Evaluating language-specific attention treatment and play attention in aphasia: standardized language, attention, functional communication, and P/FROM outcomes

Background Aphasia is a language disorder that can occur following stroke and is often accompanied by cognitive deficits, including impairments in attention, which may influence language processing and rehabilitation outcomes in some individuals. While Language-Specific Attention Treatment (L-SAT), a language-embedded attention intervention, and Play Attention (PA), a primarily nonlinguistic attention-training intervention incorporating biofeedback, have each shown potential benefits, no studies have compared their effects on standardized outcomes in the same cohort of people with aphasia (PWA).Aims This study explored the effects of L-SAT and PA on standardized language, attention, functional communication, and patient/family-reported outcomes (P/FROMs) in PWA. It was hypothesized that L-SAT would be associated with greater improvements in language, functional communication, and P/FROMs, whereas PA would be associated with greater improvements in attention outcomes.Methods & Procedures Four PWA (two with mild Anomic aphasia and two with Broca’s aphasia – one moderate and one very severe) completed both L-SAT and PA using a randomized crossover exploratory multiple-case design. Outcomes included standardized language (WAB, BNT, DCT), attention (TEA), functional communication (CADL-3), and P/FROM (ALA, RSAB) assessments, measured at baseline, immediately post-treatment, and at one-month follow-up.Outcomes & Results Both interventions were associated with improvements across language, attention, functional communication, and P/FROMs, although the magnitude and pattern of change varied across participants. Across participants, composite language scores and P/FROMs showed greater mean improvement following L-SAT, whereas attention outcomes showed greater mean improvement following PA. Functional communication outcomes showed a mixed pattern across participants.Conclusions Both interventions were associated with improvements across multiple outcome measures. Findings provide preliminary evidence that both language-embedded and nonlinguistic attention-training approaches may contribute to improvements across multiple domains, although the magnitude and pattern of response varied considerably across individuals, highlighting the importance of considering individual differences when evaluating treatment outcomes. Given the exploratory design and modest magnitude of the observed changes, future research should examine these approaches in larger samples with longer intervention periods to determine whether more robust and consistent treatment effects can be achieved.