Stephen J Page1, Sarah E Wallace2. 1. School of Health and Rehabilitation Sciences, The Ohio State University Wexner Medical Center, Columbus, Ohio B.R.A.I.N. (Better Rehabilitation and Assessment for Improved Neuro-recovery) Laboratory, The Ohio State University Wexner Medical Center, Columbus, Ohio. 2. Department of Speech Language Pathology, Duquesne University, Pittsburgh, Pennsylvania.
Abstract
BACKGROUND: Constraint-induced language therapy (CILT) has received recent attention as a possible intervention to improve expressive language in people with nonfluent aphasia. Difficulties have been reported with the practical implementation of constraint-induced movement therapy due to its intensive treatment parameters. It remains unknown whether similar challenges may exist with CILT. OBJECTIVE: To determine the opinions of speech-language pathologists (SLPs) about CILT for people with nonfluent aphasia. METHOD AND PROCEDURES: One hundred sixty-seven SLPs completed an electronic survey assessing their opinions of various aspects of CILT. OUTCOMES AND RESULTS: Over 60% of participants felt that people with aphasia would be very unlikely or somewhat unlikely to adhere to CILT. The majority felt that people with aphasia would hold high or moderate concerns with the number of hours spent in therapy (high, 41.8%; moderate, 31.4%), the number of days spent in therapy (high, 44.4%; moderate, 24.8%), likelihood for managed care reimbursement (high, 74.8%; moderate, 15.2%), and other logistical issues (high, 39.2%; moderate, 30.7%). With respect to providing CILT, participants cited the number of hours of therapy (high, 37.3%; moderate, 21.6%) and the number of consecutive days of therapy (high, 29.4%; moderate, 20.3%) as concerns. There were 70.6% who indicated that their facilities lacked resources to provide CILT, and 90.9% felt that most facilitates do not have the resources to provide CILT. CONCLUSIONS: Some SLPs hold significant concerns with the administration of CILT, particularly related to its dosing and reimbursement parameters. Additional work is needed to investigate the issues that were identified in this survey using qualitative methods with SLPs and people with aphasia and to examine modified CILT protocols.
BACKGROUND: Constraint-induced language therapy (CILT) has received recent attention as a possible intervention to improve expressive language in people with nonfluent aphasia. Difficulties have been reported with the practical implementation of constraint-induced movement therapy due to its intensive treatment parameters. It remains unknown whether similar challenges may exist with CILT. OBJECTIVE: To determine the opinions of speech-language pathologists (SLPs) about CILT for people with nonfluent aphasia. METHOD AND PROCEDURES: One hundred sixty-seven SLPs completed an electronic survey assessing their opinions of various aspects of CILT. OUTCOMES AND RESULTS: Over 60% of participants felt that people with aphasia would be very unlikely or somewhat unlikely to adhere to CILT. The majority felt that people with aphasia would hold high or moderate concerns with the number of hours spent in therapy (high, 41.8%; moderate, 31.4%), the number of days spent in therapy (high, 44.4%; moderate, 24.8%), likelihood for managed care reimbursement (high, 74.8%; moderate, 15.2%), and other logistical issues (high, 39.2%; moderate, 30.7%). With respect to providing CILT, participants cited the number of hours of therapy (high, 37.3%; moderate, 21.6%) and the number of consecutive days of therapy (high, 29.4%; moderate, 20.3%) as concerns. There were 70.6% who indicated that their facilities lacked resources to provide CILT, and 90.9% felt that most facilitates do not have the resources to provide CILT. CONCLUSIONS: Some SLPs hold significant concerns with the administration of CILT, particularly related to its dosing and reimbursement parameters. Additional work is needed to investigate the issues that were identified in this survey using qualitative methods with SLPs and people with aphasia and to examine modified CILT protocols.
Entities:
Keywords:
aphasia; constraint-induced language therapy; speech-language pathology; survey