Communication and quality of life outcomes from an interprofessional intensive, comprehensive, aphasia program (ICAP).

BACKGROUND: Intensive Comprehensive Aphasia Programs (ICAPs) have developed in response to a growing need for treatments which produce changes in language function in people with aphasia, especially in the chronic phase of recovery. ICAPs are growing in number and several papers have presented preliminary results of their use, but little data exist about their efficacy or effectiveness. OBJECTIVE: This paper explores the communication effects of an ICAP program that incorporated evidenced-based individual and group treatment in an interprofessional program. METHOD: Twenty-seven individuals with chronic aphasia were provided with 30 h of interprofessional treatment a week for a four-week period in both individual and group formats. A delayed treatment, within-participant research protocol was used. Language measures were taken at two intervals pre- and two intervals post treatment. Functional, narrative, and quality of life measures were taken once pre and once post treatment. RESULTS: Significant change was observed on targeted language functions post treatment. Significant treatment effects were also observed on functional and quality of life measures as well as on all impairment-based language measures for the group. CONCLUSION: The results provide evidence of linguistic and quality of life change in individuals with chronic aphasia who were treated in an interprofessional ICAP.

The reliability and stability of verbal working memory measures.

The psychometric properties of several commonly used verbal working memory measures were assessed. One hundred thirty-nine individuals in five age groups (18-30, 50-59, 60-69, 70-79, and 80+ years) were tested twice (Time I and Time II) on seven working memory span measures (alphabet span, backward digit span, missing digit span, subtract 2 span, running item span, and sentence span for syntactically simple and complex sentences), with an interval of approximately 6 weeks between testing. There were significant effects of age on all but two of the tasks. All the measures had adequate internal consistency. Correlations between performances at Time I and Time II were significant for all the tasks, other than the missing digit span task. The magnitude of the correlations was similar across the age groups and ranged from .52 to .81. Classification of subjects into discrete memory span groups on the basis of a single measure was highly inconsistent across testing sessions and tasks. Classification into upper and lower quartiles was more stable than using a cutoff score for group membership or than classification into high-, medium-, and low-span groups. Correlational analyses showed that there was a moderate relationship between performances on many of the span tasks. Confirmatory factor analysis suggested that six of the seven tasks reflected a common factor. Both test-retest reliability and stability of classification improved when a composite measure reflecting performance on several tasks was used.

Verbal working memory and on-line syntactic processing: evidence from self-paced listening.

Two experiments investigated the relationship between performance on standard tests of verbal working-memory and the on-line construction of syntactic form. In Experiment 1, working-memory was measured in 100 college students on a version of the Daneman and Carpenter (1980) reading-span task, and online syntactic processing was assessed using a self-paced listening task with four sentence types. In Experiment 2, working-memory was measured in 48 college students on two versions of the reading-span task and two other tests of verbal working-memory, and on-line syntactic processing was assessed using the self-paced listening task with an additional sentence type. In both experiments, there was no relationship between working-memory capacity and the increase in processing time seen for the on-line construction of syntactic form for either syntactically more complex or syntactically simpler sentences. The results indicate that the capacity of the working-memory system that is measured by standard working-memory tests does not determine the efficiency of on-line syntactic processing. They are consistent with the view that the working-memory system used for parsing is at least partially separate from that measured by traditional measures of working-memory capacity.