Traditional aphasia treatment approaches focus initially on restoration of language, but quickly move to use of alternative modes of communication when progress is slow. Constraint Induced Aphasia Therapy (CIAT), a more intensive form of treatment, is based on the concept of frequent, long sessions and forced use of the impaired language system. Prior to the present study, the relationship between CIAT and stress had not been explored; therefore, this study compared cortisol stress levels and improvement of language skills in two groups of subjects, all of whom presented with expressive aphasia. Ten subjects participated in CIAT, and received 10 days of intensive treatment over two weeks. Ten subjects received traditional aphasia treatment, and received six days of treatment over two weeks. The study also examined perceived stress, depression, and quality of life as variables that might influence candidacy for CIAT. All participants in each group provided salivary cortisol samples, and completed perceived stress, depression, and quality of life questionnaires pre-treatment, mid-treatment, and post-treatment. Language skills were assessed pre-treatment and post-treatment. Results showed that, at baseline and at the end of treatment, there was no difference between groups on measures of cortisol stress levels; however, at mid-treatment, cortisol stress levels were significantly higher in the CIAT group. Participants in the CIAT group showed significant improvement on word repetition and overall aphasia quotient, whereas participants in the traditional treatment group showed no significant change. There were no significant changes in perceived stress scores, depression scores, or quality of life scores across time in either of the two groups. Implications for use of CIAT as a viable and effective treatment method for individuals with aphasia are discussed.

LLU Discipline

Rehabilitation Sciences


Occupational Therapy


School of Allied Health Professions

First Advisor

Shaughnessy, Paige

Second Advisor

Berk, Lee S.

Third Advisor

Daher, Noha

Fourth Advisor

Swain, Deborah

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded

January 2013

Date (Title Page)




Library of Congress/MESH Subject Headings

Aphasia - Treatment; Language disorders - Treatment; Aphasia - Therapy; Language Disorders - Therapy; Language Therapy - Methods; Aphasia - Rehabilitation;

Subject - Local

Stress; Depression; Constraint Induced Aphasia Therapy; Language Recovery; Rehability Therapy; Traditional Aphasia Therapy



Page Count

86 p.

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses & Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives