Annette Ashin used to teach English at the University of Illinois, but she always thought of her husband, Ken, as the more articulate one of the pair. “I used to call him up when I was struggling to put a sentence together perfectly,” she says.
In December 2010, Ken Ashin, a former software engineer, had a stroke that left him with aphasia, a chronic language disorder marked by communication challenges in reading, writing, understanding language, and speaking.
“In the beginning he could hardly say three or four words,” says Annette. She researched Boston-area resources that could help Ken with rehabilitation and chose Sargent’s Aphasia Resource Center because it was “the most receptive, flexible, and welcoming of all the institutions that we explored,” she says.
For the next six years, Ken came to Sargent every couple of weeks to participate in an array of programs and studies designed to improve his language skills and advance our understanding of aphasia. In one ongoing three-year study—the Aphasia Conversation Treatment program led by Elizabeth Hoover, clinical director of the Aphasia Resource Center at Sargent—he helped researchers investigate the effectiveness of two types of conversation-based therapy.
In the study funded in part by a $500,000 grant from the National Institutes of Health (NIH), the first the NIH has awarded for group conversational treatment in aphasia, participants were divided into three groups: the first conversed in pairs moderated by a therapist; the second worked in larger groups, and the third did not participate in therapy (though they did receive treatment later). In both pairs and large groups, the participants worked on personalized skills like word retrieval and speaking in complete sentences.
“In [a] larger group where you have a broader range of opinions and topics…you can glean confidence and psychosocial support.” —Elizabeth Hoover
As a member of the group that worked in pairs, Ken partnered with a fellow study participant, who he credits as “a major catalyst” in his recovery, says Annette. “They were similar in a lot of ways. Both of them are iconoclastic, said what they thought, didn’t care what anybody else thought. So, they got along really well. The therapist let the conversation continue and facilitated.”
Hoover and the study’s coprincipal investigator Gayle DeDe (’02,’08), director of the Philadelphia Aphasia Community at Temple University, have just started analyzing the data. Their initial findings suggest that the participants who worked in pairs showed improvement in specific language skills such as repetition and verb naming, while participants who worked in large groups gained more confidence in functional communication, or how effectively they could perform daily tasks like reading signs in a grocery store and asking for directions.
“In the smaller groups you have more opportunity for conversational turns, so those language tasks—word retrieval, for example—tended to improve more strongly, but in the larger group where you have a broader range of opinions and topics in the conversation, you can glean confidence and psychosocial support,” says Hoover, a clinical associate professor of speech, language, and hearing sciences.
In both groups, the participants showed more improvement than those who did not receive treatment.
“I had noticed all along that Ken can say things spontaneously more successfully than when he’s pressured,” Annette says. “The therapy experience improved that spontaneous response to a situation. We learned not only from the research team and the therapists, but also from the other aphasia patients.”
Ken adds, “I appreciated it.”