Long-term Recovery in Stroke Accompanied by Aphasia: A Reconsideration.

This was not a treatment study. The paper did not test an intervention, so the changes cannot be credited to any therapy. The sample was small and selected from aphasia centers. The sample of 26 participants is not enough to describe all people with chronic aphasia. Only 11 of the 16 improvers had repeat discourse data, so the language sample findings rest on a very small subgroup. The 3 decliners were too few for statistical comparison, and one died within a few months of the second test. The three decliners were older than the mean ages of the improvers and maintainers, but the study could not compare age across groups statistically. Stroke severity, lesion size, and neuroimaging data were not available, so important biological factors could not be examined. Participants varied in time since stroke, from 0.5 to 15.3 years at first testing, and retest intervals were one year or more. Discourse changes were not always improvement. More words or longer utterances may not mean better language.

Do not conclude that community aphasia centers or repeated testing caused the improvements. The study assigned no treatment, and the participants were not receiving formal language therapy, so it reports change over time, not an intervention effect.