treatment had significantly higher scores on communication and language tests compared to those who did not receive the treatment. Improvements were seen after just two months and continued after four months of treatment, with no decline in performance after stopping the treatment. Another study compared individual and group treatments and found that both methods led to significant improvements in language abilities, suggesting that group therapy is a viable option for managing aphasia. ^{1 2 3 4 5}

What safety data exists for conversation therapy for aphasia?

The provided research does not specifically address safety data for conversation therapy for aphasia. The studies focus on the efficacy, mechanisms of change, and outcomes of the therapy, such as improvements in communication, language impairment, and quality of life. However, there is no mention of adverse effects or safety concerns, suggesting that the therapy is generally considered safe, but specific safety data is not detailed in these abstracts. ^{2 5 6 7 8}

Is Conversation Treatment for Aphasia a promising treatment?

Yes, Conversation Treatment for Aphasia is promising because it can improve communication skills and reduce social isolation for people with aphasia. It also helps them practice communication in a group setting, which can boost their confidence and help them connect with others. ^{2 4 5 6 9}

Eligibility Criteria

This trial is for English-speaking adults with aphasia, a language disorder typically caused by stroke. They must be at least 6 months post-stroke and have enough understanding to join in conversations. The study includes all severity levels of aphasia but excludes those with other neurological diseases, developmental disabilities, or serious illnesses like cancer.

Inclusion Criteria

I have been diagnosed with difficulty in speaking or understanding language.

You need to be able to understand and take part in conversations, as shown by standardized tests for language difficulties.

I have severe difficulty speaking or understanding speech.

Exclusion Criteria

I have not had any neurological diseases, except for a stroke.

Participants will be asked to abstain from concurrent speech language treatment

I do not have any serious illnesses right now.

Treatment Details

Interventions

• Conversation Treatment for Aphasia (Behavioral Intervention)

Trial Overview The study tests group conversation treatment's effectiveness on communication skills in people with aphasia. It examines how different group sizes (2 vs. 6-8 people) and compositions (similar vs. different types of aphasia), as well as the severity of aphasia, impact the treatment outcome.

Participant Groups

Group I: Experimental: Group composition Experimental Treatment 1 Intervention

Outcomes will be measured for individuals who participate in homogeneous compared to heterogeneous groups (6-8 people with aphasia), based on aphasia severity (severe vs. mild-moderate aphasia).

Group II: Experimental: Group Size x Aphasia Severity Experimental Treatment 1 Intervention

Outcomes will be measured for individuals who participate in large group (6-8 group members) compared to dyads (2 group members), and whether this relationship differs as a function of aphasia severity (severe vs. mild-moderate aphasia).

Group III: Treatment efficacy: Delayed Control Group Active Control 1 Intervention

Treatment cycle 1 only.

Conversation Treatment for Aphasia is already approved in United States, Australia, European Union for the following indications:

🇺🇸 Approved in United States as Conversation Treatment for Aphasia for:

• Aphasia

🇦🇺 Approved in Australia as Aphasia Group Therapy for:

• Aphasia
• Chronic Aphasia

🇪🇺 Approved in European Union as Group Conversation Treatment for Aphasia for:

• Aphasia
• Stroke-related Aphasia

Find a Clinic Near You

Research Locations Nearby Select from list below to view details:

Temple University Philadelphia, PA

Boston University - Charles River Campus Boston, MA

Adler Aphasia Center Maywood, NJ

Who Is Running the Clinical Trial?

Boston University Charles River Campus Lead Sponsor

Temple University Collaborator

Adler Aphasia Center Collaborator

References

1. United States pubmed.ncbi.nlm.nih.gov

The efficacy of group communication treatment in adults with chronic aphasia. [2022] We examined the effects of group communication treatment on linguistic and communicative performance in adults with chronic aphasia. Participants were randomly assigned to two treatment and two deferred treatment groups. Groups were balanced for age, education level, and initial aphasia severity. Twenty-four participants completed the 4-month treatment trial. While in the treatment condition, all participants received 5 hours of group communication treatment weekly, provided by a speech-language pathologist. The focus of treatment included increasing initiation of conversation and exchanging information using whatever communicative means possible. While awaiting group communication treatment, participants in the deferred treatment groups engaged in such activities as support, performance, or movement groups in order to control for the effects of social contact. Linguistic and communicative measures were administered to all participants at entry, after 2 and 4 months of treatment, and following 4 to 6 weeks of no treatment. In addition, participants in the deferred treatment groups received an additional administration of all measures just before their treatment trial. Results revealed that participants receiving group communication treatment had significantly higher scores on communicative and linguistic measures than participants not receiving treatment. In addition, significant increases were revealed after 2 months of treatment and after 4 months of treatment. No significant decline in performance occurred at time of follow-up.

2. United States pubmed.ncbi.nlm.nih.gov

Identifying mechanisms of change in a conversation therapy for aphasia using behaviour change theory and qualitative methods. [2019] Conversation therapy for aphasia is a complex intervention comprising multiple components and targeting multiple outcomes. UK Medical Research Council (MRC) guidelines published in 2008 recommend that in addition to measuring the outcomes of complex interventions, evaluation should seek to clarify how such outcomes are produced, including identifying the hypothesized mechanisms of change.

