The Benefits of Conversation Group Treatment for Individuals With Chronic Aphasia: Updated Evidence From a Multisite Randomized Controlled Trial on Measures of Language and Communication

Purpose: Aphasia is a communication disorder that affects up to 30% of stroke survivors. Insufficient access to communication services creates personal, social, and financial costs to people with aphasia (PwA), care partners, and the community. Group conversation treatment has the potential to improve communication and reduce social isolation in a cost-effective manner, but little is known about its critical ingredients. This multicenter randomized controlled trial examined the effects of conversation treatment and whether the pattern of changes on outcome measures differed when treatment was delivered in large groups compared to dyads. Method: One hundred four PwA were randomly assigned to a dyad, large group, or delayed control condition. Conversation group treatment was 1 hr, twice weekly, over 10 weeks. Individual communication goals were addressed within thematically oriented conversation treatment. To evaluate treatment effects, primary (Aphasia Communication Outcome Measure [ACOM]) and secondary outcome measures were examined at pretreatment, posttreatment, and 6 weeks posttreatment. Results: The ACOM did not show significant changes in the planned omnibus analyses. Post hoc analyses suggested that the large group, but not dyad, treatment condition showed a treatment effect on the ACOM from pre- to posttreatment. Both treatment conditions showed changes on a measure of naming, and the dyads also showed improvement on a measure of repetition. Conclusions: The study failed to show the effects of conversation treatment in the omnibus analysis, but there was evidence that conversation group treatment, delivered in a large group, is effective for people with chronic aphasia. This study also illustrated how manipulating the size of the group may alter the outcomes for individuals. The results of this study offer support for a cost-effective treatment option for PwA across the continuum of care. Supplemental Material: https://doi.org/10.23641/asha.28719578