Background Little is known about the efficacy of language production treatment in subacute severe nonfluent aphasia. Although Melodic Intonation Therapy (MIT) is a language production treatment for this disorder, until now MIT effect studies have focused on chronic aphasia. Purpose This study examines whether language production treatment with MIT is effective in subacute severe nonfluent aphasia. Methods A multicenter, randomized controlled trial was conducted in a waiting-list control design: patients were randomly allocated to the experimental group (MIT) or the control group (control intervention followed by delayed MIT). In both groups, therapy started at 2 to 3 months poststroke and was given intensively (5 h/wk) during 6 weeks. In a second therapy period, the control group received 6 weeks of intensive MIT. The experimental group resumed their regular treatment. Assessment was done at baseline (T1), after the first intervention period (T2), and after the second intervention period (T3). Efficacy was evaluated at T2. The impact of delaying MIT on therapy outcome was also examined. Results A total of 27 participants were included: n = 16 in the experimental group and n = 11 in the control group. A significant effect in favor of MIT on language repetition was observed for trained items, with mixed results for untrained items. After MIT there was a significant improvement in verbal communication but not after the control intervention. Finally, delaying MIT was related to less improvement in the repetition of trained material. Conclusions In these patients with subacute severe nonfluent aphasia, language production treatment with MIT was effective. Earlier treatment may lead to greater improvement.

The ScreeLing is an accurate test that can be easily administered and scored to detect aphasia in the first weeks after stroke. Furthermore, the ScreeLing is suitable for revealing underlying linguistic deficits, especially semantic and phonological deficits.

Background: This study explores the psychometric qualities of the Scenario Test, a new test to assess daily‐life communication in severe aphasia. The test is innovative in that it: (1) examines the effectiveness of verbal and non‐verbal communication; and (2) assesses patients' communication in an interactive setting, with a supportive communication partner. Aims: To determine the reliability, validity, and sensitivity to change of the Scenario Test and discuss its clinical value. Methods & Procedures: The Scenario Test was administered to 122 persons with aphasia after stroke and to 25 non‐aphasic controls. Analyses were performed for the entire group of persons with aphasia, as well as for a subgroup of persons unable to communicate verbally (n = 43). Reliability (internal consistency, test–retest reliability, inter‐judge, and intra‐judge reliability) and validity (internal validity, convergent validity, known‐groups validity) and sensitivity to change were examined using standard psychometric methods. Outcomes & Results: The Scenario Test showed high levels of reliability. Internal consistency (Cronbach's α = 0.96; item‐rest correlations = 0.58–0.82) and test–retest reliability (ICC = 0.98) were high. Agreement between judges in total scores was good, as indicated by the high inter‐ and intra‐judge reliability (ICC = 0.86–1.00). Agreement in scores on the individual items was also good (square‐weighted κ values 0.61–0.92). The test demonstrated good levels of validity. A principal component analysis for categorical data identified two dimensions, interpreted as general communication and communicative creativity. Correlations with three other instruments measuring communication in aphasia, that is, Spontaneous Speech interview from the Aachen Aphasia Test (AAT), Amsterdam–Nijmegen Everyday Language Test (ANELT), and Communicative Effectiveness Index (CETI), were moderate to strong (0.50–0.85) suggesting good convergent validity. Group differences were observed between persons with aphasia and non‐aphasic controls, as well as between persons with aphasia unable to use speech to convey information and those able to communicate verbally; this indicates good known‐groups validity. The test was sensitive to changes in performance, measured over a period of 6 months. Conclusions & Implications: The data support the reliability and validity of the Scenario Test as an instrument for examining daily‐life communication in aphasia. The test focuses on multimodal communication; its psychometric qualities enable future studies on the effect of Alternative and Augmentative Communication (AAC) training in aphasia.