Speech therapy and aphasia rehabilitation in New Zealand hospitals

Participants will receive "Individualised, Comprehensive Aphasia Treatment". This treatment protocol has been created for the study and involves 1:1 speech-language therapy sessions, group therapy sessions (of 2 or more participants), education (on aphasia), and a supplementary home exercise programme. Content: Content has been derived from evidenced-based practice, clinical guidelines and best practice recommendations for aphasia. All sessions (1:1, group and education sessions) will follow the hui process (see Lacey et al., 2011, The Hui Process: a framework to enhance the doctor– patient relationship with Maori, The New Zealand Medical Journal, 124, 72-78 for an overview). Kaupapa (treatment) will include a selection of evidence-based approaches that are relevant and meaningful for the individual participant’s goals. Education sessions will cover topics such as an overview of what aphasia is, common challenges, and conversation repair strategies. Supplementay exercise programmes may include: paper-based worksheets or use of computer programmes/apps to support evidence-based treatments, and/or practical transfer tasks. Delivery agent: 50% of input will be delivered by a speech-language therapist with >5 years of experience working aphasia. 50% will be delivered by final year speech-language therapy students, who have completed course work in aphasia and an orientation programme created for the study, under the supervision of a speech-language therapist with >5 years of experience working with people with aphasia and supervising students. Delivery mode: The mode delivery is face-to-face, with a combination of 1:1 and group therapy. Intensity: The treatment will be provided over 2 weeks, with 10 x 1:1 treatment sessions (5 times a week for 2 weeks) and 2 group sessions (once per week for 2 weeks). 1:1 sessions , education sessions and group sessions will be approximately 45 minutes each. Home exercise programme nd may include: paper-based worksheets or use of computer programmes/apps to support evidence-based treatments, and/or practical transfer tasks will provide an additional 15 minutes or more of daily language exercises. Location: The intervention will occur in hospital during inpatient admissions. Adherence: Adherence will be assessed with the use of checklists for attendance and content of sessions. Allocation: participants will be allocated to a condition (treatment or control) based on location of enrolment, with one site providing the treatment condition and the other providing ‘usual care’ as below. Different from usual care: the major differences between the treatment condition and the control condition in this study include increased intensity of input in the treatment condition, the utilisation of group therapy, and the group education sessions.