Journal article
Improving Language in Individual Conversation-Level Therapy: Group and Individual Results of ECoLoGiC Treatment for People With Moderate and Severe Aphasia
American journal of speech-language pathology, Vol.35(2), pp.476-499
03/2026
DOI: 10.1044/2025_AJSLP-25-00113
PMID: 41557843
Abstract
The aim of this study was to evaluate group- and individual-level impact of ECoLoGiC (Expanding Communication and Language Opportunities Generated in Conversation) Treatment (ECoLoGiC-Tx), an aphasia intervention aimed at improving conversational language. In addition, treatment fidelity for the speech-language pathologists (SLPs) who delivered treatment was evaluated, providing feasibility data to optimize successful future field implementation.
Ten people with moderate or severe aphasia completed 10 weeks of ECoLoGiC-Tx delivered twice weekly for 1 hr. Testing occurred at pretreatment, posttreatment, and at 6 weeks maintenance. Conversation/monologue samples were collected three times per testing phase. Group results were analyzed using linear mixed models. Individual data were analyzed using effect size and minimal detectable change criteria. Treatment fidelity was analyzed using an established 23-point checklist.
Robust results indicate generalization across measure types at group and individual levels. Participants improved their ability to convey meaning in conversation, the primary focus of ECoLoGiC-Tx. They demonstrated an average gain of 11.31 points on the Western Aphasia Battery-Revised (range: -1 to 21.5), and 7/10 participants shifted to a less impaired category of severity (e.g., from severe to moderate aphasia). Group-level change did not occur for reading, sentence construction in a picture task or in monologue, or Grammaticality in conversation/monologue. SLP fidelity was 97.3%.
Pilot study findings were replicated, with robust group and individual results. Exceptional improvements occurred for 9/10 participants. Results demonstrate generalization of skills to conversation and reduced aphasia severity for most participants. Deliverability of ECoLoGiC-Tx was evidenced by very high treatment fidelity by practicing SLPs, suggesting good potential for successful field implementation.
https://doi.org/10.23641/asha.30856571.
Details
- Title: Subtitle
- Improving Language in Individual Conversation-Level Therapy: Group and Individual Results of ECoLoGiC Treatment for People With Moderate and Severe Aphasia
- Creators
- Marion C Leaman - University of Kansas Medical CenterLisa A Edmonds - Columbia UniversityJacob J Oleson - University of IowaKristine N Williams - University of Kansas Medical Center
- Resource Type
- Journal article
- Publication Details
- American journal of speech-language pathology, Vol.35(2), pp.476-499
- DOI
- 10.1044/2025_AJSLP-25-00113
- PMID
- 41557843
- NLM abbreviation
- Am J Speech Lang Pathol
- ISSN
- 1058-0360
- eISSN
- 1558-9110
- Publisher
- American Speech-Language-Hearing Association
- Grant note
- School of Health Professions Pilot Grant from the University of Kansas Medical Center
Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award UL1TR002366 (awarded to Marion C. Leaman, PI; with Lisa A. Edmonds, Jacob J. Oleson, and Kristine N. Williams as Other Significant Contributors). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. In addition, this research was supported by the School of Health Professions Pilot Grant from the University of Kansas Medical Center (awarded to Marion C. Leaman, with Lisa A. Edmonds and Kristine N. Williams as consultants). The authors thank the participants and their families as well as the treating speech-language pathologists, namely, Jenna Brooks, Curtis Chapin, April Lee, and Alissa Potocnik, and the Research Assistants, namely, Saoirse Boyd, Brenna Brown, Josie Broxterman, Keela Bryant, Gabriella Daunarummo, Emma Davidson, Julia Edmondson, Abhinaya Ganesh, Olivia Johnson, Ishita Kapoor, Holly Maddalena, Sophia Mehnert, Megan Petersen, Karlie Pieper, Liz Santillan, Jacqueline Serati, Paige Simons, Julia Sitz, Rebecca Smuck, Alina Ward, and Lillie Weise.
- Language
- English
- Electronic publication date
- 01/20/2026
- Date published
- 03/2026
- Academic Unit
- Biostatistics; Nursing; Otolaryngology
- Record Identifier
- 9985130238002771
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