The Applicability and Outcome of Constraint Induced Language Therapy (CILT) in Early Aphasia Rehabilitation
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AbstractThe purpose of this doctoral study was to explore the applicability and outcome of constraint induced language therapy (CILT) on verbal expressive speech in early aphasia rehabilitation, that is, one to four months post stroke. CILT is a behavioural approach based on the theories of neurological rehabilitation and experience-dependent brain plasticity. CILT-treatment emphasises expressive speech production for three hours a day for ten days with constraints to spoken language, and was carried out by speech and language pathologists. Ten persons with aphasia participated in a pre- and post-test intervention study with follow-up in local rehabilitation hospitals. The results of the study are presented in three papers. In the first paper, the first cases participating in an early aphasia rehabilitation CILT-study were described, and results revealed positive improvement on the treated language measures. The second paper explored and demonstrated treatment outcome generalisation to more complex oral text production (i.e. conversational interview) for three cases. The final paper presented statistical significant outcome changes post intervention on the individual and group level on several language tests, as well as continued statistical significant improvement at the follow-up. Consistent with the treatment focus, expressive tasks showed greater improvement than receptive tasks or reading/writing. Participant evaluation revealed positive experiences with CILT, thereby supporting the clinical relevance of CILT.
In conclusion, the application and clinical relevance of CILT to early aphasia rehabilitation is supported with individual modification of the treatment schedule.
The doctoral study was conducted at the Department of Special Needs Education, Faculty of Education, University of Oslo, 2006-2010.
List of papers. Paper III are removed due to copyright restrictions
Paper I: Kirmess, M., & Maher, L. M. (2010). Constraint induced language therapy in early aphasia rehabilitation. Aphasiology, 24(6), 725 - 736. DOI: 10.1080/02687030903437682
Paper II: Kirmess, M., & Lind, M. (2011). Spoken language production as outcome measurement following constraint induced language therapy. Aphasiology, 1-32. DOI: 10.1080/02687038.2011.589986
Paper III: Kirmess, M. (Submitted). “I like to come here and do a job” - Participant experience and long-term outcomes of CILT in early aphasia rehabilitation. International Journal of Speech-Language Pathology. Manuscript ID TASL-2010-0104b