The Aphasiology Archive
University Library System, University of Pittsburgh
    

Constrained Versus Unconstrained Intensive Language Therapy in Two Individuals with Chronic, Moderate-to-Serve Aphasia and Apraxia of Speech: Behavioral and fMRI Outcomes

Kurland, Jacquie and Pulvermüller, Friedemann and Silva, Nicole and Burke, Katherine and Andrianopoulos, Mary
Constrained Versus Unconstrained Intensive Language Therapy in Two Individuals with Chronic, Moderate-to-Serve Aphasia and Apraxia of Speech: Behavioral and fMRI Outcomes. American Journal of Speech-Language Pathology, 21(Suppl.), May, 2012, pages s65-s87.

This is the latest version of this eprint.

Abstract

Purpose: This Phase I study investigated behavioral and functional MRI (fMRI) outcomes of 2 intensive treatment programs to improve naming in 2 participants with chronic moderate-to-severe aphasia with comorbid apraxia of speech (AOS). Constraint-induced aphasia therapy (CIAT; Pulvermüller et al., 2001) has demonstrated positive outcomes in some individuals with chronic aphasia. Whether constraint to the speech modality or treatment intensity is responsible for such gains is still under investigation. Moreover, it remains to be seen whether CIAT is effective in individuals with persistent severe nonfluent speech and/or AOS.

Method: A single-subject multiple-baseline approach was used. Both participants were treated simultaneously, first with Promoting Aphasics' Communicative Effectiveness (PACE; Davis & Wilcox, 1985) and then with CIAT. Pre-/posttreatment testing included an overt naming fMRI protocol. Treatment effect sizes were calculated for changes in probe accuracy from baseline to posttreatment phases and maintenance where available.

Results: Both participants made more and faster gains in naming following CIAT. Treatment-induced changes in BOLD activation suggested that better naming was correlated with the recruitment of perilesional tissue.

Conclusion: Participants produced more target words accurately following CIAT than following PACE. Behavioral and fMRI results support the notion that the intense and repetitive nature of obligatory speech production in CIAT has a positive effect on word retrieval, even in participants with chronic moderate-to-severe aphasia with comorbid AOS.

EPrint Type:Journal (Paginated)
Keywords:aphasia, apraxia of speech, neuroplasticity, intensive language therapy, constraint-induced aphasia therapy, fMRI
Subjects:UNSPECIFIED
ID Code:2343
Conference:Clinical Aphasiology Conference: Clinical Aphasiology Conference (2011 : 41st : Fort Lauderdale, FL : May 31-June 4, 2011)
Publication:American Journal of Speech-Language Pathology
Volume:21
Number:Suppl.
Pages:s65-s87
Alternative Locations:http://dx.doi.org/10.1044/1058-0360(2012/11-0113)
DOI or Unique Handle:10.1044/1058-0360(2012/11-0113)
Additional Information:This article is based on a paper originally presented at the CAC20xx Conference. Permission to view the full-text articles is subject to the publisher’s access restrictions.

Available Versions of this Item