Skip to main content Accessibility help

The Aphasia Action, Success, and Knowledge Programme: Results from an Australian Phase I Trial of a Speech-Pathology-Led Intervention for People with Aphasia Early Post Stroke

  • Brooke Ryan (a1), Kyla Hudson (a1), Linda Worrall (a1), Nina Simmons-Mackie (a2), Emma Thomas (a1), Emma Finch (a1) (a3), Kathy Clark (a4) and Jennifer Lethlean (a4)...


Background: Speech pathologists work to optimise communication and reduce the emotional and social impact of communication disability in patients with aphasia but need evidence-based interventions to effectively do so.

Objective: This phase 1 study aims to evaluate an Australian speech-pathology-led intervention called the Aphasia Action, Success, and Knowledge (Aphasia ASK) programme for patients with aphasia early post stroke.

Methods: A convergent parallel mixed-methods design was utilised. The intervention included up to six individual face-to-face sessions with seven participants with aphasia and their nominated family member(s). Quantitative outcomes assessing mood, quality of life, and communication confidence were conducted for the participants with aphasia. Follow-up interviews were conducted with both participants with aphasia and family members to determine their perceptions of the programme.

Results: Significant improvements were found in communication confidence and mood after treatment and the gains were maintained at 3-month follow-up. Participants with aphasia and their family members reported a good level of satisfaction with the programme.

Conclusions: Findings suggest the Aphasia ASK programme is a suitable intervention with positive initial outcomes for people with aphasia. A larger scale evaluation with a greater variety of participants is now required. An Australian cluster randomised control trial is planned.


Corresponding author

Address for correspondence: Dr Brooke Ryan, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, 4072, Queensland, Australia. E-mail:


Hide All
Babbitt, E., Heinemann, A., Semik, P., & Cherney, L. (2011). Psychometric properties of the Communication Confidence Rating Scale for Aphasia (CCRSA): Phase 2. Aphasiology, 25 (6–7), 727735.
Bowen, D.J., Kreuter, M., Spring, B., Cofta-Woerpel, L., Linnan, L., Weiner, D., . . . Fernandez, M. (2009). How we design feasibility studies. American Journal of Preventive Medicine, 36 (5), 452457. doi:
Brock, K., Black, S., Cotton, S., Kennedy, G., Wilson, S., & Sutton, E. (2009). Goal achievement in the six months after inpatient rehabilitation for stroke. Disability and rehabilitation, 31 (11), 880886. doi: 10.1080/09638280802356179
Brown, K., Davidson, B., Worrall, L. and Howe, T. 2013. Making a good time: The role of friendship in living successfully with aphasia. International Journal of Speech-Language Pathology, 15 (2), 165175. doi:10.3109/17549507.2012.6928142
Brown, K., Worrall, L., Davidson, B., & Howe, T. (2010). Snapshots of success: An insider perspective on living successfully with aphasia. Aphasiology, 24 (10), 12671295.
Brumfitt, S.M., & Sheeran, P. (1999). The development and validation of the visual analogue self-esteem scale (VASES). British Journal of Clinical Psychology, 38 (4), 387400.
Chapey, R., Duchan, J., Elman, R., Garcia, L., Kagan, A., Lyon, J., & Simmons-Mackie, N. (2008). Life participation approach to aphasia: A statement of values for the future. In Chapey, R. (Ed.), Language intervention strategies in aphasia and related neurogenic communication disorders (pp. 279289). Philadelphia: Lippincott Williams & Wilkins.
Ch'Ng, A.M., French, D., & Mclean, N. (2008). Coping with the challenges of recovery from stroke: Long term perspectives of stroke support group members. Journal of Health Psychology, 13 (8), 11361146. doi: 10.1177/1359105308095967.
Code, C. (2003). The quantity of life for people with chronic aphasia. Neuropsychological Rehabilitation, 13 (3), 379390.
Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., & Petticrew, M. (2008). Developing and evaluating complex interventions: The new Medical Research Council guidance. BMJ, 337.
Creswell, J., & Clark, V. (2011). Designing and conducting mixed methods research (2nd ed.). Thousand Oaks, California: Sage Publications.
Cruice, M., Worrall, L., & Hickson, H. (2006). Perspectives of quality of life by people with aphasia and their family: Suggestions for successful living. Topics in Stroke Rehabilitation, 13 (1), 1424.
Donnellan, C., Hickey, A., Hevey, D., & O'Neill, D. (2010). Effect of mood symptoms on recovery one year after stroke. International Journal of Geriatric Psychiatry, 25 (12), 12881295.
Graneheim, U.H., & Lundman, B. (2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24 (2), 105112.
Grant, J.S., Elliott, T.R., Newman-Giger, J., & Bartolucci, A.A. (2001). Social problem-solving abilities, social support, and adjustment among family caregivers of individuals with a stroke. Rehabilitation Psychology, 46 (1), 4457.
Grawburg, M., Howe, T., Worrall, L., & Scarinci, N. (2013). Third-party disability in family members of people with aphasia: A systematic review. Disability and Rehabilitation, 35 (16), 13241341. doi:10.3109/09638288.2012.735341.
Grohn, B., Worrall, L., Simmons-Mackie, N., & Brown, K. (2012). The first 3-months post-stroke: What facilitates successfully living with aphasia? International Journal of Speech-Language Pathology, 2012, 14 (4), 390400.
Grohn, B., Worrall, L., Simmons-Mackie, N., & Hudson, K. (2014). Living successfully with aphasia during the first year post-stroke: A longitudinal qualitative study. Aphasiology, 28 (12), 14051425.
Hallowell, B., & Chapey, R. (2008). Introduction to language intervention strategies in adult aphasia. In Chapey, R. (Ed.), Language intervention strategies in aphasia and related neurogenic communication disorders (5th ed., pp. 319). Philadelphia: Lippincott Williams & Wilkins.
Hilari, K., Northcott, S., Roy, P., Marshall, J., Wiggins, R., Chataway, J., & Ames, D. (2010). Psychological distress after stroke and aphasia: The first six months. Clinical Rehabilitation, 24 (2), 181190.
Hoffmann, T., Glasziou, P., Boutron, I., Milne, R., Perera, R., Moher, D., . . . Michie, S. (2014). Better reporting of interventions: Template for intervention description and replication (TIDieR) checklist and guide. BMJ-British Medical Journal, 348, g1687.
Howe, T., Davidson, B., Worrall, L., Hersh, D., Ferguson, A., Sherratt, S., & Gilbert, J. (2012). ‘You needed to rehab . . . families as well’: family members’ own goals for aphasia rehabilitation. International journal of language & communication disorders, 47 (5), 511521. doi: 10.1111/j.1460-6984.2012.00159.x
