SLPPilotAphasiology2018

The feasibility of improving discourse in people with aphasia through AAC: Clinical and functional MRI correlates.

Aimee Dietz, Jennifer Vannest, Thomas Maloney and 3 others

PMID 32999522

WHAT IT FOUND

The main behavioral tests did not show clear group differences.

Five of six people using AAC improved enough to be counted as responders, versus two of six in usual care. Story retell changes favored AAC.

Key findings

01No statistically significant differences between groups were found on behavioral measures at pre- or post-treatment.

02Five of six people in the AAC group were responders, compared with two of six in the usual care group.

03For spoken discourse, clinically significant changes favored AAC for increases in counted words, CIUs and T-Units, and a decrease in mazes.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

Only twelve participants completed the study, so the results cannot show how the treatment would work in a larger clinic population. The two groups received different treatments, so the study cannot separate the effect of the AAC device from narrative practice. The main behavioral tests did not show statistically significant group differences, and several positive findings came from secondary effect-size and responder analyses. Usual care was highly personalized and treatment fidelity was not sampled, making it hard to compare the two approaches directly. The fMRI task used verb generation, not connected speech, so it may not capture the brain changes most relevant to AAC discourse treatment.

The easy way to misread this

Do not conclude that high-tech AAC is proven superior to usual care. The main behavioral tests did not show statistically significant group differences, and the paper states that the changes cannot be directly attributed to the device.

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