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Temple Program Receives Pioneering NIH Aphasia Grant

Research Associate Professor Gayle DeDe and her team have been awarded a grant from the National Institutes of Health to investigate the effectiveness of conversational therapy for people with aphasia.

The three-year grant marks the first time the NIH has funded research on conversational treatment for aphasia, a chronic language disorder that can affect any aspect of communication.

“It feels like a huge milestone. I think it's something that [NIH has] wanted to do,” DeDe says.

Temple’s Department of Communication Sciences and Disorders is ideally suited for this type of study because it operates the Philadelphia Aphasia Community at Temple (PACT), which provides services to an active community of people with aphasia. The study will include 48 people with aphasia – a large number for a study like this, DeDe notes – at PACT and at Boston University, where DeDe completed her PhD in 2008. Her collaborator on the study is Elizabeth Hoover, clinical director of BU’s Aphasia Resource Center.

In addition to answering some basic questions about why conversation therapy is effective, the study will provide important evidence that may help conversation therapy to become an expense that insurance companies will reimburse.

Because aphasia is considered a chronic condition, people living with this condition may benefit from long-term treatment for both language skills and psychological and social support. “People living with aphasia are easily misperceived as having an intellectual disability, so socially, aphasia can be devastating and very isolating,” DeDe says.

Commonly presenting after a stroke (though it can happen after any kind of brain injury), aphasia can interfere with a person’s ability to speak, to comprehend language, to write, and to read. The most common symptom, DeDe says, is word-finding difficulty. Imagine those moments when you have a word on the tip of your tongue but you just can’t seem to locate it and get it out. “In aphasia that happens a lot more often,” she says. “It can happen every time a person wants to speak.”

Traditional therapy for aphasia occurs one-on-one, with a speech-language pathologist and a client practicing what are known as targets: those words which consistently trip up the client. Everyday vocabulary – the names of loved ones, items that come up in daily commerce such as coffee, phone, home – get the most attention. Target practice is effective up to a point, but the contrived setting doesn’t guarantee that clients won’t hit a wall outside the therapist’s office.

“If you know what somebody's target is, you can sort of backtrack. A conversation is unpredictable. People with aphasia can have a really hard time expressing themselves or understanding what others are saying,” DeDe says.

In conversation therapy, real-world interactions take place at a more relaxed pace in an environment set up to boost patients’ confidence along with their language skills. “When it’s working well, to the outside eye conversational treatment just looks like people talking,” DeDe says.

In reality, it’s a lot more sophisticated than that. Conversational treatment incorporates specific principles and practices to help each client work on their specific difficulties.

“I hope that we can show that we can generate meaningful changes using this method. And it's my hope that we can do this in a way that is reportable and replicable,” DeDe says. “Larger than that, my hope is that the people who participate in the study, and in these conversation groups, are able to show improvements in their language and in their quality of life.”

If you or someone you know has aphasia and may be interested in participating in this study, please contact Gayle DeDe at 215-204-2453 or gayle.dede@temple.edu.

Learn more about Temple’s Department of Communication Sciences and Disorders.  

Posted:  March 15, 2017