Has speech and language therapy been shown not to work?

摘要

Ideally, all medical treatments should have an evolving evidence base. Speech and language therapy (SALT), together with other complex interventions, is no different. Without this evidence, and in a world of limited resources, to convince funders and patients that they are getting value for money becomes increasingly challenging. In the case of SALT for treatment of patients who have experienced stroke, the clinical imperatives that such an evidence base must address are clear: what are the components that make SALT effective? What dose (time on task) is required? How intensively should therapy be delivered? How soon after stroke, and for how long, should SALT be made available to patients? These Questions have been addressed and partially answered over the past 40 years. The ACT NoW (Assessing Communication Therapy in the North West) study, recently published in the British Medical Journal,1 was an attempt to add to this literature, focussing on the effectiveness of SALT delivered in the early phase (within 4 months) after stroke.