title: An enhanced protocol for constraint-induced aphasia therapy II: a case series.
abstract: OBJECTIVE
  The initial version of Constraint-Induced Aphasia Therapy (CIAT I) consisted of a single exercise. This study sought to evaluate the feasibility for future trials of an expanded and restructured protocol designed to increase the efficacy of CIAT I.
  
  
  METHODS
  The subjects were 4 native English speakers with chronic stroke who exhibited characteristics of moderate Broca's aphasia. Treatment was carried out for 3.5 hr/day for 15 consecutive weekdays. It consisted of 3 components: (a) intensive training by a behavioral method termed shaping using a number of expressive language exercises in addition to the single original language card game, (b) strong discouragement of attempts to use gesture or other nonverbal means of communication, and (c) a transfer package of behavioral techniques to promote transfer of treatment gains from the laboratory to real-life situations.
  
  
  RESULTS
  Participation in speech in the life situation improved significantly after treatment. The effect sizes (i.e., d') in this domain were ≥ 2.2; d' values ≥ 0.8 are considered large. Improvement in language ability on a laboratory test, the Western Aphasia Battery-Revised (Kertesz, 2006), did not achieve statistical significance, although the effect size was large--that is, 1.3 (13.1 points).
  
  
  CONCLUSIONS
  These pilot results suggest in preliminary fashion that CIAT II may produce significant improvements in everyday speech.
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Johnson
authors.forename: Edward
authors.initials: E
authors.lastname: Taub
authors.forename: Leslie H
authors.initials: LH
authors.lastname: Harper
authors.forename: Jamie T
authors.initials: JT
authors.lastname: Wade
authors.forename: Mary H
authors.initials: MH
authors.lastname: Bowman
authors.forename: Staci
authors.initials: S
authors.lastname: Bishop-McKay
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Haddad
authors.forename: Victor W
authors.initials: VW
authors.lastname: Mark
authors.forename: Gitendra
authors.initials: G
authors.lastname: Uswatte
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001039:Aphasia, Broca / Q000175:diagnosis / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods*; D001921:Brain / Q000473:pathology; D017028:Caregivers / Q000193:education; D015331:Cohort Studies; D003145:Communication Methods, Total; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007808:Language Therapy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011214:Practice, Psychological; D011594:Psychometrics; D013068:Speech Production Measurement; D013070:Speech Therapy / Q000379:methods*; D020521:Stroke / Q000150:complications; D014163:Transfer, Psychology