Aphasia rehabilitation can target auditory comprehension

5.10 Aphasia rehabilitation can target auditory comprehension at the: 
● word level (e.g., auditory discrimination, lexical access, semantic access)
● sentence level
● above-sentence level.

References: Brady et al., 2016: Cochrane review; Fleming et al., 2021: RCT; The RELEASE collaborators, 2022a: Meta-analysis of 25 RCTs (959 IPD); Wallace et al., 2022: Scoping review of 28 studies (12 group studies, 11 SCEDs, 5 case studies)

NHMRC Level of Evidence: I 

Rationale: While the relative paucity of research on this topic should be noted (see e.g., Wallace et al., 2022), a meta-analysis shows evidence of benefit of speech and language therapy targeting auditory comprehension (the RELEASE collaborators, 2022a). This extends the findings of a previous Cochrane review which found no evidence of harm of such therapy (Brady et al., 2016). High dosage (20-50 hours), intensity (>9 hours/week), and frequency (4-5 days/week) are associated with the greatest gains (the RELEASE collaborators, 2022a). Based on the available evidence, there is not a specific treatment approach that is recommended for treating people with aphasia with auditory comprehension impairments (Wallace et al., 2022), however tailoring of difficulty (the RELEASE collaborators, 2022a) and treatment items, along with a higher dose of intervention (approximately 100 hours; Fleming et al., 2021) may be required.

Compensatory strategies for auditory comprehension (e.g., augmentative and alternative communication) may also be considered (see statement 5.14).

References:

1. Brady, M.C., Kelly, H., Godwin, J., Enderby, P., & Campbell, P. (2016). Speech and language therapy for aphasia following stroke. The Cochrane Database of Systematic Reviews, 6(6). DOI: 10.1002/14651858.cd000425.pub4
2. Brady, M.C., Kelly, H., Godwin, J., Enderby, P., & Campbell, P. (2016). Speech and language therapy for aphasia following stroke. The Cochrane Database of Systematic Reviews, 6(6). DOI: 10.1002/14651858.cd000425.pub4
3. The RELEASE collaborators. (2022a). Dosage, intensity and frequency of language therapy for aphasia: an individual participant data network meta-analysis. Stroke, 53(3). 956-967. DOI: 10.1161/STROKEAHA.121.035216
4. Wallace, S.E., Patterson, J., Purdy, M., Knollman-Porter, K. & Coppens, P. (2022). Auditory comprehension interventions for people with aphasia: A scoping review. American Journal of Speech-Language Pathology, 131(5S), 2404-2420. DOI: 10.1044/2022_AJSLP-21-00297