Bridging the gap: can impairment-based therapy for anomia have an impact at the psycho-social level?

Background: Studies of therapy with people with aphasia tend to use impairment-based and functional measures of outcome. The views of participants are not formally evaluated. Current health and socialcare practice requires intervention to be explicitly client-centred and evidence-based. It is therefore important to investigate the broader effects of speech and language therapy. Aims: To explore the outcome of a therapy for anomia using the Communication Disability Profile (CDP), focusing particularly on participants' ratings of 'activity'. Methods & Procedures: Overall eight people with aphasia and their conversation partners participated in the study. There was a range of severity and type of aphasia. Following two baselines (at least 8 weeks apart), there were two phases of therapy for anomia each lasting 8 weeks. This first involved the use of spoken and written cues to aid word finding. The second encouraged the use of targeted words in connected speech and conversation. Eight weeks later, after no further therapy, participants were reassessed. Outcomes & Results: Participants' word finding in picture-naming improved significantly, as did their activity ratings. The relationship between the group's word-retrieval scores and CDP activity ratings over the course of the study tended towards significance, although there was considerable variation across individuals. Furthermore, all participants rated participation in activities requiring communication higher at the end than the start of the project. Conclusions: The findings suggest that therapy which targets word retrieval can have an impact on people with aphasia's views of their communicative activity and life participation. The findings support therapists' clinical insight that impairment-based interventions can effect change beyond scores on language tests.