Topic > Aphasia (CILT and Constraint-Induced Speech Therapy

According to the World Health Organization, 795,000 Americans suffer from stroke each year and of those who survive, 25 to 40 percent will develop aphasia. The National Aphasia Association defines aphasia as “a language disorder, affecting the production or understanding of speech and the ability to read or write.” Many of these people who suffer from aphasia will be subjected to therapy sooner or later. Several approaches have been shown to be effective in reducing symptoms. A recent topic of interest in the past two decades has been the role played by intensity in aphasia therapy undergoing intensive versus non-intensive aphasia therapy, as well as to identify constraint-specific intensive therapies that are effective. Another topic of interest in the aphasia community involves the “recovery window” for those with aphasia. It was commonly believed that language recovery from aphasia stabilizes within the first year after a stroke (Pedersen et al., 1995); however, new evidence suggests that when an intensive therapy such as CILT is implemented, results can be seen many years later. This article will examine the role that intensity plays in aphasia therapy, look more closely at CILT compared to other approaches, and evaluate current research regarding the “window of recovery” in patients with aphasia. Most of the research examining treatment intensity (sometimes known as dosage) has been completed in the last twenty years. Among these studies, there is evidence both for and against implementing therapy intensively... half of the article... look at the effect these variables had on measures of speech impairment in people with stroke - induced aphasia. This study also supported the idea that greater intensity of therapy was associated with improvements in language impairment. Many studies exploring the effects of treatment intensity on recovery from aphasia do so by examining a specific type of intensive therapy known as constraint-induced speech therapy (CILT). Pulvermuller et al. (2001) was the first to examine how constraints placed on a person with aphasia to limit them to only one means of verbal communication could improve verbal production. The idea arose from evidence in the field of physical therapy that great motor improvements are possible when the less affected limb is constrained and intensive therapy is provided to the more severely affected limb (Taub, Uswatte, Pidikiti, 1999).