The Effects of Multimodal Communication Treatment With Discourse and Group Activities via Telepractice on People With Severe Nonfluent Aphasia: A Case Study.

PURPOSE: Nonfluent aphasia can be characterized by prominent difficulty with speech production. Compensatory and functional aphasia treatments, including multimodal communication treatment (MCT), have been highlighted for their support of life participation because they aim to circumvent spoken language difficulties through use of other modalities. The current study explored an expanded version of MCT, by including a discourse task and group activities on telepractice (MCT with discourse and group activities via telepractice [teleMCT+DG]) to mirror daily communication and improve communication success for people with severe nonfluent aphasia.

METHOD: Two participants with severe aphasia participated in teleMCT+DG for 10 weeks (two individual and one group treatment sessions per week) to practice five communication modalities (speaking, writing, drawing, gesturing, and using a communication book) during a story generation task. Participants' success of modality production for target items during the story generation task was analyzed.

RESULTS

Participant 1 with Broca's aphasia demonstrated a trend of increasing his communication using nonspoken modalities during story generation. Participant 2 with global aphasia demonstrated evidence of improving his nonspoken communication skills during story generation, which helped improve the success of his communication.

CONCLUSIONS

The common trend from the two participants suggested positive evidence of increased success driven by the successful use of nonspoken modalities. This study supported the benefits of training compensatory strategies (multimodal communication) to improve communication success in people with nonfluent aphasia, though further research is needed to identify modifications for specific aphasia profiles.