Event Abstract

Back to Event

Investigating the Effects of Intensive Oral Reading Therapy and Intensive Language Action Therapy for Chronic Mild Aphasia and Alexia

Jennifer L. Mozeiko1* and Carl A. Coelho1
  • 1 University of Connecticut, Speech, Language and Hearing Sciences, United States

Abstract High intensity therapy focused on improving language production in people with chronic aphasia has been largely successful when administered at a dosage of thirty hours over two weeks (i.e., Pulvermüller et al., 2001). In one study, unanticipated increases in reading were observed in addition to gains in language performance for participants with mild aphasia (Mozeiko, Myers, & Coelho, 2016). To date, oral reading treatments aimed at improving reading comprehension have had limited success (Purdy et al., 2016); however, improvements in discourse have been reported (Cherney, 2010.) In the current study, we use a crossover repeated measures design to compare the effects of a high intensity reading therapy (HIRT; Mozeiko & Richard) and intensive language action therapy (ILAT; Difrancesco, Pulvermüller, & Mohr, 2012) and hypothesize that any oral-verbal stimulation is likely to show an effect of treatment if presented at the same high intensity. Methods All six participants were monolingual native English speakers with chronic, mild aphasia (classified by WAB-R AQ) resulting from a single left hemisphere CVA. Participants were reading at a grade level of 1.2-5.4 prior to treatment, according to the Gray’s Oral Reading Test (GORT). Three participated in HIRT first, three in ILAT first. Daily discourse and oral reading probes were administered for each participant. ILAT uses language games to encourage complex sentence production. In HIRT, oral reading activities were conducted using principles from evidence-based oral reading treatments such as ORLA (Cherney, 2010) and ARCS (Rogalski & Edmonds, 2008). Outcome measures included discourse efficiency, reading accuracy, reading comprehension, and aphasia severity. Results Overall, five of the six participants demonstrated gains on the WAB-R AQ, four of six on the TORC and four of the six on the GORT. Repeated measures ANOVA showed a significant effect of time on the WAB-AQ (p<.05). After the first treatment administration, the three who received HIRT first improved on the WAB by at least 3 points, two improved on the TORC and none on the GORT. Two participants demonstrated additional gains on the TORC following ILAT. Follow-up scores showed additional improvement for all three participants. For those who received ILAT-first, changes were more attenuated. One of three showed gains on the WAB post-treatment and additional gains at follow-up. This same participant showed gains on the TORC following the first treatment but gains were not increased following HIRT and were not maintained at follow-up. Gains on the GORT were only evident at follow-up. The other two participants also made gains on the GORT- one after ILAT, one after HIRT. Consistent positive results were not observed on discourse measures. Discussion The following will be discussed: • A significant effect of time and not group suggests that treatment type may be a less important consideration than the intensity of oral-verbal stimulation. • Those with the highest AQs at the beginning of treatment made the greatest gains in reading outcomes suggesting that aphasia severity may predict responsiveness to treatment for reading. • HIRT or ILAT may be valid treatment options for some people with mild aphasia to improve reading.

Acknowledgements

This work would not have been possible without the assistance from student clinicians and research assistants Stephen Graham and Mia Archambault. We are also grateful to the six participants who dedicated their summers to this project and to family members who assisted with transportation.

References

Cherney, L. R. (2010). Oral reading for language in aphasia: impact of aphasia severity on cross-modal outcomes in chronic nonfluent aphasia. In Seminars in Speech and Language (Vol. 31, pp. 42–51).

Difrancesco, S., Pulvermüller, F., & Mohr, B. (2012). Intensive language-action therapy (ILAT): The methods. Aphasiology, 26(11), 1317–1351.

Kurland, J., Pulvermüller, F., Silva, N., Burke, K., & Andrianopoulos, M. (2012). Constrained vs. Unconstrained Intensive Language Therapy in Two Individuals with Chronic, Moderate-to-Severe Aphasia and Apraxia of Speech: Behavioral and fMRI Outcomes. American Journal of Speech-Language Pathology.

Mozeiko, J., Myers, E., & Coelho, C. (2017). Treatment response to a double administration of Constraint Induced Language Therapy in chronic aphasia. Manuscript in review.

Mozeiko, J. & Richard, M. (November, 2015). Intensive Oral Reading Program for Discourse
in Chronic Mild Aphasia. Poster presented at the annual convention of the American Speech-Language-Hearing Association, Denver, CO.

Pulvermüller, F., Neininger, B., Elbert, T., Mohr, B., Rockstroh, B., Koebbel, P., & Taub, E. (2001). Constraint-induced therapy of chronic aphasia after stroke. Stroke, 32(7), 1621–1626.

Purdy, M., Madden, E., Coppens, P., Freed, D., Mozeiko, J. & Wallace, S. (November, 2016). A
Systematic Review of Reading Comprehension Treatment for Aphasia. Poster presented at the annual convention of the American Speech-Language-Hearing Association, Philadelphia, PA

Rogalski, Y., & Edmonds, L. A. (2008). Attentive Reading and Constrained Summarisation (ARCS) treatment in primary progressive aphasia: A case study. Aphasiology, 22(7–8), 763–775.

Keywords: reading treatment, treatment dosage, Aphasia treatment, reading comprehension, ILAT

Conference: Academy of Aphasia 55th Annual Meeting , Baltimore, United States, 5 Nov - 7 Nov, 2017.

Presentation Type: poster presentation

Topic: General Submission

Citation: Mozeiko JL and Coelho CA (2019). Investigating the Effects of Intensive Oral Reading Therapy and Intensive Language Action Therapy for Chronic Mild Aphasia and Alexia. Conference Abstract: Academy of Aphasia 55th Annual Meeting . doi: 10.3389/conf.fnhum.2017.223.00109

Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters.

The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated.

Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed.

For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions.

Received: 02 May 2017; Published Online: 25 Jan 2019.

* Correspondence: Dr. Jennifer L Mozeiko, University of Connecticut, Speech, Language and Hearing Sciences, Storrs, CT, 06269, United States, jennifer.mozeiko@uconn.edu