Metacognitive Strategy Training Is Feasible for People With Aphasia.
Jessica Kersey, William S Evans, Katie Mullen and 7 others
PMID 34176360WHAT IT FOUND
Adapted strategy training using supported conversation was feasible for stroke survivors with aphasia.
Therapists maintained fidelity, participants engaged well, and disability scores improved similarly to patients without aphasia, though only half mastered the strategy.
Key findings
01Therapists maintained high fidelity to strategy training principles while simultaneously applying supported conversation techniques.
02Participants with aphasia achieved disability improvements similar to matched participants without aphasia who received the same training.
03Only 50% of participants met the criteria for mastering the strategy training skills.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample size was very small (n=13 analysed), limiting the generalisability of the findings. Retention was low, with only 13 of 16 enrolled participants completing enough sessions for analysis due to early discharge. The study did not include a concurrent control group, so improvements cannot be definitively attributed to the intervention rather than spontaneous recovery or usual care. The definition of 'mastery' may have been too restrictive, as many participants improved functionally without meeting all strategy criteria. Participants were mostly White and had moderate to severe aphasia, so results may not apply to other demographics or those with very severe or no functional communication.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not assume this intervention works better than usual care. The improvement in disability scores was similar to matched controls without aphasia, and the study lacked a concurrent control group to isolate the effect of the training from spontaneous recovery.