Kagan, A. (1998). Supported conversation for adults with aphasia: Methods and resources for training conversation partners. Aphasiology, 12 (9), 816830.
Kang, H., Stewart, R., Kim, J., Jang, J., Kim, S., Bae, K., . . . Yoon, J. (2013). Comparative validity of depression assessment scales for screening post stroke depression. Journal of Affective Disorders, 147 (1–3), 186191.
Kauhanen, M.L., Korpelainen, J.T., Hiltunen, P., Määttä, R., Mononen, H., Brusin, E., . . . Myllylä, V. V. (2000). Aphasia, depression, and non-verbal cognitive impairment in ischaemic stroke. Cerebrovascular Diseases, 10 (6), 455461.
Kimbarow, M.L. (2007). Integrating life participation approaches to aphasia treatment with adult learning theory: A synergistic approach. Topics in Language Disorders, 27 (4), 318323.
Kirkevold, M., Bronken, B.A., Martinsen, R., & Kvigne, K. (2012). Promoting psychosocial well-being following a stroke: Developing a theoretically and empirically sound complex intervention. International Journal of Nursing Studies, 49 (4), 386397.
Kneebone, I. (2016). Stepped psychological care after stroke. Disability and rehabilitation, 38 (18), 18361843. doi: 10.3109/09638288.2015.1107764
Kutlubaev, M.A., & Hackett, M.L. (2014). Part II: Predictors of depression after stroke and impact of depression on stroke outcome: An updated systematic review of observational studies. International Journal of Stroke, 9 (8), 10261036.
Long, A., Hesketh, A., Bowen, A., & ACT NoW Research Study. (2009). Communication outcome after stroke: A new measure of the carer's perspective. Clinical Rehabilitation, 23 (9), 846856.
LPAA Project Group, Chapey, R., Duchan, J., Elman, R., Garcia, L., Kagan, A. . . Mackie, , , N. S. (2000). Life participation approach to aphasia: A statement of values. The ASHA Leader, 5 (3), 46.
National Stroke Foundation (2014). The National Stroke Audit Rehabilitation Services Report, Melbourne, Australia.
Northcott, S., Burns, K., Simpson, A., & Hilari, K. (2015). ‘Living with Aphasia the Best Way I Can': A Feasibility Study Exploring Solution-Focused Brief Therapy for People with Aphasia. Folia Phoniatrica et Logopaedica, 67 (3), 156167.
Parr, S., Byng, S., Gilpin, S., & Ireland, C. (1997). Talking about aphasia: Living with loss of language after stroke. Buckingham: Open University Press.
Paul, D., Frattali, C., Holland, A., Thompson, C., Caperton, C., & Slater, S. (2005). Quality of communication life scale. Rockville, MD: American Speech-Language-Hearing Association.
Pedersen, P., Jørgensen, H., Nakayama, H., Raaschou, H., & Olsen, T. (1995). Aphasia in acute stroke: Incidence, determinants, and recovery. Annals of Neurology, 38 (4), 659666.
Robey, R. (2004). A five-phase model for clinical-outcome research. Journal of Communication Disorders, 37 (5), 401411.
Sarno, M. (1997). Quality of life in aphasia in the first post-stroke year. Aphasiology, 11 (7), 665679.
Sekhon, J.K., Douglas, J., & Rose, M.L. (2015). Current australian speech-language pathology practice in addressing psychological well-being in people with aphasia after stroke. International Journal of Speech-Language Pathology, 17 (3), 252262.
Seligman, M.E.P., Steen, T.A., Park, N., & Peterson, C. (2005). Positive psychology progress: Empirical validation of interventions. American Psychologist, 60 (5), 410421.
Shadden, B. (2005). Aphasia as identity theft: Theory and practice. Aphasiology, 19 (35), 211223.
Simmons-Mackie, N., & Damico, J.S. (2011). Counseling and aphasia treatment: Missed opportunities. Topics in Language Disorders, 31 (4), 336351.
Sjöqvist Nätterlund, B. (2010). A new life with aphasia: Everyday activities and social support. Scandinavian Journal of Occupational Therapy, 17 (2), 117129.
Thomas, S., & Lincoln, N. (2008). Predictors of emotional distress after stroke. Stroke, 39 (4), 12401245.
Thomas, S. A., Thomas, S. A., Walker, M. F., Macniven, J. A., & Haworth, H. (2013). Communication and low mood (CALM): A randomized controlled trial of behavioural therapy for stroke patients with aphasia. Clinical Rehabilitation, 27 (5), 398408. doi: 10.1177/0269215512462227
Wade, D.T., Hewer, R.L., David, R.M., & Enderby, P.M. (1986). Aphasia after stroke: Natural history and associated deficits. Journal of Neurology, Neurosurgery & Psychiatry, 49 (1), 1116.
Whyte, J., Gordon, W., & Gonzalez Rothi, L.J. (2009). A phased developmental approach to neurorehabilitation research: The science of knowledge building. Archives of Physical Medicine and Rehabilitation, 90 (11), S3S10.
Zemva, N. (1999). Aphasic patients and their families: Wishes and limits. Aphasiology, 13 (3), 219224.
Zigmond, A. S., & Snaith, R.P. (1983). The hospital anxiety and depression scale, Acta Psychiatrica Scandinavica, 67, 361370.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed