How intensive does anomia therapy for people with aphasia need to be?

TitleHow intensive does anomia therapy for people with aphasia need to be?
Publication TypeJournal Article
Year of Publication2011
AuthorsSage, KE, Snell, C, Ralph, MALambon
JournalNeuropsychol Rehabil
Date Published2011 Jan

The intensity of aphasia therapy has been a key clinical question. The aim of this case-series study was to compare the outcome of intensive and non-intensive therapy in the relearning of words for people with aphasia. Eight participants took part in a study comparing the intensity of delivery of the therapy. Participants received two courses of the same therapy (each lasting 10 sessions) delivered either intensively or non-intensively. Therapy consisted of confrontation naming with progressive phonemic and orthographic cues. Post-therapy assessments were carried out immediately after the study and one month later. Performance was also monitored during each therapy session. Immediately post-therapy, both types of therapy had improved naming accuracy considerably and there was no significant difference between the two interventions. One month later, seven out of eight participants showed a small yet significant difference in naming accuracy, favouring non-intensive over intense therapy. There were no differences in the learning patterns during the therapy sessions between the intensive and non-intensive therapies. For the majority of people with aphasia post-stroke, both intense and non-intense therapy for anomia leads to improved naming performance. Retention at one-month post therapy is relatively superior after non-intensive therapy.

Practical Implications

There may be cause for the speech therapist to consider how the person with aphasia learns and what the best conditions for them to do that are. It is worth looking at longer term retention of what is done in impairment therapy and at whether the person has enough time and help from the therapist to put what they have learned into practice outside the therapy room.

Lay Summary

Aphasia is a language difficulty which can happen after a stroke. The person who has aphasia may not be able to understand what is said to them nor to respond easily with the words they want. When someone cannot find the words they want to say, this is called anomia. There are some therapies available which help the person to learn to say the words again. But it is not clear how often and how much time the person who has anomia should spend learning to say these words again. This study wanted to see if the way in which people tried to relearn words made a difference as to whether they would remember them in the long term and be able to use them again. The focus of this study was to see whether it would be better to learn every day for two weeks (intensively) or to spread out the learning by doing the same thing but over 5 weeks.
Eight people who had had a stroke and were finding it hard to find their words, agreed to learn 80 words they were having trouble with. Four people started to learn 40 of their chosen words by practising every day for two weeks and 4 people started to learn 40 words by practising twice a week for 5 weeks. They then had a rest and after a break, swapped around. They were all asked to learn 40 more words (which they had chosen) but if they had done it intensively the first time, they did it over a longer time period the second time (and visa-versa).
Everyone in the study learned words and it did not seem to make much difference at first whether they learned them intensively or at a more leisurely pace. However, after a longer period of time, when they were asked to recall what words they had learned, they found that they were able to more easily remember the words that they had learned over the 5 weeks rather than those which they had crammed into two weeks intensively.
Several possible reasons were put forward to explain why this might be the case, given than it is often assumed that working intensively is a good way to learn. Perhaps the intensive learning provoked some boredom and people became tired, making it harder to learn. Perhaps when there is more time to learn, things stay more solidly in our memory and there is longer for the person to think about what they had learnt more and to use the rods in everyday environments.

ISSN Number1464-0694
KeywordsAnomia, Intensity, Language Therapy, Learning, Stroke
Alternate JournalNeuropsychol Rehabil
PubMed ID21181603
Grant List / / Medical Research Council / United Kingdom