Feasibility and cost analysis of implementing high intensity aphasia clinics within a sub-acute setting

Wenke, Rachel; Lawrie, Melissa; Hobson, Tania; Comben, Wendy; Romano, M. C.; Ward, Elizabeth C.; Cardell, Elizabeth

doi:10.3109/17549507.2014.887777

Cited by 36 publications

(39 citation statements)

References 33 publications

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“…Families also reported similar thoughts and additionally, made comments that the therapy could have been longer. 156 In Mackenzie's study, families reported almost the exact same ideas regarding language and conversation as we found:…”

Section: Discussionsupporting

confidence: 73%

“…Only a few intensive research studies have reported feedback from participants and family members. 56,156 While these two treatment studies did not provide all aspects of the definition of intensive and comprehensive aphasia programs, one study provided two hours of daily treatment for 11 weeks (e.g., individual session and computer or group or SLP assistant session) and the other study provided five hours of daily treatment for four weeks (e.g., individual and group sessions). Both provided individualized treatments; however, there was no mention of family education or involvement.…”

Section: Discussionmentioning

confidence: 99%

“…56,156 These studies used questionnaires to gain feedback from persons with aphasia and/or their family members.…”

Section: Discussionmentioning

confidence: 99%

“…155 Wenke and colleagues solicited feedback of participants following an intensive sub-acute protocol, which was not an intensive comprehensive program. 156 The responses indicated that the participants thought the therapy was helpful, enjoyed the social aspect, noted the quality of the staff, reported increased confidence, and saw improvements in themselves.…”

Section: Introductionmentioning

confidence: 99%

“…56 Wenke et al also asked caregivers for feedback following the intensive sub-acute treatment study and caregivers reported their family member with aphasia showed increased confidence, positive changes, they noted the quality of the staff, and felt the treatment "could go longer." 156 While research regarding behavioral outcomes from ICAPs is emerging, the perspectives of the primary stakeholders, the person with aphasia and their family member is still lacking. It is important to know how they describe their experience.…”

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: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

“…56,156 These studies used questionnaires to gain feedback from persons with aphasia and/or their family members.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%