Structure, Processes, and Retrospective Outcomes From an Intensive Comprehensive Aphasia Program

Abstract

ICAPs can have a significant effect on the language impairment and participation of people with aphasia, but further research is required to determine if the effect is comparable to other types of service delivery.

Outcomes of an Intensive Comprehensive Aphasia Program

“…Similarly, several other studies from established clinical and research ICAPs have found that most participants make progress in at least one area when assessed with both impairment and patient-reported outcome measures. 43,57,73,74,112,150 While we know that there are significant quantitative gains following participation in an ICAP occur, we do not know what the stakeholders think about these types of treatment programs.…”

“…112 Effect sizes were large for the WAB Aphasia Quotient (AQ), Language Quotient (LQ), and Cognitive Quotient (CQ) and moderate for the BNT. Family-reported effect size was large on the CETI and moderate for participantreported CETI, ASHA QCL, and CCRSA.…”

“…Consistent with Donabedian's quality control model that stresses the importance of understanding how changes in structure and process impact outcomes, 25,26 Babbitt and colleagues analyzed the structure, process, and outcomes of one ICAP. 22,23,112 They described how the structure and process of that ICAP differed from that of traditional therapy, with resulting outcomes that included significant changes from pre-to post-treatment on various behavioral measures. Similarly, several other studies from established clinical and research ICAPs have found that most participants make progress in at least one area when assessed with both impairment and patient-reported outcome measures.…”

“…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).…”

“…112 The TIR is a ratio of how many hours of therapy are delivered per week divided by the total potential hours of therapy that could be delivered, using a 40-hour work week as a maximum number of hours. Based on the reported number of hours of therapy per week, the Therapeutic Intensity Ratio (TIR) for these studies ranges from 40% to 75%.…”