A Novel Approach to Real-life Communication: Narrative Intervention in Aphasia

This study compares two groups of clients with aphasia, one receiving a novel speech pathology intervention and the other receiving usual speech pathology care. Participants in both groups will receive 20 sessions of intervention (400 treatment sessions in total). Sessions (approx. 1 hour duration) will be offered 4 x per week over a 5 week period. This is commensurate with length of stay at the local sites and realistic for community based intervention. A total of 200 therapy sessions will therefore be provided to the 10 participants in the experimental group, and 200 sessions to the control group (by the usual speech pathologist). For the experimental group, the intervention protocol will be developed following principles set out in Whitworth (2010), using a metalinguistic approach to increase awareness of both sentence and narrative structure. Beginning with narratives using picture sequences, the therapy will focus initially on identifying the main event/s in each picture, accessing the verb and the relevant nouns for each event, followed by creating a complete argument structure around each. A framework for narrative discourse, based on story grammar, will be introduced, and sentences organized around setting the scene (the beginning), the events taking place (the middle), and concluding the story (the end). More naturalistic situations will be introduced using a mind-mapping approach where diagrams are then used to retrieve and then link ideas, events, and words in a way that leads to the organization and planning of thoughts for subsequent production.