Conversation Therapy for Aphasia

Not currently recruiting at 2 trial locations

Overseen By Gayle DeDe, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Boston University Charles River Campus

Disqualifiers: Neurological disease, Developmental disabilities, Cancer, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 3 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 24

Duration: 10 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a conversation therapy designed to assist individuals with aphasia, a condition affecting speech and communication, often due to a stroke. Researchers are examining whether group characteristics, such as size and composition, along with the severity of aphasia, influence the effectiveness of this therapy. Participants will engage in guided discussions on everyday topics to enhance communication skills. The trial seeks native English speakers who experienced a stroke at least six months ago and have been diagnosed with aphasia, without other serious medical conditions. As an unphased trial, it offers participants the chance to contribute to innovative research that could improve therapy options for aphasia.

Do I have to stop taking my current medications for the trial?

The trial protocol does not specify whether you need to stop taking your current medications. However, you must abstain from any concurrent speech language treatment.

Will I have to stop taking my current medications?

The trial protocol does not specify whether you need to stop taking your current medications. However, you will need to stop any concurrent speech language treatment while participating in the trial.

What prior data suggests that this conversation therapy is safe for people with aphasia?

Research has shown that conversation therapy for aphasia is generally safe and well-tolerated. In one study with 24 adults who had long-term aphasia, participants in group communication sessions showed significant improvements. No serious side effects were reported, indicating the treatment's safety for people with aphasia.

The therapy involves group sessions where participants discuss everyday topics like current events or travel. It aims to improve communication skills and is designed to be practical and supportive for everyone involved.

Some studies have also examined online versions of this therapy and found them easy to use, with participants reporting high satisfaction. This supports the idea that conversation therapy is a safe and promising option for those seeking to improve their speech and communication skills. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Conversation Therapy for Aphasia because it explores the impact of group dynamics on treatment outcomes, which is a fresh angle in aphasia rehabilitation. Traditional aphasia therapies often focus on one-on-one speech therapy sessions, but this approach looks at how group size and composition—like pairing individuals with similar or varying severities—can influence recovery. By investigating these variables, the trial aims to uncover more personalized and potentially more effective ways to improve communication skills in people with aphasia, offering hope for tailored interventions that go beyond standard care.

What evidence suggests that this trial's treatments could be effective for aphasia?

Research shows that conversation treatment can greatly improve communication for people with aphasia. Studies have found that group conversation sessions enhance language skills and quality of life. This trial will explore different approaches to conversation treatment. One arm will assess the treatment's efficacy in a delayed control group. Another arm will examine outcomes based on group size and aphasia severity, comparing large groups to dyads. A third arm will evaluate outcomes based on group composition, comparing homogeneous to heterogeneous groups. Although benefits can vary with group size, composition, and aphasia severity, the overall approach has shown positive results. ^{2 3 6 7 8}

Who Is on the Research Team?

Elizabeth Hoover, PhD

Principal Investigator

Boston University

Gayle DeDe, PhD

Principal Investigator

Temple University

Are You a Good Fit for This Trial?

This trial is for English-speaking adults with aphasia, a language disorder typically caused by stroke. They must be at least 6 months post-stroke and have enough understanding to join in conversations. The study includes all severity levels of aphasia but excludes those with other neurological diseases, developmental disabilities, or serious illnesses like cancer.

Inclusion Criteria

I have been diagnosed with difficulty in speaking or understanding language.

You need to be able to understand and take part in conversations, as shown by standardized tests for language difficulties.

I have severe difficulty speaking or understanding speech.

Exclusion Criteria

I have not had any neurological diseases, except for a stroke.

Participants will be asked to abstain from concurrent speech language treatment

I do not have any serious illnesses right now.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive conversation group treatment for aphasia in either large groups or dyads, facilitated by a speech pathologist focusing on everyday topics.

10 weeks

20 visits (in-person, twice per week)

Follow-up

Participants are monitored for changes in communication ability using the Aphasia Communication Outcome Measure and Comprehensive Aphasia Test.

12 weeks

Assessments at 4 weeks and 12 weeks post-treatment

What Are the Treatments Tested in This Trial?

Interventions

• Conversation Treatment for Aphasia

Trial Overview The study tests group conversation treatment's effectiveness on communication skills in people with aphasia. It examines how different group sizes (2 vs. 6-8 people) and compositions (similar vs. different types of aphasia), as well as the severity of aphasia, impact the treatment outcome.

How Is the Trial Designed?

Group I: Experimental: Group composition Experimental Treatment 1 Intervention

Outcomes will be measured for individuals who participate in homogeneous compared to heterogeneous groups (6-8 people with aphasia), based on aphasia severity (severe vs. mild-moderate aphasia).

Group II: Experimental: Group Size x Aphasia Severity Experimental Treatment 1 Intervention

Outcomes will be measured for individuals who participate in large group (6-8 group members) compared to dyads (2 group members), and whether this relationship differs as a function of aphasia severity (severe vs. mild-moderate aphasia).

Group III: Treatment efficacy: Delayed Control Group Active Control 1 Intervention

Treatment cycle 1 only.

Conversation Treatment for Aphasia is already approved in United States, European Union for the following indications:

Approved in United States as Conversation Treatment for Aphasia for:

• Aphasia

Approved in European Union as Group Conversation Treatment for Aphasia for:

• Aphasia
• Stroke-related Aphasia

Who Is Running the Clinical Trial?

Boston University Charles River Campus

Lead Sponsor

Trials

125

Recruited

14,100+

Temple University

Collaborator

Trials

321

Recruited

89,100+

Adler Aphasia Center

Collaborator

Trials

1

Recruited

160+

Published Research Related to This Trial

The study identified seven mechanisms of change in conversational behavior for people with aphasia, highlighting how therapy enhances skills, motivation, and opportunities for effective communication.

The findings provide valuable insights into the processes that facilitate behavioral change during conversation therapy, distinguishing between motivating change and embedding new strategies, which can inform future clinical practices and research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Identifying mechanisms of change in a conversation therapy for aphasia using behaviour change theory and qualitative methods. Johnson, FM., Best, W., Beckley, FC., et al.[2019]

In a 6-week group therapy program for three individuals with aphasia, only one participant showed significant improvement in communication skills, specifically in discourse ratings, while the other two showed no notable changes.

The study suggests that the group treatment format may not be effective for enhancing linguistic abilities in people with aphasia, and highlights challenges in measuring improvements in connected speech.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An Exploration of the Impact of Group Treatment for Aphasia on Connected Speech. Mason, C., Nickels, L., McDonald, B.[2021]

In a study involving 48 participants with chronic aphasia, conversation group treatment significantly improved language impairment and quality of life compared to a delayed control group, indicating its efficacy.

The results suggested that smaller dyad groups were more effective for improving language impairment, while larger groups were better for enhancing functional communication and discourse production, highlighting the importance of group dynamics in treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Two to Tango or the More the Merrier? A Randomized Controlled Trial of the Effects of Group Size in Aphasia Conversation Treatment on Standardized Tests. DeDe, G., Hoover, E., Maas, E.[2020]

A sociolinguistic analysis of group therapy for aphasia involving eight adults showed that therapy can effectively enhance both communication skills and personal identity through supportive discourse.

Key elements of successful identity negotiation in therapy included ensuring group members felt 'heard', promoting their competence, fostering group solidarity, and managing interactions to support positive personal identities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Negotiation of identity in group therapy for aphasia: the Aphasia Café. Simmons-Mackie, N., Elman, RJ.[2016]

In a 4-month study involving 24 adults with chronic aphasia, those who received group communication treatment showed significant improvements in both communicative and linguistic performance compared to those who did not receive treatment.

