Constraint induced language therapy in early aphasia rehabilitation

Abstract

Background: Constraint induced language therapy (CILT) focuses on improving acquired expressive language deficits after stroke by applying intensive, use-dependent treatment with constraint to spoken verbal expression. Most CILT research has utilised individuals with chronic aphasia, and previous results indicated improvement on the language assessments after intervention that was largely retained at follow-up. Aims: The purpose of this study was to explore the applicability and outcome of a programme of CILT in individuals in the early phase of recovery from aphasia (1–2 months post onset) in an inpatient rehabilitation hospital setting. Methods & Procedures: A 10-day/3 hours a day pre–posttest CILT intervention case series was carried out 1–2 months post onset with three Norwegian rehabilitation inpatients with aphasia following left CVA. Procedures involved card activities using high- and low-frequency picture stimuli with communicative relevance at four levels of complexity, either in a small group or one-to-one with a trained SLP. Outcomes & Results: Results suggested an overall improvement on the language assessments post CILT intervention, as well as at the follow-up. A greater degree of improvement in performance on expressive speech tasks compared to receptive and written tasks suggested a treatment-specific effect of CILT for early aphasia rehabilitation. Participant evaluation of the CILT intervention reflected positive feedback for the treatment experience and satisfaction with individual gains. Challenges in the application of CILT to this phase of recovery were the need to accommodate the demands of the inpatient rehabilitation setting and the decreased stamina of the participants. Conclusions: The results of this study support the applicability of CILT in early aphasia rehabilitation, with some modifications of the original protocol.