Treatment Time and Treatment Selection in Aphasia: A Preliminary Study Using Vignettes.

Abstract

Little is known about the factors that clinicians use when selecting treatments. The purpose of this preliminary study was to explore a possible factor, available treatment time, in the aphasia treatment selection process. A case-based vignette survey was created using de-identified assessment data from the AphasiaBank database. Six vignettes varied by aphasia type and severity and were presented under two different treatment time alternatives: 7.5 or 60 hr. Respondents were asked to select the single treatment that they would "almost certainly use" under each treatment time scenario. Treatment options were obtained from the American Speech-Language-Hearing Association Practice Portal. Respondents also answered questions about their confidence level in administering the treatments and their primary reason for selecting a particular treatment for each case scenario. A total of 26 practicing speech-language pathologists with at least 5 years of clinical experience with aphasia completed the survey. A majority of respondents (76%-84%) changed the treatment they would "almost certainly use" based on a change in treatment time availability. The most frequently given reason for the overall treatment selection was that the treatment was likely to produce a functional outcome. Neither the respondents' reported confidence levels nor their years of experience were related to treatment selection. This is one of the first studies to investigate how clinicians select aphasia treatment. Treatment time emerged as a consistent factor in selecting aphasia treatment in this preliminary study. Recommendations for next research steps are given. We suggest that aphasia treatment research be disseminated with clear information about required treatment time. https://doi.org/10.23641/asha.23646855.