Metacognitive Strategy Training Is Feasible for People With Aphasia

Jessica Kersey, University of Pittsburgh, PA, USA.
William S. Evans, University of Pittsburgh, PA, USA.
Katie Mullen, University of Pittsburgh Medical Center, PA, USA.
Annette Askren, VA Puget Sound Health Care System, Seattle, WA, USA.
Robert Cavanaugh, University of Pittsburgh, PA, USA.
Sarah E. Wallace, Duquesne University, Pittsburgh, PA, USA.
William D. Hula, University of Pittsburgh, PA, USA.
Michael Walsh Dickey, University of Pittsburgh, PA, USA.
Lauren Terhorst, University of Pittsburgh, PA, USA.
Elizabeth Skidmore, University of Pittsburgh, PA, USA.


Metacognitive strategy training shows promise for reducing disability following stroke, but previous trials have excluded people with aphasia. Considering the high incidence of poststroke aphasia, it is important to determine whether people with aphasia can benefit from strategy training. The purpose of this study was to determine the feasibility of an adapted strategy training protocol for people with aphasia. We recruited 16 adults with mild-moderate aphasia from inpatient stroke rehabilitation. We examined recruitment and retention, intervention delivery and fidelity, participant engagement and communication, participant strategy mastery, and change in disability. Therapists demonstrated good fidelity to intervention elements. Participants demonstrated good engagement and fair communication. The sample achieved a mean Functional Independence Measure change of 21.8 ( = 16.2, Cohen's = .95), similar to matched controls without aphasia from previous trials. An adapted strategy training protocol appears feasible for people with aphasia in inpatient stroke rehabilitation. Future studies should examine the efficacy of this approach in larger samples.