3. United States pubmed.ncbi.nlm.nih.gov

Veterans Administration cooperative study on aphasia: a comparison of individual and group treatment. [2019] Five Veterans Administration Medical Centers participated in an investigation designed to compare individual with group treatment for aphasic patients who had suffered a left hemisphere cerebral vascular accident. Patients who met selection criteria were assigned randomly to either traditional, individual, stimulus-response type treatment of specific language deficits or group therapy designed to improve communication through group interaction and discussion with no direct treatment of specific language deficits. All patients received eight hours of therapy each week beginning at four weeks postonset and continuing until 48 weeks postonset or until they dropped out of the study. A battery of language measures and a clinical neurologic evaluation were administered at intake and every 11 weeks a patient was in the study. Results show both individually and group-treated patients made significant improvement in language abilities. Individual treatment resulted in significantly better overall performance on the Porch Index of Communicative Ability; however, no significant differences were observed between groups on the other language measures. If the traditional belief is correct that significant spontaneous recovery is complete by three to six months postonset, significant improvement in both groups beyond 26 weeks postonset indicates both individual and group treatment are efficacious methods for managing aphasic patients.

4. England pubmed.ncbi.nlm.nih.gov

An Exploration of the Impact of Group Treatment for Aphasia on Connected Speech. [2021] Group treatment enables people with aphasia to practise communication skills outside the typical clinician-patient dyad. While there is evidence that this treatment format can improve participation in everyday communication, there is little evidence it impacts linguistic abilities. This project aimed to investigate the effects of 'typical' group treatment on the communication skills of people with aphasia with a focus on word retrieval in discourse.

5. United States pubmed.ncbi.nlm.nih.gov

A Randomized Controlled Trial of the Effects of Group Conversation Treatment on Monologic Discourse in Aphasia. [2023] Evidence has shown that group conversation treatment may improve communication and reduce social isolation for people with aphasia. However, little is known about the impact of conversation group treatment on measures of discourse. This project explored the impact of conversation treatment on measures of monologic discourse.

6. United States pubmed.ncbi.nlm.nih.gov

Conversation therapy for aphasia: a qualitative review of the literature. [2022] A diverse literature addresses elements of conversation therapy in aphasia including intervention rooted in conversation analysis, partner training, group therapy and behavioural intervention. Currently there is no resource for clinicians or researchers that defines and organizes this information into a coherent synopsis describing various conversation therapy practices.

7. United States pubmed.ncbi.nlm.nih.gov

Efficacy of Aphasia Group Conversation Treatment via Telepractice on Language and Patient-Reported Outcome Measures. [2023] Conversation treatment for people with aphasia (PwA) can lead to significant changes in language impairment and quality of life. The COVID-19 pandemic has resulted in the greater use of telepractice treatment delivery. However, there is little evidence regarding the efficacy of telepractice conversation groups. This study investigated the effects of telepractice group conversation treatment on standardized measures of language function and socially oriented/patient-reported outcomes compared to in-person and no-treatment control data.

8. United States pubmed.ncbi.nlm.nih.gov

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. [2020] Purpose Group conversation treatment has the potential to improve communication and reduce social isolation for people with aphasia. This project examined how 2 conflicting hypotheses-treatment dosage and group dynamics-affect treatment outcomes. Method Forty-eight participants with chronic aphasia were randomly assigned to either a dyad, a large group, or a delayed control group. Conversation group treatment was provided for an hour, twice per week, for 10 weeks. Individual goals were developed by each participant and addressed in the context of thematically oriented conversation treatment. Standardized testing across language domains was completed pretreatment (Time 1), posttreatment (Time 2), at a 6-week maintenance point (Time 3), and at 11-month follow-up for the experimental groups. Results Treatment groups showed greater changes on standardized measures than the control group posttreatment. Dyads showed the most changes on measures of language impairment, whereas changes on the self-reported functional communication measure (Aphasia Communication Outcome Measure) and connected speech task only showed significant changes in the large group. Conclusions This randomized controlled trial on conversation treatment indicated that both treatment groups-but not the delayed control group-showed significant changes on standardized tests. Hence, conversation treatment is associated with changes in measures of language impairment and quality of life. Dyads showed the most changes on measures of language impairment, whereas changes on the functional communication measure (Aphasia Communication Outcome Measure) and discourse production only showed significant changes in the large group. Thus, group size may be associated with effects on different types of outcome measures.

9. United States pubmed.ncbi.nlm.nih.gov

Negotiation of identity in group therapy for aphasia: the Aphasia Café. [2016] There has been increasing interest in ensuring that aphasia intervention includes attention to the negotiation of a robust identity after the life-altering changes that often accompany the onset of aphasia. But how does one go about simultaneously improving communication and positive identity development within aphasia therapy? Socially oriented group therapy for aphasia has been touted as one means of addressing both psychosocial and communicative goals in aphasia.