A meta‐analysis of studies carried out between 1946 and 1988 concerned with the efficacy of speech and language therapy treatment for aphasic patients

Abstract

SA n examination of the empirical evidence for the eficacy of speech and language therapy treatment for adult aphasic patients is undertaken with the aid of meta-analysis which affords a statistical method of systematic data summary and synthesis. Patient characteristics and treatment outcomes are correlated to identify factors that contribute to the demonstration of a treatment effect. One of the most striking results of this retrospective study was the identification of the overwhelming failure to report data or include, in experimental controls, variables that might crucially affect outcome.Une ttude sur les tvidences empiriques de l'eficacitt des traitements rtalists par les orthophonistes avec des patients aphasiques adultes, a e'te' mente avec l'aide de la mtta-analyse qui offre une mtthode statistique systtmatique de synthese et de rtsumt des donntes. La corre'lation des caracte'ristiques des patients et les rksultats des traitements a tte' Ctudite pour mettre en tvidence les facteurs qui contribuent a la dtmonstration des effets du traitement. Un des resultats les plus marquants de cette etude rttrospective a ttC la mise en tvidence de l'absence gtntralisCe de donntes pre'cises et l'incapacitt d'inclure, dans les contrdes exptrirnentaux, des variables qui sont de'terminantes pour les rtsultats. Mit der Hilfe einer Metaanalyse, die eine statistische Methode der systematischen Datenzusammenfassung ermoglichte, haben wir eine Untersuchung des empirischen Beweismaterials f i r die positive Auswirkung von Sprachtherapie bei Aphasie durchgefiihrt. Besonderheiten der Patienten wurden mit Behandlungsergebnissen korreliert, u m die Faktoren festzustellen, die zu einer positiven Therapie beitragen. Eins der auffallendsten Ergebnisse dieser Studie war die Feststellung eines erheblichen Datenmangels in den anderen Berichten und bei den Kontrollgruppen das Fehlen von Variablen, die einen bedeutenden Einfluss auf das Endergebnis haben konnten.

Veterans Affairs/Department of Defense Clinical Practice Guideline for the Management of Adult Stroke Rehabilitation Care

“…Depending on the pathology and site of lesion, dysarthria for some patients may decrease dramatically, whereas for others, dysarthria persists and requires direct intervention of the affected subsystem (articulation, resonance, phonation, respiration, or prosody), development of compensatory behaviors, or training in the use of augmentative/alternative communication devices. If intervention is indicated, treatment can help maximize recovery of communication abilities and prevent learning of ineffective or inappropriate compensatory behaviors [55][56][57][58][59][60][61] (Evidence LevelϭA, B).…”

Evaluating Single-Subject Treatment Research: Lessons Learned from the Aphasia Literature

“…Several researchers have conducted systematic reviews of the aphasia treatment literature and provided useful meta-analyses of the outcomes from group studies (Whurr, Lorch, & Nye, 1992;Robey, 1994;Robey, 1998). In general, these meta-analyses offer converging evidence to suggest that aphasia treatment brings about meaningful, positive change in language performance relative to untreated controls.…”

Language and praxis in written production: A rehabilitation paradigm

“…Sasanuma (in her commentary to the target article) quite rightly points out the methodological limitations of the earlier research on the use of the writing prosthesis as a treatment tool, Unfortunately, lack of carefully controlled research design and lack of rigorously detailed research reporting is true of much aphasia research on the efficacy of treatment that was carried out before 1985 (Whurr et al 1992). …”