A feasibility study of a novel computer-based treatment for sentence production deficits in aphasia, delivered by a combination of clinician-led and self-managed treatment sessions

Abstract

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 that the feasibility of this mode of delivering verb and sentence treatments is explored. Aims: This study explored the feasibility and preliminary effectiveness of a novel computer-based treatment for sentence production deficits in aphasia, delivered by a combination of face-to-face and self-managed treatment sessions. The effect of treatment on verb and sentence production, discourse and functional communication was assessed. Methods & Procedures: The study used a pre-post design with six single cases: three males and three females aged 49–81 years. The Sentence Production Treatment (SPT) was developed based on the evidence from systematic reviews of verb-in-isolation and sentence treatments respectively. The SPT was low dose (8 hours) and clinician delivered, supplemented by a minimum set level (16 hours) of self-managed computer-based treatment. The feasibility of the SPT was investigated by: monitoring recruitment and retention of participants; logging any technical issues; assessing the fidelity of face-to-face treatment delivery using checklists; and monitoring compliance with self-delivered treatment. Outcomes & Results: The SPT was found to be feasible and acceptable to the six participants. Treatment effects were noted on trained verb production and sentence production for five participants each. Generalisation to untrained verb and sentence targets and discourse was more limited, however four participants perceived functional communication improvements. Conclusions: The study represents the first preliminary evidence that a computer-based sentence level treatment for sentence production deficits in aphasia, which included a self-managed component, is feasible and can be effective. Given these overall positive findings of feasibility and benefit, further feasibility testing is warranted, exploring intervention refinement and candidacy.