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Supervised Home Training of Dialogue Skills in Chronic Aphasia: A Randomized Parallel Group Study

American Speech-Language-Hearing Association
Journal of Speech, Language, and Hearing Research
Authors:
R. Nobis-Bosch at HSD Hochschule Döpfer
R. Nobis-Bosch
Luise Springer
Luise Springer
Luise Springer
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Irmgard Radermacher
Irmgard Radermacher
Irmgard Radermacher
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Walter Huber
Walter Huber
Walter Huber
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Purpose The aim of this study was to prove the efficacy of supervised self-training for individuals with aphasia. Linguistic and communicative performance in structured dialogues represented the main study parameters. Method In a cross-over design for randomized matched pairs, 18 individuals with chronic aphasia were examined during 12 weeks of supervised home training. Intensive language training, assisted by an electronic learning device (B.A.Bar), was compared with nonlinguistic training. Language performance, communicative abilities, and cognitive abilities were controlled before and after each intervention and at follow-up. The language training was designed to facilitate dialogue skills as required in everyday life. Results Robust and specific improvements in the participants' linguistic and communicative abilities were obtained using B.A.Bar dialogue training but not with nonlinguistic training. The transfer to general linguistic and communicative performance remained limited when the whole group was considered. For 30%–50% of the participants, individual analysis revealed significant improvements in spontaneous language and general communicative skills. Furthermore, individual participants demonstrated significant improvements regarding standardized aphasia assessment and proxy rating of communicative effectiveness. Conclusion Supervised home training works. This study has proven that it is an effective tool for bolstering linguistic and communicative skills of individuals with aphasia.
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JSLHR
Article
Supervised Home Training of Dialogue
Skills in Chronic Aphasia: A Randomized
Parallel Group Study
Ruth Nobis-Bosch,
a,b
Luise Springer,
a,b
Irmgard Radermacher,
a,b
and Walter Huber
a,b
Purpose: The aim of this study was to prove the efficacy of
supervised self-training for individuals with aphasia. Linguistic
and communicative performance in structured dialogues
represented the main study parameters.
Method: In a cross-over design for randomized matched pairs,
18 individuals with chronic aphasia were examined during
12 weeks of supervised home training. Intensive language training,
assisted by an electronic learning device (B.A.Bar), was compared
with nonlinguistic training. Language performance, communicative
abilities, and cognitive abilities were controlled before and after
each intervention and at follow-up. The language training was
designed to facilitate dialogue skills as required in everyday life.
Results: Robust and specific improvements in the participants’
linguistic and communicative abilities were obtained using B.A.Bar
dialogue training but not with nonlinguistic training. The transfer
to general linguistic and communicative performance remained
limited when the whole group was considered. For 30%–50% of the
participants, individual analysis revealed significant improvements
in spontaneous language and general communicative skills.
Furthermore, individual participants demonstrated significant
improvements regarding standardized aphasia assessment and
proxy rating of communicative effectiveness.
Conclusion: Supervised home training works. This study has
proven that it is an effective tool for bolstering linguistic and
communicative skills of individuals with aphasia.
Key Words: aphasia, home training, B.A.Bar, dialogue training
Acquired language disorders are some of the most
frequent and long lasting disabilities resulting
from stroke, and they lead to communicative and
psychosocial handicaps (Martin, Thompson, & Worrall,
2007; Pulvermüller & Berthier, 2008). Nonetheless,
many individuals with aphasia retain sufficient learning
capabilities for improving their communicative and lin-
guistic skills during speech and language therapy, even
in the chronic stage. Long-term treatment is required to
help them best participate in a full range of daily activ-
ities. However, as the aphasia persists, the extent of the
individual’s treatment eventually declines due to limited
organizational and financial resources. Thus, there is a
tendency to restrict the treatment and provide it only
during the acute and postacute stages (Mannheim, Halper,
& Cherney, 2009). Consequently, in light of these restric-
tions, it is essential to develop and investigate new, ef-
ficient ways to improve the self-learning of individuals
with aphasia.
Increasing Treatment Intensity
Through Home Training
Thereiswideagreementthatsignificant improvements
can be obtained only with a high frequency of treatment
(Bhogal, Teasell, & Speechley, 2003; Cherney, Patterson,
Raymer, Frymark, & Scholling, 2008; Pulvermüller et al.,
2001; Robey, 1998). In their review of controlled group
studies, Bhogal et al. (2003) reported significant out-
comes only from those studies that had provided in-
tensive treatment—that is, an average of 8.8 hr per week
for 11 weeks. This seems unrealistic for general clin-
ical practice. Supervised self-training at home is a real
alternative.
a
University Hospital Aachen, Aachen, Germany
b
RWTH Aachen University, Aachen, Germany
Correspondence to Ruth Nobis-Bosch:
Ruth.Nobis.Bosch@rwth-aachen.de
Editor: Karla McGregor
Associate Editor: Mary Kennedy
Received September 18, 2009
Revision received March 21, 2010
Accepted December 3, 2010
DOI: 10.1044/1092-4388(2010/09-0204)
Journal of Speech, Language, and Hearing Research •Vol. 54 •1118–1136 •August 2011 •DAmerican Speech-Language-Hearing Association1118
... Finally, the intervention was computerized to allow opportunities for self-managed home practice. This may increase the frequency with which participants engage with intervention activities (Nobis-Bosch et al., 2011). High-intensity aphasia therapy (8.8 h per week for 11 weeks) has been found to be more effective compared with lower intensity therapy, administered over a longer time span (Bhogal et al., 2003). ...
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  • Aug 2021
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... It contrasted success in naming the symbols depending on whether the participants were given cues or developed personalised cues. The other study, by Nobis-Bosch et al. (2011) looks at the use of barcoded pictures to allow the participants to be able to practice repeating dialogues. ...
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... In the digital age and its applications on tablets and smartphones, it is important to investigate modern treatment options especially in the neurologic field. A small population study investigating the effect of computer-assisted self-training vs. nonlinguistic cognitive therapy in 18 patients showed improved communication skills (17,18). Due to different limitations concerning the population, further investigations are necessary in the future (19). ...
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Article
Full-text available
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