Background and aim: Aphasia as a common consequence of stroke, is an acquired neurologic communication disorder that can affect symbol language processing. Different types of intervention approaches have been introduced. Multimodal Communication Program (MCP) is a new augmentative alternative communication approach in chronic aphasia. The aim of this study was to investigate the effect of MCP on communication skills of patients with chronic aphasia.
Methods: This prospective, single subject, A-B-A design study was done during 2016 in Semnan, Iran. Participants were two patients with severe aphasia with a single left-hemisphere stroke. Three phases, including baseline, intervention and follow-up were administered. The patients received nine-hour intervention, over 10 working days. 
Results: Three different scores were calculated for each patient: verbal efforts, the frequency of each modality and the accuracy of switching between modalities and the reaction time. The frequency of verbal modality increased for both patients. They could switch between modalities more successfully than before the intervention. The results for the reaction time, however were challenging. The onset reaction time decreased for patient 1, and increased during switching between modalities, and patient 2 showed the opposite.
Conclusion: The MCP can improve the communication skills in patients with chronic post stroke aphasia. However, some factors, such as reduction of the patients’ reaction time is probably related to the amount of allocated resources during intervention. 
Trial registration: The trial was registered at IRCT center with ID: IRCT2016032325194N3.
Funding: The study was financed by Semnan University of Medical Sciences (Grant no.: A-10-333-3).


Keywords: Chronic aphasia, Stroke, Communication, Reaction time


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