Performance Variability as a Predictor of Response to Aphasia Treatment.
E Susan Duncan, Tanya Schmah, Steven L Small
PMID 27053642WHAT IT FOUND
People with chronic aphasia improved on five of seven language measures after six weeks of computer-assisted repetition therapy.
Those whose repetition varied more before therapy showed greater improvement.
Key findings
01Participants improved on five of seven language measures after six weeks of therapy, including overall aphasia scores, repetition, naming, and the repetition test.
02After removing outlier and near-threshold subjects, higher pre-therapy repetition variability was associated with greater improvement, and it was the only pre-therapy predictor selected.
03Repetition variability decreased during treatment, and greater reduction in variability was associated with greater improvement.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study included 19 people with chronic aphasia, and one was excluded from repetition analysis, leaving 18 for that outcome. The supplied text does not report a comparison group, so it does not show that the therapy alone caused the gains. Several participants were removed from the variability analysis because of outlier status or near-ceiling performance, which can affect the predictor result. The predictor finding was limited to repetition accuracy, a motor speech task, and the authors say it may not apply to purely cognitive language tasks. All participants were in chronic aphasia stages, so the results do not show what would happen in acute recovery. Attention, mood, and fatigue were not measured, although they can affect variability. The sample was too small to determine whether fluent and nonfluent aphasia types benefited differently. Repetition scoring was done by a single speech-language pathologist, and reliability rates were not reported. Week 12 scores were not used because two participants missed that assessment, so maintenance was not fully analysed.
Declared interests
The supplied text does not include a conflicts of interest statement. The article is labelled as supported by non-U.S. government and NIH extramural research.
The easy way to misread this
Do not use high variability as a proven way to choose aphasia therapy. This was a small study without a comparison group, it included only chronic aphasia, the predictor was tested only on repetition, and some participants were removed from the variability analysis.