title: Constraint Induced Aphasia Therapy: Volunteer-led, unconstrained and less intense delivery can be effective.
abstract: BACKGROUND
  Constraint Induced Aphasia Therapy (CIAT) has been shown to be effective in the treatment of aphasia, but clinicians have expressed concern regarding how far CIAT is practical to implement in clinical practice.
  
  
  OBJECTIVE
  To determine whether CIAT delivered in a less-intense, lower dose, reduced constraint and volunteer-led format could produce positive outcomes in people with chronic aphasia.
  
  
  METHODS
  Two groups were run, each with two people with chronic aphasia. Treatment involved a standard CIAT card-exchange game, supplemented by a home activity. Spoken language was required for responses but alternative modalities of communication were also permitted. Each group was led by a trained volunteer, lasted 90 minutes and was delivered twice a week for four weeks.
  
  
  RESULTS
  Three of the four participants showed significant improvements in target word retrieval following treatment. No significant improvements were observed for untreated stimuli or language tasks. Two participants showed increases in the elaboration of their responses, and the same two showed an increase in the frequency with which they engaged in communication activities.
  
  
  CONCLUSIONS
  Clear gains in performance were observed for the majority of people with aphasia who participated in a less intense format, considerably lower dose and less constrained form of CIAT led by trained volunteers. This suggests that this 'clinically realistic' service delivery model for CIAT could be added to the clinical repertoire of speech pathologists.
authors.affiliation: ARC Centre of Excellence in Cognition and Its Disorders (CCD), Department of Cognitive Science, Macquarie University, Sydney, NSW, Australia.
authors.forename: Lyndsey
authors.initials: L
authors.lastname: Nickels
authors.affiliation: Department of Speech Pathology, Royal Rehabilitation Centre Sydney, Sydney, NSW, Australia.
authors.forename: Amanda
authors.initials: A
authors.lastname: Osborne
mesh_terms: D000328:Adult; D000368:Aged; D001037:Aphasia / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D007807:Language Tests; D007808:Language Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010364:Pattern Recognition, Visual / Q000502:physiology; D011897:Random Allocation; D016896:Treatment Outcome; D014838:Volunteers / Q000523:psychology*
keywords: Aphasia; constraint induced aphasia therapy; group treatment; rehabilitation; volunteer