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Constraint-Induced Language Therapy

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Kristin Knight

on 6 December 2013

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Transcript of Constraint-Induced Language Therapy

Constraint-Induced Language Therapy (CILT)
CILT Method (cont.)
Shaping: cards become more complex across training sessions requiring players to use more advanced verbal communication to request cards.
Initially, all relevant utterances are accepted, but utterances are gradually constrained by explicit rules formulated by the therapist and by shaping and modeling.
Reinforcement: given when patients use a request/response that corresponds to their response level.
Performance levels can vary within a group
Patients are encouraged to activate his/her upper level of language skills
Three Main Principles of CILT
Massed practice (repetition & intensity)
Constraint of the communication mode used (speech only)
Forced use of spoken language in communication activities
Neural Plasticity & CILT
Principles of Experience-Dependent Neural Plasticity: Implications for Rehabilitation After Brain Damage
(Kleim & Jones, 2008)
10 Principles of Plasticity (Kleim & Jones, 2008)
Principle #4 - Repetition
Principle #5 - Intensity
Induction of plasticity requires sufficient repetition and sufficient training intensity
CILT Method
Massed practice of language exercises (3-4 hours per day)
Duration: 10 days
Participants: 2-3 patients + 1-2 therapists
Activity: structured card game using 32 cards (16 pairs)
Mode of communication: spoken words or sentences
Task: player 1 picks one card and explicitly addresses another co-player to request a card with the object shown; co-player determines if he/she has the card and either gives player 1 the card or explicitly denies the request.
Theoretical Origins of
Constraint-Induced Language Therapy
Based on principles of Constraint-Induced Movement Tx
Unaffected limb restrained to facilitate use of affected limb (i.e. hemiparetic arm)
Tx of used with patients who have limb impairment as the result of a stroke
Positive results from CIMT prompted researchers to determine if similar benefits can be reached in other domains using Constraint-Induced tx
Pulvermuller et al. 2001
PICO Question
Do adults with chronic moderate-severe aphasia
using Constraint-Induced Language Therapy
as compared to traditional approaches or
approaches which allow non-verbal communication
increase their communicative effectiveness after intervention with CILT?
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