Stepped Care for Aphasia

Study Overview
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Brief Summary
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This study is recruiting people who had a stroke at least 1 month ago and now have a language impairment called aphasia. Living with aphasia can have devastating effects on communication and quality of life, and it is not uncommon for survivors with aphasia to face psychological problems like depression and anxiety. Participants who are eligible for this study will undergo baseline testing, engage in a 5-week treatment focused on psychological well-being, undergo post-treatment testing, and then testing again 1-month later. Check-in phone calls will be conducted during the 1-month off period and participants will be interviewed about their experience at the end of the study as well. Compensation will be provided to participants with aphasia.

Official Title
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Stepped Care Model of Psychological Care for Aphasia

Conditions
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Aphasia, Stroke

Intervention / Treatment
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* Behavioral: Psychosocial intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18-81 years old Native English speaker (English fluency by age 7) Aphasia as a result of a left-hemisphere ischemic or hemorrhagic stroke (WAB-R Aphasia Quotient < 93.8) At least 1-month post-stroke Confirmation of left hemisphere stroke per medical records Discharged from hospital Participant is willing and able to consent for themselves. Exclusion Criteria: Uncorrected hearing or visual impairment that prevents completion of experimental activities as determined by self-report History of other neurological disorder or disease beside stroke (e.g., dementia, traumatic brain injury) as determined by self-report and/or medical records Self-reported history of premorbid learning disability Severe auditory comprehension deficits (as indicated by a score of more than two standard deviations below norms on the Auditory Verbal section of WAB-R)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 81 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Psychosocial intervention<br> | Behavioral: Psychosocial intervention<br>* an SLP-administered 5-week treatment focused on psychological well-being<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in the Hospital Anxiety and Depression Scale at 1-Month Follow-Up | Change in the total depression and anxiety Hospital Anxiety and Depression Scale scores between baseline and at 1-month post-treatment. Minimum score 0, maximum score 21 for each scale. Higher scores mean a worse outcome. | through study completion, an average of 10 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Dynamic Visual Analogue Mood Scales at 1-Month Follow-Up | Total summary score (min: 0, max: 100, higher scores indicate better outcome) and sadness score (min: 0, max: 100, higher scores indicate better outcome) | through study completion, an average of 10 weeks | 
| Change in Stroke Aphasia Depression Questionnaire - 10 at 1-Month Follow-Up | Total score (min: 0, max: 30, higher scores indicate worse outcome) | through study completion, an average of 10 weeks | 
| Change in Behavioural Outcomes of Anxiety Scale at 1-Month Follow-Up | Total score (min: 0, max: 30, higher scores indicate worse outcome) | through study completion, an average of 10 weeks | 
| Change in Modified Perceived Stress Scale at 1-Month Follow-Up | Total score (min: 0, max: 40, higher scores indicate worse outcome) | through study completion, an average of 10 weeks | 
| Change in Stroke Aphasia Quality of Life - 39 at 1-Month Follow-Up | Total score (min: 1, max: 5), physical score (min: 1, max: 5), psychosocial score (min: 1, max: 5), and communication score (min: 1, max: 5), higher scores on all scales indicate better outcomes | through study completion, an average of 10 weeks | 
| Change in Communication Confidence Rating Scale for Aphasia at 1-Month Follow-Up | Total score (min: 10, max: 40, higher scores indicate better outcome) | through study completion, an average of 10 weeks |