The impact of a university-based intensive comprehensive aphasia programme (ICAP) on language, functional communication and quality of life in people with chronic aphasia

Abstract

ABSTRACT Background Intensive Comprehensive Aphasia Programmes (ICAPs) are increasingly considered the preferred option for high intensity aphasia rehabilitation. This is due to the emerging evidence that shows the potential of the programme to improve language impairment as well as psychosocial wellbeing and quality of life (QoL) in persons with chronic aphasia. Aims The aim of the study was to investigate whether a university-based, student-led, online ICAP led to measurable improvements in language, functional communication and QoL in persons with aphasia (PwAs). Methods & Procedures Eleven PwAs (six women, five men; M age = 60.4 years; M time post onset = 14.6 months) participated in a 10-week ICAP that provided 36 hours of treatment in total. Outcome measures relating to language impairment, functional communication and QoL were administered before and after the ICAP and included a range of subtests of the Comprehensive Aphasia Test (CAT) and the Communication Activities of Daily Living – second edition (CADL-2), the Assessment for Living with Aphasia (ALA), the Aphasia Impact Questionnaire (AIQ-21) and the Communication Outcomes after Stroke Scale (Carer COAST). Pre- and post-ICAP performances were tested for significance using Wilcoxon signed-rank tests. In addition, effect sizes were calculated. Outcomes & Results Post-ICAP, significant gains occurred in the CAT subtests of auditory and reading comprehension as well as naming objects, with large effect sizes being noted for the subtests of reading comprehension and naming objects. Significant changes were also observed between the pre- and post-assessment scores for the AIQ-21 and the Carer COAST, whereby the latter yielded large effect sizes. By contrast, CADL-2 and ALA scores did not change significantly as a result of the ICAP intervention. Conclusions Results indicate that the ICAP effectively improved participants’ language and functional communication skills, as well as QoL for both PwAs and their communication partners. Findings further indicate that a student-led ICAP implemented in a university setting can be considered a viable and pragmatic solution to offering ICAPs to achieve the high intensity needed to effect positive changes in communication.