A gamified aphasia intervention: playing naming and scenario games in teams improves language and wellbeing

Background: Aphasia rehabilitation faces serious challenges: 1. It needs to provide intensive therapy when national health resources are scarce; 2. It needs to maintain engagement when intensive practice with a speech and language therapist may be draining and possibly demotivating; 3. It needs to break negative interactions between lack of confidence and avoiding language practice. 4. It needs to demonstrate functional communication gains.

Aims: Our Gamified Aphasia INtervention based on Playing social games in Teams (GAIN-PT) addresses these challenges. We aimed to demonstrate GAIN-PT’s acceptability, in terms of engagement and satisfaction with therapy, and efficacy, in terms of increased ability to produce sententences and trained words.

Method and Procedure: Our study expands on a previous incarnation of this approach (Romani et al. 2019) by developing, along with a naming game, six scenario games where participants practised communicative interactions in common everyday scenarios. Two groups of six participants each played the games three times a week for 2 hours each time, over 8 weeks (for a total of 48 hours). Gains were assessed in terms of picture naming and narrative production. Assessment was carried out before therapy (5 participants assessed with two baselines one month apart), immediately after therapy, and at maintenance (two months after therapy). Each group was facilitated by one/two assistants thus reducing costs for professional SLT.

Results: Attendance and satisfaction with therapy were very high (88% of therapy hours attended) with participants stressing improvements, but also having fun and making friends. Confidence improved significantly when measured with a questionnaire. Retrieval of the practiced words improved significantly, both when assessed with therapy materials (14% improvement in picture naming at the end of therapy and 17% after maintenance, corresponding, respectively, to 33 and 43 words gained), and when measured in narrative production (5% improvement at the end of therapy and 12% after maintenance). Narrative production also showed a significant increase in number and percentage of relevant words produced (CIUs), and in number and length of sentences, and a significant reduction in the rate of errors.

Outcomes: We have demonstrated the benefits of GAIN-PT as a useful, additional tool for aphasia rehabilitation which widens options, addresses existing challenges, and results in optimal levels of engagement, language outcomes, and satisfaction with therapy. Playing games where people with aphasia can support each other and repeatedly practise speech in everyday life scenarios is a promising way to further aphasia rehabilitation.