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Promoting strategic television viewing in the context of progressive language impairment

Background: Television viewing is one of the most common and readily accessible leisure pursuits in the developed world today. Unfortunately, access to this powerful form of mass communication is frequently diminished in individuals experiencing progressive language impairment, with deficits in both the comprehension and expression of television content reported from the very early stages of the illness. Considering the wide appeal of television viewing in today's culture, it seems reasonable to conclude that improving access to television content should be considered as an ecologically valid goal for intervention in clinical populations with progressive language impairment who have demonstrated difficulties comprehending and speaking about this powerful form of mass communication. This consideration becomes more pressing when we attend to recent research highlighting the potential neuroprotective effect of engagement in cognitively and intellectually stimulating social and leisure pursuits by individuals with dementing illness. Aims: This pilot therapy programme aimed to explore the effectiveness of aphasia‐friendly television viewing formats for improving discourse comprehension and production in people with progressive language impairment. It was predicted that following intervention, group participants would (1) recall significantly more story information units from the episode, (2) achieve higher transactional success, and (3) demonstrate improved comprehension when viewing aphasia‐friendly television episodes than they did prior to group intervention. Methods & Procedures: Four participants with progressive language impairment attended eight sessions of group‐based intervention as part of their usual language therapy programme. Each session aimed to instantiate strategic television viewing capabilities in participants through the application of aphasia‐friendly television viewing principles to novel episodes of a popular 30‐minute documentary programme. Repeated measures ANOVA was used to analyse the differences between participants' pre‐therapy viewing patterns and supported post‐therapy measures of episode‐related story information unit production, while paired t‐tests were used for analysis of discourse comprehension measures. Outcomes & Results: Participants demonstrated significant increases in story information unit reporting and comprehension indicated by performance on concrete and opinion based questions post‐therapy. There was no significant difference in participants' post‐therapy comprehension of inferential questions. Conclusions: This pilot therapy programme affirms the prediction that aphasia‐friendly television viewing formats are successful in achieving significant improvements in episode related discourse production, communication effectiveness, comprehension of concrete question forms, and opinion generation in individuals with progressive language impairment. It supports the notion that novel, ecologically based intervention techniques can be beneficial in enhancing access to preferred leisure activities in individuals with progressive language impairment. Thanks to Jemma Selby and Stephanie Danker (final year Human Communication Science students, Curtin University), who helped facilitate the treatment group; to our colleagues at the Neurosciences Unit for their ongoing support; and to Lyndsey Nickels and Karen Croot for comments on an earlier version of this manuscript. Most importantly, we would like to thank our clients with progressive language impairment and their families who are the source of our inspiration and who have made this project so rewarding.