Madeline Cruice

• BSpPath (Hons I), PhD in Speech Pathology
• Lecturer at City, University of London

Introduction Life with aphasia affects the whole family with shorter, less frequent conversations, frustration, reduced social networks, isolation and tension in relationships. Evidence suggests communication partner training (CPT) benefits families. However, expected improvements are poorly articulated. The Aphasia Partnership Training (APT) proje...

Purpose Rating the quality of conversations can assess communication skills in both people with acquired brain injury and their communication partners. This study explored the clinical feasibility and reliability of two conversation rating scales: the Adapted Measure of Participation in Conversation (MPC) and the Adapted Measure of Support in Conve...

Background There is a growing evidence base to support the use of self-management interventions for improving quality of life after stroke. However, stroke survivors with aphasia have been underrepresented in research to date. It is therefore unclear if self-management is an appropriate or effective approach for this group. To address this gap in t...

[Open access paper available through DOI link above and at: https://doi.org/10.1111/1460-6984.13105] Background: Accessibility of data visualization has been explored for users with visual disabilities but the needs of users with language disabilities have seldom been considered. Aim: This scoping review synthesised what is known about data visua...

Background Stroke survivors with aphasia want to improve their everyday talking (discourse). In current UK practice, 90% of speech and language therapists believe discourse assessment and treatment is part of their role but are hampered by barriers in resources, time and expertise. There is a clinical need for well-articulated discourse assessment...

Background Speech and language therapists (SLTs) and care home activities staff play key roles in managing and supporting the communication needs of older residents in care homes. However, the current practice and perspectives of these two professions in the United Kingdom has not been examined. Aims To investigate the practice patterns and views...

Purpose: This study synthesizes participant and outcome data from peer-reviewed Intensive Comprehensive Aphasia Programme (ICAP) studies. Methods: A systematic review was conducted following PRISMA guidelines. Study eligibility criteria were specified in relation to population, intervention, comparison, outcome, and design considerations. Data w...

Background: Research evidence suggests aphasia therapy must be delivered at high intensity to effect change. Comprehensive therapy, addressing all domains of the International Classification of Functioning, Disability and Health, is also called for by people with aphasia and their families. However, aphasia therapy is rarely intense or comprehensi...

Background: Evidence-based recommendations for a core outcome set (COS; minimum set of outcomes) for aphasia treatment research have been developed (the Research Outcome Measurement in Aphasia-ROMA, COS). Five recommended core outcome constructs: communication, language, quality of life, emotional well-being and patient-reported satisfaction/impac...

Background Digital technology is increasingly researched in aphasia rehabilitation but mostly to replicate conventional speech and language therapies. While creative activities are employed in therapy for aphasia, these are not achieved through digital technology and little is known about the impact of digital creativity on people with aphasia. Ai...

Background The assessment of people with aphasia (PWA) should include the evaluation of specific language disorders and the impact of these disorders on their activities and participation in society. Due to the lack of assessment tools in Portugal aimed at the activity and participation levels of PWA, it was necessary to translate and adapt an exis...

Background There is increasing evidence that face-to-face treatments for verb and sentence production deficits in aphasia can be effective. However, very few studies have investigated supplementing such treatments with self-managed computer-based home practice. Given the increasing importance of computer-based aphasia treatment, it is imperative th...

The growing body of information-seeking and decision-making literature in motor neu-rone disease (MND) has not yet explored the impact of health literacy. Health literacy relates to the skills people have to access, understand, and use health information and is influenced by motivation to engage with healthcare. We aimed to better understand how pe...

Background: Communication and cognitive impairments are known barriers to shared decision-making. Most people diagnosed with motor neurone disease (MND) will develop a motor speech impairment over the disease course. Some will develop cognitive, linguistic or behavioural disturbance. Despite this, the impact of communication and cognitive impairme...

Aphasia (language impairment) is common after stroke with negative impacts on all modes of communication. This article describes novel technologies developed at City, University of London, aiming to facilitate creative self-expression in people with aphasia. Outcomes from community workshops are summarised, in which people with aphasia trialled the...

Background: We require high-quality information on the current burden, the types of therapy and resources available, methods of delivery, care pathways and long-term outcomes for people with aphasia. Aim: To document and inform international delivery of post-stroke aphasia treatment, to optimise recovery and reintegration of people with aphasia. Me...

Background: Speech and language therapists and nurses need to work together to keep patients with swallowing difficulties safe throughout their acute stroke admission. Speech and language therapists make recommendations for safe swallowing following assessment and nurses put recommendations into practice and monitor how patients cope. There has be...

Purpose This study explored the acceptability to service providers of delivering a novel group support intervention for people with aphasia (PWA) in a virtual world. Materials and methods The service providers were six group coordinators and 10 volunteers. Fourteen of the service providers participated in a semi-structured qualitative interview an...

Purpose This review article synthesizes and evaluates the evidence for sentence production treatments in aphasia, systematically charting impairment-based and functional communication outcomes. It reports (a) the level of evidence and fidelity of sentence treatments; (b) the impact of treatment on production of trained and untrained verbs and sente...

Background The communication skills of older adults living in care homes is an underexplored topic. Ageing can lead to reduced communication ability and activity; and in the care home environment there may also be fewer communication opportunities. This situation is likely to negatively impact well-being. Previous reviews have found evidence of the...

Background Self-management is a promising approach to improve quality of life after stroke. However, evidence for the appropriateness and effectiveness of self-management for stroke survivors with aphasia is limited. This article reports on the process used to develop a supported self-management intervention for stroke survivors with aphasia (SSWA)...

Coordination of international aphasia research would minimise duplication of effort, support synergistic international activities across languages and multidisciplinary perspectives, and promote high-quality conduct and reporting of aphasia research, thereby increasing the relevance, transparency, and implementation of findings. The Collaboration o...

Purpose Aphasia is an acquired language disorder that typically occurs as a result of a stroke. People with aphasia experience communication difficulties and risk secondary impacts, for example, affecting social and work life and mental health. Intensive Comprehensive Aphasia Programmes (ICAPs) aims to address the multiple consequences of aphasia u...

Background Although spoken discourse is an outcome prioritised by all stakeholders in aphasia rehabilitation, assessment and treatment of discourse are not routine clinical practice. The small evidence base, varied clinical expertise, multiple barriers in the workplace, and challenges for clients in understanding their altered language abilities al...

Background Treatment fidelity (TF), that is, the degree to which the treatment delivery has adhered to protocol, is an important aspect of establishing treatment validity and reliability. Research has shown that establishing TF is only done in a small percentage of aphasia treatment studies. Aims This project supports the work of the CommuniCATE s...

Discourse (a unit of language longer than a single sentence) is fundamental to everyday communication. People with aphasia (a language impairment occurring most frequently after stroke, or other brain damage) have communication difficulties which lead to less complete, less coherent, and less complex discourse. Although there are multiple reviews o...

Purpose To explore how the information-sharing context influences how speech and language therapy (SLT) and nursing staff interact on stroke units and what they discuss. Methods Ethnographic methodology was used, with data collected during 40 weeks of fieldwork across three inner city stroke units in the UK. Data comprised field notes collected du...

Purpose Healthcare decision making in motor neurone disease (MND) focuses on symptom management and quality of life. Decision making may be affected by personal approach to receiving information, decision making style, and disease symptoms. This study explored decision making from the perspectives of people living with motor neurone disease (plwMND...

About a third of strokes cause aphasia, or language loss, with profound consequences for the person’s social participation and quality of life. These problems may be mitigated by group social support. But this intervention is not available to all individuals. This study investigated whether it is feasible to deliver group social support to people w...

Background Aphasia negatively impacts face-to-face social participation and the difficulties that people experience using the phone exacerbate these challenges in staying in touch with family and friends. Videoconferencing enables multimodal communication, and teamed with supported conversation, could facilitate access to conversation and thereby i...

Background Improved discourse production is a priority for all key stakeholders in aphasia rehabilitation. A Cochrane review of randomised controlled trials (RCTs) for aphasia found speech and language therapy treatment to be effective for improving the ability to communicate in everyday interaction. However, this large-scale review did not focus e...

Background: Discourse assessment and treatment in aphasia rehabilitation is a priority focus for a range of stakeholder groups. However, a significant majority of speech and language therapists (SLTs) infrequently conduct discourse analysis, and do not feel competent in doing so. Known barriers identified in other countries, specifically a lack of...

Background : Definitions reflect the current state of knowledge about a health condition. An agreed definition of aphasia is central to the progression of the science and clinical practice relevant to aphasia. Aim : To establish consensus on a definition of aphasia. Methods & Procedures : A three-round modified e-Delphi study was conducted with aph...

Purpose This study investigated the effects of technology-enhanced reading therapy for people with reading impairments, using mainstream assistive reading technologies alongside reading strategies. Method The study used a quasirandomized waitlist controlled design. Twenty-one people with reading impairments following stroke were randomly assigned...

Purpose Aphasia research demonstrates increasing interest in the treatment of verb retrieval deficits. This systematically conducted scoping review reports on the level and fidelity of the current evidence for verb treatments; on its effectiveness regarding the production of trained and untrained verbs, functional communication, sentences, and disc...

Purpose: Interventions are often poorly described in published controlled trials, with relatively little information regarding intervention development, content and fidelity. This makes it difficult to conduct replication studies, interpret and compare findings across studies and for therapists to deliver the intervention in clinical practice. Comp...

Rationale: Motor neurone disease (MND) is a neurodegenerative disease presenting with progressive weakness of voluntary muscles. For any condition, person-centred health care relies on the sharing of information and a mutual understanding of the person's needs and preferences. Decision making in MND becomes more complex as there is no cure and a h...

Background: Quality of life (QOL) is important to people with aphasia and their family members and is influenced by a range of factors within the scope of practice for speech and language therapy. Interestingly though, clinicians largely assess patients’/clients’ QOL informally through discussion, and rarely measure QOL as an outcome from aphasia r...

Background: Cognitive-communication disorders are common following an acquired brain injury (ABI). Remediation should involve individualized goal-setting, yet few reports describe the effectiveness of setting communication goals in a group setting. Aims: To describe a process for setting and achieving goals for people with ABI. Methods & proced...

Purpose: To determine whether treatment was acceptable to participants and perceived as beneficial by exploring the experiences of people with cognitive communication difficulties following acquired brain injury who participated in a novel, group, communication, project-based treatment. The purpose of the treatment was to improve participants’ comm...

Background: Aphasia services are currently faced by increasing evidence for therapy of greater intensity and comprehensiveness. Intensive Comprehensive Aphasia Programs (ICAPs) combine these elements in an evidence-based, time-limited group program. The incorporation of new service delivery models in routine clinical practice is, however, likely to...

Communication is important for all stroke care. This chapter describes communication impairments caused by stroke, and suggests strategies that nurses and others in the stroke team can use to facilitate communication. It suggests techniques and strategies to reduce communication barriers, particularly when nursing patients who have post‐stroke comm...

Purpose: To apply a human rights lens to measuring patient experience. Specifically, to determine if the perspectives of communicatively vulnerable people have been included in the patient experience research used to inform the development of the Australian Hospital Patient Experience Question Set (AHPEQS). Method: Thirty-nine qualitative studies o...

Background Communication impairments are common and pervasive for people a long time following acquired brain injury (ABI). These impairments have a significant impact on a person's quality of life (QOL) post‐injury. Project‐based treatment is a treatment approach that could have an impact on communication skills and QOL for people with ABI a long‐...

Purpose: The aim of the synthesis was to develop a new understanding about the influences on communication in interprofessional teams from therapist and nurse perspectives. Methods: Six electronic databases were searched, combined with citation tracking and hand searching, yielded 3994 papers. Three researchers were involved in screening and qualit...

Background: A core outcome set (COS; an agreed, minimum set of outcomes) was needed to address the heterogeneous measurement of outcomes in aphasia treatment research and to facilitate the production of transparent, meaningful, and efficient outcome data. Objective: The Research Outcome Measurement in Aphasia (ROMA) consensus statement provides...

Background: Communication partner training (CPT) is an umbrella term for a complex behavioural intervention for communications partners (CPs) of people with aphasia (PWA) and possibly PWA themselves, with many interacting components, deployed in flexible ways. Recent systematic reviews (Simmons-Mackie, Raymer, Armstrong, Holland, & Cherney, 2010; S...

Background: There are many validated and widely used assessments within aphasiology. Few, however, describe language and life with aphasia from the perspective of the person with aphasia. Across healthcare, patient experience and user involvement are increasingly acknowledged as fundamental to person-centred care. As part of this movement, Patient...

Background Acquired writing impairment, or dysgraphia, is common in aphasia. It affects both handwriting and typing, and may recover less well than other aphasic symptoms. Dysgraphia is an increasing priority for intervention, particularly for those wishing to participate in online written communication. Effective dysgraphia treatment studies have...

Background: Discourse is an increasing focus of assessment in clinical and research settings because it reflects everyday communication. Everyday communication is likely to include a range of different discourse genres, e.g., describing a scene, or reflecting on life experiences. It is likely that speakers use verbs differently in these different d...

Verbs with multiple senses can show varying argument structure frequencies, depending on the underlying sense. When acknowledge is used to mean 'recognise', it takes a direct object (DO), but when it is used to mean 'admit' it prefers a sentence complement (SC). The purpose of this study was to investigate whether people with aphasia (PWA) can expl...

Background: Aphasia and other acquired language impairments have the potential to impact greatly on quality of life by disrupting everyday conversation. Different intervention approaches are available to speech and language therapists (SLTs), such as targeting the language impairment itself and/or addressing activity or participation barriers. Conv...

Background: Mild reading difficulties are a pervasive symptom of aphasia. While much research in aphasia has been devoted to the study of single word reading, little is known about the process of (silent) sentence reading. Reading research in the non-brain-damaged population has benefited from the use of eye-tracking methodology, allowing inference...

People with aphasia can be marginalized by a communicatively inaccessible society. Compounding this problem, routinized exclusion from stroke research leads to bias in the evidence base and subsequent inequalities in service provision. Within the United Kingdom, the Clinical Research Network of the National Institute of Health identified this probl...

Aphasia has a significant impact on a person’s life in relationships, employment and/or education, socialising, civic engagement and quality of life. The key negative psychosocial consequences of aphasia are well documented and include depression and low mood, reduced social engagement and/or social isolation. Thus, aphasia rehabilitation needs to...

Background and Aims: Stroke and aphasia impact not only the individual, but also immediate family members (FM). Understanding this impact on FM enables clinicians to best support them in rehabilitation, as per recent best practices for stroke and aphasia rehabilitation1. Many positive, neutral and negative outcomes in the different components of th...

Background and Aims: Stroke and aphasia impact not only the individual, but also immediate family members (FM). Understanding this impact on FM enables clinicians to best support them in rehabilitation, as per recent best practices for stroke and aphasia rehabilitation 1. Many positive, neutral and negative outcomes in the different components of t...

Purpose: To identify important treatment outcomes from the perspective of people with aphasia and their families using the ICF as a frame of reference. Methods: The nominal group technique was used with people with aphasia and their family members in seven countries to identify and rank important treatment outcomes from aphasia rehabilitation. P...

Viva voce exams are used in many disciplines as a test of students’ knowledge and skills. Whilst acknowledged as a useful form of assessment, vivas commonly lead to a great deal of anxiety for students. This anxiety is also apparent for vivas in phonetics, where the students must produce and recognise sounds drawn from across the world’s languages,...

Objective: This study reports on Danish speech and language therapists' knowledge and understanding of quality of life (QoL) in aphasia, including therapists' views on education and training in relation to preparedness for working on QoL, use of measures, and barriers to applying QoL in practice. Methods: Fourteen Danish clinicians completed a 4...

Purpose – The purpose of this paper is to gain consensus regarding the clinical priorities and tasks required in supporting communication needs in those living with semantic dementia and their families, by specialist speech and language therapists (SLTs), working in clinical practice within dementia care settings in the UK. Design/methodology/appr...

Background: There is a need for clinical tools that capture the real-life impact of aphasia. This study reports on a psychometric investigation of two self-report tools: the Communicative Activities Checklist and the Social Activities Checklist (COMACT; SOCACT), which assess the dimensions of communication activity and social participation in aphas...

Background: E-readers may facilitate reading in aphasia through “aphasia-friendly” features such as altering text size and formatting, and text-to-speech functions. However, no previous research has examined whether e-readers help people with aphasia to read. Aims: This project explored: • whether people with aphasia can learn to use e-readers fol...

This study identifies predictors and normative data for quality of life (QOL) in a sample of Portuguese adults from general population. A cross-sectional correlational study was undertaken with two hundred and fifty-five (N = 255) individuals from Portuguese general population (mean age 43 years, range 25-84 years; 148 females, 107 males). Particip...

Background: Addressing the long-term consequences of stroke is a top 10 research priority, and understanding the views of different stakeholders is essential in designing appropriate patient-centred multidisciplinary rehabilitation.Aims: This study reports on the perspectives of 38 individuals who live with or work with aphasia: people with aphasia...

Over the past 20 years, research in aphasia has shown that its consequences in daily life of the person with this condition, as well as in the life of all those who are related to the person with aphasia, can be devastating. It also highlighted the need for speech and language therapists to assess the impact of aphasia on the performance of their c...

Background: Although several treatments for acquired reading difficulties exist, few studies have explored the effectiveness of treatment for mild reading difficulties and treatment for reading difficulties associated with cognitive impairment. Aims: This study explored the effectiveness of an individual strategy-based reading treatment of 11 sessi...

Purpose In this study, the authors investigated whether gesture, naming, and strategic treatment improved the communication skills of 14 people with severe aphasia. Method All participants received 15 hr of gesture and naming treatment (reported in a companion article [Marshall et al., 2012]). Half the group received a further 15 hr of strategic t...

The International Classification of Functioning, Disability and Health (ICF) (WHO 2001) urges health professionals, including Speech and Language Therapists (SLTs), to consider the different possible consequences of a disease in their different domains: Body Functions and Structures, Activities and Participation in real life situations. It also hig...

Background: Improving Quality of Life (QOL) is the ultimate goal of aphasia therapy. Understanding clients' perspectives on the impact of disability in their lives is crucial in determining therapy approaches focused on clients' real needs. QOL measures elicit clients' perspectives in a systematic manner. Many applications of QOL measures in aphasi...

Purpose In this study, the authors (a) investigated whether a group of people with severe aphasia could learn a vocabulary of pantomime gestures through therapy and (b) compared their learning of gestures with their learning of words. The authors also examined whether gesture therapy cued word production and whether naming therapy cued gestures. M...

It is important for professionals working with individuals with acquired neurogenic communication disorders to consider their clients' psychological well-being. Much is known about the significant emotional, social and psychological consequences of aphasia after stroke; however, little is known about the individuals' psychological well-being. This...

Unlabelled: It is increasingly important that clinicians address the health-related quality of life (HRQOL) of adults with communication disorders in clinical practice. The overall aim of this paper is to draw conclusion about the suitability of the Short Form 36 Health Survey for the communication disorders of aphasia and stuttering. This study r...

There is a growing body of research which has investigated the experience of the migrant health worker. However, only one of these studies has included speech and language therapists thus far, and then only with extremely small numbers. The aim of this study was to explore the experiences and perspectives of migrant speech and language therapists l...

Background: A life-coaching and positive psychology approach to aphasia has recently been advocated by Audrey Holland, to whom this issue is dedicated. Aims: This paper reviews our recent research which informs the three basic assumptions behind a life-coaching approach to aphasia: (1) learning to live successfully with aphasia takes time; (2) apha...

Background: There is an increasing need in speech and language therapy for clinicians to provide intervention in the context of the broader life‐quality issues for people with aphasia. However, there is no descriptive research that is explicitly focused on quality of life (QoL) from the perspectives of older people with aphasia.