Participants demonstrated notable progress after just 2 months of treatment, and their improvements were maintained even after a follow-up period without treatment, indicating the lasting benefits of the intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The efficacy of group communication treatment in adults with chronic aphasia. Elman, RJ., Bernstein-Ellis, E.[2022]

Both individual and group therapy significantly improved language abilities in aphasic patients after a left hemisphere stroke, indicating that both treatment methods are effective.

Individual treatment led to better overall performance on the Porch Index of Communicative Ability compared to group therapy, although no significant differences were found on other language measures, suggesting that while individual therapy may have advantages, both approaches are beneficial.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Veterans Administration cooperative study on aphasia: a comparison of individual and group treatment. Wertz, RT., Collins, MJ., Weiss, D., et al.[2019]

In a randomized controlled trial with 48 participants with chronic aphasia, conversation group treatment improved certain aspects of monologic discourse, particularly in the complete utterance (CU) method, after 10 weeks of treatment.

However, the primary outcome measure, percent correct information units (CIUs), did not show significant changes, indicating that while conversation treatment may enhance the overall amount of language produced, it does not necessarily improve the efficiency of language production.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Randomized Controlled Trial of the Effects of Group Conversation Treatment on Monologic Discourse in Aphasia. Hoover, E., DeDe, G., Maas, E.[2023]

This review organized 30 studies on conversation therapy for aphasia into a comprehensive taxonomy, highlighting various approaches such as treatment participants, guiding orientations, and service delivery methods.

It identified significant gaps in the literature, particularly regarding one-on-one conversation therapy for individuals with aphasia, and emphasized the need for valid measures of natural conversation and high-quality research in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Conversation therapy for aphasia: a qualitative review of the literature. Simmons-Mackie, N., Savage, MC., Worrall, L.[2022]

Telepractice conversation treatment for people with aphasia led to significant improvements in language function, particularly in tasks like repetition and picture description, compared to no treatment.

While both telepractice and in-person conversation groups showed benefits, the in-person treatment resulted in greater improvements across more outcome measures, suggesting that in-person interactions may be more effective for language recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of Aphasia Group Conversation Treatment via Telepractice on Language and Patient-Reported Outcome Measures. Dunne, M., Hoover, E., DeDe, G.[2023]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/37487551/

Efficacy of Aphasia Group Conversation Treatment via ... This study investigated the effects of telepractice group conversation treatment on standardized measures of language function and socially oriented/patient- ...

2. pubs.asha.org pubs.asha.org/doi/10.1044/2025_AJSLP-24-00279

The Benefits of Conversation Group Treatment for ... Group conversation treatment has the potential to improve communication and reduce social isolation in a cost-effective manner.

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10721252/

Efficacy of Aphasia Group Conversation Treatment via ... Conversation treatment for people with aphasia (PwA) can lead to significant changes in language impairment and quality of life.

4. clinicaltrials.gov clinicaltrials.gov/study/NCT05113160

Conversation Group Treatment for Aphasia: Does it Work? The proposed research will test the efficacy of group conversation treatment for people with aphasia and explore whether the effects of treatment differ as ...

5. pubs.asha.org pubs.asha.org/doi/10.1044/2022_AJSLP-22-00011

Conversation as an Outcome of Aphasia Treatment The review summarizes the various tools and procedures used to measure conversation as an outcome of aphasia intervention.

6. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/40209074/

The Benefits of Conversation Group Treatment for Individuals ... Conclusions: The study failed to show the effects of conversation treatment in the omnibus analysis, but there was evidence that conversation ...

7. withpower.com withpower.com/trial/phase-aphasia-2022-7c51e

Conversation Therapy for Aphasia · Info for Participants In a 4-month study involving 24 adults with chronic aphasia, those who received group communication treatment showed significant improvements in both ...

8. pubs.asha.org pubs.asha.org/doi/10.1044/2025_PERSP-24-00258

Game-Based Group Therapy for People With Aphasia Results: Game-based therapy was easy to implement in an online group setting. Adherence and satisfaction were high. Quality of life and language scores did not ...