Imitation-based aphasia therapy increases narrative content: a case series

Abstract

Objective: To test the generalization of an intensive imitation-based aphasia therapy to an unrelated narrative production task. Design: ABA design study (A= no treatment; B= treatment) comparing imitation therapy to a baseline condition (pre-therapy). Participants produced narratives at two pre-therapy and two post-therapy time points. Narratives were analyzed for correct information units to determine the number and percent of communicative words produced. Setting: A rehabilitation clinic and participants’ homes. Participants: Nineteen people with chronic aphasia following left hemisphere stroke. Interventions: Six weeks of intensive imitation therapy (3 x 30 minutes/day; 6 days/week) of words and phrases delivered via dedicated laptop. Main measures: We performed t-tests to assess post-therapy changes in narrative production, as well as for intervals during which no intervention was provided. We used stepwise regression to examine the predictive value of demographic, behavioral, and neurological variables in determining treatment outcome. Results: Significant gains were made on the narrative production task in both the number (mean = 34.36; p = 0.009) and percent (mean = 3.99; p = 0.023) of correct information units produced. For percent of correct information units, the number of therapy sessions completed was the sole predictor of changes in production following therapy (r= +0.542; p = 0.020). No variables predicted change in number of correct information units produced. There were no significant differences between the two pre-therapy or the two post-therapy time points ( p > 0.294). Conclusions: Intensive imitation-based aphasia therapy may promote generalization to an unrelated narrative production task. Further investigation is indicated.