The National Center for Evidence-Based Practice
in Communication Disorders
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Service Delivery


(e.g. inpatient, day treatment, home, telerehabilitation)



External Scientific Evidence


Evidence-Based Practice Guidelines

No evidence-based practice guidelines were found.

Evidence-Based Systematic Reviews

Evidence-Based Review of Stroke Rehabilitation
Teasell, R. W., Foley, N. C., et al. (2011).
Retrieved from
This review meets the criteria for a high-quality evidence-based systematic review.
Added: October 2012

This is an update of the Teasell et al. (2009) evidence-based review investigating the effectiveness of pharmacological and non-pharmacological interventions for stroke rehabilitation. Of particular interest to speech-language pathologists are the modules specific to aphasia, dysphagia, perceptual disorders and cognitive disorders. The levels of evidence used to summarize the review findings are based on the United States Agency for Health Care Policy and Research (AHCPR) criteria:  

  • Level 1a: Strong evidence supported by a meta-analysis or two or more randomized controlled trials (RCTs) with at least “fair” quality.
  • Level 1b: Moderate evidence supported by at least one RCT of “fair” quality.
  • Level 2: Limited evidence supported by at least one controlled trial with a minimum of 10 participants in each arm of the study.
  • Level 3: Findings supported by expert consensus opinion in the absence of evidence.
  • Level 4: Conflicting evidence based on disagreement between the findings of at least two RCTs. Where there are more than four RCTs, conclusions are based on the results of the majority of studies, unless conflicting results are reported in a higher quality study.
  • Limited evidence (Level 2) suggests that community-based aphasia programs improve language outcomes
  • Limited (Level 2) evidence suggests that aphasia assessment delivered via telehealth is comparable to face-to-face assessment.
  • At this time, there is insufficient evidence regarding the delivery of speech and language treatment delivered remotely. "Preliminary case series have reported positive results for a program of naming therapy" (Module 14; p. 36).

Clinical Expertise/Expert Opinion

Consensus Guidelines  
No consensus guidelines were found. 

Client/Patient/Caregiver Perspectives

Reconciling the Perspective of Practitioner and Service User: Findings From The Aphasia in Scotland Study
Law, J., Huby, G., et al. (2010).
International Journal of Language & Communication Disorders, 45(5), 551-60
Added: May 2012
This is a qualitative study of 21 speech-language pathologists and 14 individuals with aphasia. This study examines the views and perspectives of service providers and patients in the treatment of aphasia
Many respondents reported "a preference for therapy provided in the home" (p. 555)
Assessing Acquired Language Disorders in Adults via the Internet
Theodoros, D., Hill, A., et al. (2008).
Telemedicine and e-Health, 14(6), 552-9
Added: May 2012
This is a randomized controlled trial of 32 individuals with aphasia. This study examines the validity and reliability of assessing aphasia via telehealth. Patient satisfaction with face-to-face assessment and internet-based assessment was reported
  • No significant differences were found between face-to-face and internet-based assessment using the Boston Diagnostic Aphasia Examination-3 and Boston Naming Test.
  • Overall satisfaction with telehealth assessment was high. All patients assigned to receive internet-based assessment indicated that they were "at least satisfied with the service, while 67% of the cohort was more than satisfied or very satisfied with the experience" (p. 557).
  • Ninety percent of the respondents were confident with results of assessment and all indicated that they would participate in this format of service delivery again.
  • Eighty percent of the respondents indicated that "they would be equally satisfied if the service was delivered either online or FTF [face-to-face]" (p. 557)
The Effects of Aphasia Severity on the Ability to Assess Language Disorders Via Telerehabilitation
Hill, A. J., Theodoros, D. G., et al. (2009).
Aphasiology, 23(5), 627-642
Added: May 2012
This is a qualitative study of 32 individuals with acquired aphasia. This study examines the influence of severity of aphasia on the ability to assess aphasia via telerehabilitation services. Along with comparing telerehabilitaiton and face-to-face aphasia assessments, satisfaction data were also analyzed
  • All participants reported satisfaction with assessment via telerehabilitation methods and rated audio and visual quality of services as excellent.
  • No significant differences were found in participant satisfaction based on severity of aphasia

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