FAQs for Professionals – Intensive Aphasia Therapy
1. Why should my client participate in intensive aphasia therapy?
Intensive rates of aphasia therapy have been repeatedly shown to yield larger treatment effects than non-intensive rates. ASHA’s (American Speech-Language-Hearing Association) Position Statement on Evidence-Based Practice (2005) states that we must provide services consistent with the best evidence available. To read ASHA’s Policy statement and related documents, go to www.asha.org, click on the “ASHA Members” drop-down menu along the top, and open “Evidence-Based Practice”. From the Evidence-Based Practice page, you can also search the Evidence-Based Practice Compendium for standards, guidelines, and systematic reviews on evidence associated with aphasia rehabilitation.
2. What is “intensive” therapy?
A range of weekly rates of therapy have been described as “intensive”. At least five hours of treatment weekly seems to be an agreed upon minimum. Most programs described as “intensive” offer 10-20 hours of treatment weekly. The exact rate of therapy to produce the best effect has not yet been systematically investigated.
3. Why does intensive aphasia therapy typically produce good outcomes?
Intensive treatment exploits at least three important principles of learning and behavior change. First, massed practice (multiple repetitions close together in time) produces generally better and more robust outcomes for many skills than distributed practice. Second, intensive rates of treatment are typically delivered with multiple clinicians, enhancing transfer across communication partners and contexts. Thirdly, time is available to address a number of communication skills simultaneously and thoroughly.
A supplementary benefit of any organized aphasia program is the potent effect of peer support and social interaction. Social support has a documented strong positive effect on stroke outcomes.
4. Who is a good candidate for intensive therapy?
Not every person with aphasia is a good candidate. There is very little scientific evidence about candidacy for intensive treatment. Based on the existing evidence and clinical expertise, a good candidate is someone who has a predominant language disorder (not a predominant cognitive disorder), who is medically stable, and who has the physical, psychological, and cognitive endurance to participate in four hours of therapy daily.
5. What do you need for a referral?
We will contact any referring professional to gather relevant reports or background information, contingent on the client’s authorization. We will send a complete report of progress and treatment procedures to you according to the client’s authorization as well, so that you may continue to follow the client after their course of intensive treatment, if desired.
6. Does insurance cover intensive treatment?
We are not a Medicare provider, and Medicare beneficiaries will be informed that Medicare will not cover the costs of services at our facility.
Individuals with benefits for outpatient speech-language pathology services may have some services covered, depending on policy details. Contact our office for more information.
7. What if my client may not be able to tolerate 20 hours of therapy weekly?
After July 15, non-intensive aphasia services will also be available at our Center. Contact us to get details.
8. Should my client participate in intensive treatment as soon as possible, or can treatment be deferred and still produce good outcomes?
Most studies of the effects of intensive treatment have involved individuals with chronic aphasia (6 months or more post onset, up to 10 years post onset). These studies have shown very positive results of the intensive treatment. The existing literature suggests that waiting until a client is ready will not decrease the potential for positive outcome of the intensive regimen.
9. Are students performing services?
Students operate in a peripheral manner and will not directly treat clients.
