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Beyond randomised controlled trials: The case for effective case studies of the effects of treatment in aphasia
Author(s) -
Howard David
Publication year - 1986
Publication title -
international journal of language and communication disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.101
H-Index - 67
eISSN - 1460-6984
pISSN - 1368-2822
DOI - 10.3109/13682828609018546
Subject(s) - aphasia , set (abstract data type) , psychology , randomized controlled trial , treatment effect , treatment and control groups , psychotherapist , physical therapy , cognitive psychology , medicine , computer science , surgery , pathology , programming language , traditional medicine
Randomised controlled trials (RCTs) of aphasia therapy have not established that speech therapy is effective with aphasic patients. The characteristics of RCTs, and the assumptions they make, are examined and it is argued that RCTs could never have produced useful information about the effects of treatment with aphasic patients; it is not sensible to investigate the effects of a set of heterogeneous treatment techniques applied to a heterogeneous group of subjects measuring improvement with generalised and insensitive assessment techniques. Instead, effective studies of treatment in aphasia will investigate the usefulness of specific and motivated treatment methods applied to specific aphasic patients. The methodological requirements of scientific studies of aphasia treatment of this kind are discussed, and the appropriateness of three types of experimental design is considered.