A pilot study of use-dependent learning in the context of Constraint Induced Language Therapy

Abstract

This investigation reports the results of a pilot study concerning the application of principles of use-dependent learning developed in the motor rehabilitation literature as Constraint Induced Therapy to language rehabilitation in a group of individuals with chronic aphasia. We compared treatment that required forced use of the language modality, Constraint Induced Language Therapy, (CILT) to treatment allowing all modes of communication. Both treatments were administrated intensively in a massed practice paradigm, using the same therapeutic stimuli and tasks. Results suggest that whereas both interventions yielded positive outcomes, CILT participants showed more consistent improvement on standard aphasia measures and clinician judgments of narrative discourse. These findings suggest that CILT intervention may be a viable approach to aphasia rehabilitation.

Intensive language training in the rehabilitation of chronic aphasia: Efficient training by laypersons

“…However, no significant differences were present between groups. These findings replicate previous studies that report substantial improvement in language functions and measures of connected speech after CIAT in patients with different aphasia syndromes and levels of aphasia severity (Barthel et al, 2006;Maher et al, 2006;Meinzer et al, 2005;Pulvermueller et al, 2001). These results also agree with previous evidence of effective treatment provided by trained laypersons (David et al, 1982;Lesser et al, 1986;Marshall et al, 1989;Meikle et al, 1979;Shewan & Kertesz, 1984;Wertz et al, 1986;Worrall & Yiu, 2000).…”

“…In the present study, we selected CIAT as the treatment of choice because substantial and stable improvement of language function in chronic aphasia has been demonstrated (Maher et al, 2006;Meinzer et al, 2005;Pulvermueller et al, 2001). The short-term nature of the treatment controls for confounds related to extended treatment intervals (e.g., dropouts, influence of unspecific factors).…”

Constraint-Induced Linguistic Therapy for Aphasic Patients in Hungary

“…We can claim that therapeutic language games could regain some of patients' lost linguistic functions in a very short time with a quite intensive guided practice [18][19][20] not to avoid the problematic forms of verbal stimuli but with the help of corporation and motivation. The indicators of this activity and intensity based therapy focus on both the production and the comprehension of speech in an appropriate communicative context.…”

The Changing “Face” of Aphasia Therapy

“…For example, Bhogal and colleagues conducted a literature review which suggests that intensive speech language therapy delivered over a short period of time (average of 8.8 hours per week for 11.2 weeks) resulted in significant improvements, while lower-intensity therapy provided over a longer period of time (average of 2 hours per week over 22.9 weeks) did not result in positive change (Bhogal, Teasell, Speechley, & Albert, 2003). Similarly, the constraint induced aphasia therapy data emphasize the importance of massed-practice in the improvement of language skills of individuals with chronic aphasia (Pulvermuller et al, 2001;Maher et al, 2006). However, providing intensive treatment to individuals with chronic aphasia can be costly, and the current healthcare environment in the United States is one which does not recognize its value.…”