Background: There is an urgent need for treatment comparison studies for chronic aphasia. Two different treatments, Constraint-Induced Aphasia Therapy Plus (CIAT Plus) and Multi-Modality Aphasia Therapy (M-MAT) aim to improve spoken language production through intensive shaping of responses, and social-mediated repetitive practice. CIAT Plus constrains responses to the verbal modality, while M-MAT includes gesture, drawing, writing and reading-based cues to assist production. Aims: This Phase 1 study compared the efficacy of CIAT Plus and M-MAT. The study also aimed to investigate the relationship between treatment responsiveness and participant's aphasia severity and cognitive variables. Methods & Procedures: We utilised 11 single-subject multiple baseline designs with a cross-over for treatment type. Participants had chronic aphasia (17–88 months post onset) and a range of aphasia severities (WAB AQ 36.2–92.8). Participants named 180 noun and verb probes three times at pre-, mid-, post-treatments and at 1- and 3-month follow-ups. Both CIAT Plus and M-MAT were delivered for 32 hours over 2 weeks. Six participants received M-MAT first while five received CIAT Plus first. Standard case charts were developed for visual analysis of each participant's probe results. Within-subject effect sizes (ESs) were calculated on naming the probe scores. Discourse measures were analysed with descriptive statistics. Participant's satisfaction with each treatment type was probed. Results & Conclusions: A total of 32 (of 44 total) immediate post-treatment ESs reached small (3), medium (7) or large (22) levels, and ranged from –0.96 to 30.6. Higher ESs were found for nouns as compared to verbs, and for items treated during the first treatment phase. The mean ES was comparable for items treated with M-MAT (M = 8.00) and CIAT Plus (M = 8.58) and was well maintained at the 1-month follow-up. As a group, aphasia severity was significantly reduced at the 1-month and 3-month follow-up time points. WAB AQ change scores immediately post-treatment favoured M-MAT for four participants and CIAT Plus for five; however, order effects are likely to have played a significant role. Treatment potency was demonstrated with generalisation to noun (8 participants) and verb production (1 participant) in discourse. Overall , CIAT Plus and M-MAT were equally efficacious for these 11 individuals, although six participants expressed preference for M-MAT and three for CIAT Plus. Delayed treatment effects were present in some participants. Future large-scale studies are required to deal with order effects and a participant's variability.

Social isolation is a key concern for individuals with dementia in long-term care. A possible solution is to promote social interaction between residents. A first step toward facilitating positive relationships between residents with dementia is to understand the mechanisms behind their interactions with each other, and also how their relationships with each other are built through such interactions. Drawing on casual conversations between residents in a special care unit for dementia, this paper uses systemic functional linguistics to examine how people with dementia use language to enact and construct their role-relations with each other. Results suggest people with dementia are able and willing conversationalists. However, factors such as the extent of communication breakdown and compatibility of the interlocutors may influence whether positive relations develop or not. Casual conversation is suggested to be a promising activity to encourage positive interpersonal processes between individuals with dementia in residential care.

Objectives: To determine whether allied health interventions delivered using telehealth provide similar or better outcomes for patients compared with traditional face-to-face delivery modes. Study design: A rapid systematic review using the Cochrane methodology to extract eligible randomized trials. Eligible trials: Trials were eligible for inclusion if they compared a comparable dose of face-to-face to telehealth interventions delivered by a neuropsychologist, occupational therapist, physiotherapist, podiatrist, psychologist, and/or speech pathologist; reported patient-level outcomes; and included adult participants. Data sources: MEDLINE, CENTRAL, CINAHL, and EMBASE databases were first searched from inception for systematic reviews and eligible trials were extracted from these systematic reviews. These databases were then searched for randomized clinical trials published after the date of the most recent systematic review search in each discipline (2017). The reference lists of included trials were also hand-searched to identify potentially missed trials. The risk of bias was assessed using the Cochrane Risk of Bias Tool Version 1. Data Synthesis: Fifty-two trials (62 reports, n = 4470) met the inclusion criteria. Populations included adults with musculoskeletal conditions, stroke, post-traumatic stress disorder, depression, and/or pain. Synchronous and asynchronous telehealth approaches were used with varied modalities that included telephone, videoconferencing, apps, web portals, and remote monitoring, Overall, telehealth delivered similar improvements to face-to-face interventions for knee range, Health-Related Quality of Life, pain, language function, depression, anxiety, and Post-Traumatic Stress Disorder. This meta-analysis was limited for some outcomes and disciplines such as occupational therapy and speech pathology. Telehealth was safe and similar levels of satisfaction and adherence were found across modes of delivery and disciplines compared to face-to-face interventions. Conclusions: Many allied health interventions are equally as effective as face-to-face when delivered via telehealth. Incorporating telehealth into models of care may afford greater access to allied health professionals, however further comparative research is still required. In particular, significant gaps exist in our understanding of the efficacy of telehealth from podiatrists, occupational therapists, speech pathologists, and neuropsychologists. Protocol Registration Number: PROSPERO (CRD42020203128).

Social isolation in dementia is a growing concern as the incidence and prevalence of dementing conditions is on the rise in many societies. Positive social interactions, which foster the construction and enactment of positive interpersonal relationships and therefore positive discursive identities, make an important contribution to emotional well-being. In this article, we investigate how two women diagnosed with dementia of the Alzheimer's type use language to relate to each other and two visiting graduate students. We use Systemic Functional Linguistics as an analytical framework, specifically investigating the use of vocatives and naming, and conversational moves and exchanges.

Background: At present, there is no consensus regarding the comparative efficacy of constraint and non-constraint treatments. Moreover, studies to date have measured the effects of treatment using single-word confrontation naming tasks and omnibus aphasia batteries. Aims: We applied reliable communicative measures of lexical and communicative behaviours to investigate the comparative impact of multi-modality aphasia therapy (M-MAT) and constraint-induced aphasia therapy plus (CIAT Plus) on three discourse genres. Methods & Procedures: Thirteen people with chronic aphasia each participated in 2 weeks of intensive CIAT Plus and 2 weeks of intensive M-MAT (30 hours over 2 weeks). Seven participants undertook CIAT Plus first, while six undertook M-MAT first. Discourse samples from three conditions were collected (picture description, Cinderella story retell and semi-structured conversation) at three time points (pre-treatment, post-CIAT Plus and post-M-MAT). Primary outcome measures included lexical measures (total words, words per minute) and communication measures (total correct information units (CIUs), CIUs per minute). Outcomes & Results: Results varied considerably within and across participants and also across the three discourse conditions. Furthermore, changes in both positive and negative directions were evident throughout the data set. There was a slight trend for better outcomes from CIAT Plus for individuals with mild aphasia and from M-MAT for individuals with moderate aphasia. Conclusions: In order to inform clinical practice and facilitate treatment planning and evaluation, further research is essential to continue to develop reliable discourse measures; to reach consensus on what constitutes “meaningful change” within discourse data and to take steps to mitigate against the variability inherent within discourse.