Aphasia LIFT: Exploratory investigation of an intensive comprehensive aphasia programme

Rodriguez, Amy D.; Worrall, Linda; Brown, Kyla; Grohn, Brooke; McKinnon, Eril; Pearson, Charlene; Hees, Sophia van; Roxbury, Tracy; Cornwell, Petrea; MacDonald, Anna D.; Angwin, Anthony J.; Cardell, Elizabeth; Davidson, Bronwyn; Copland, David A.

doi:10.1080/02687038.2013.825759

Cited by 67 publications

(53 citation statements)

References 64 publications

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“…This is comparable to previous research on ICAPS, in that the majority of participants see improvements in at least one area measured. 55,57,73,74 As other research has reported that most participants make gains in at least one area, we looked more closely to see how many participants did not make gains on any impairment and participation measures. In the nine participants (11%) who made minimal changes across the outcome measures, there was no apparent pattern, as eight participants were rated at both ends of the severity spectrum and one participant fell in the moderate range.…”

Section: Resultsmentioning

confidence: 99%

“…Rodriguez and colleagues noted that on the BNT and participation measures there were significant differences and two participation measures showed significant differences at follow up. 57 Dignam et al compared an intensive treatment to a distributed treatment and found that both groups improved significantly from pre-to posttreatment on the BNT and the distributed group demonstrated significantly greater improvement at post-treatment and follow up. 43 The participation measures showed significant differences at post-treatment and follow up for both groups and no significant differences between the groups at either time point.…”

Section: Introductionmentioning

confidence: 99%

“…55,57,73,74 People with aphasia, family members, clinicians, supporting organizations, and insurance companies invest time and considerable resources into ICAPs. However, predicting who will benefit most from participation in an ICAP has not been studied.…”

Section: Introductionmentioning

confidence: 99%

“…43,50,55,57,[72][73][74]112 To be considered an intensive program, an ICAP provides therapy ranging from 30 hours over two weeks up to 150 hours of therapy over four weeks for participants starting and ending at the same time. 50 To be considered comprehensive, a program will target impairment and activity/participation language skills, provide family education and use a variety of different treatments (e.g., individual, group, and computers).…”

Section: Introductionmentioning

confidence: 99%

“…71 An emerging body of literature is beginning to assess outcomes from clinical ICAPs. 57,[72][73][74] Hinckley and Craig (1998) retrospectively analysed the outcomes of an intensive comprehensive aphasia program in which participants received 23 hours of therapy per week over six weeks. 72 On the surface, the differences between the ICAP model of therapy and traditional therapy are clearly identified as intensity and comprehensiveness.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of an Intensive Comprehensive Aphasia Program

Babbitt¹

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Intensive comprehensive aphasia programs (ICAP) have increased over the last decade in the US and abroad. The increase in the number of clinical programs has outpaced the research that is necessary to establish the efficacy and effectiveness of these specialized treatment programs. The ICAP model incorporates principles from neuroplasticity, that is, intensive treatment provides a platform for the massed practice and repetition required to change the brain. It also incorporates comprehensive treatment that addresses not only impairment-based language deficits but also personal goals related to participation.Programs which offer intensive comprehensive treatment can provide up to 120 hours of treatment over several weeks (e.g., six hours a day, five days a week for four weeks). ICAPs are different from other types of aphasia services which generally provide two to three hours of therapy a week. This thesis examined one ICAP in depth to describe the structure, process, and outcomes using Donabedian's model of health care evaluation. This thesis also described the experiences of the ICAP from the perspectives of the primary stakeholders.Study One (Chapter Two) was a retrospective quantitative study using behavioral measures from an existing database that documented the outcomes of participants with aphasia. It found that first-time participants improved significantly in impairment-and participationbased measures, demonstrating moderate to large effect sizes. Participant characteristics were examined to determine if improvements were related to age, time post-onset, or type and severity of aphasia. None of these factors had an impact on the amount of change measured. Given that some participants did not make significant gains on a primary outcome measure, the Western Aphasia Battery -Revised Aphasia Quotient (WAB-R AQ), Study Two (Chapter Three) examined whether participant characteristics at baseline could predict who would make significant gains on the WAB-R AQ. Age and months post-onset were significantly different between the responder and the non-responder groups. Those who showed most gains on average were younger and a longer time post-onset. A logistic regression was performed and results indicated that only age (younger participants) predicted who would respond to treatment. Time post-onset, type and severity of aphasia, naming, non-verbal cognition, and communication confidence did not show significance in a predictive model. Studies Three and Four were qualitative studies involving interviews with therapists (Chapter Four) and people with aphasia and their families (Chapter Five). Both studies were 3 conducted using a phenomenological approach which allowed for the interviewees to describe their experiences in a semi-structured interview. The clinicians described the intensity of the therapy, the rewards, and challenges of the program. Therapists also considered that the ICAP model of service delivery had several positive benefits for them, but acknowledged that the intensity of therapy was challe...

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%