From Individual to Group Treatment for Aphasia: Development and Feasibility of a Group-based Adaptation of the Collaborative Referencing Intervention

Background: Addressing the challenge of improving everyday communication for people with aphasia (PWA), the Collaborative Referencing Intervention (CRI) was developed to promote language learning through meaningful communicative activities and has demonstrated positive outcomes in one-on-one treatment contexts. To approximate the multiparty nature of everyday communication, we examined the feasibility of adapting CRI to a group format (G-CRI). Method: Using a mixed-methods design, three PWA and one clinician participated in 10 G-CRI sessions, each consisting of four collaborative referencing trials. Participants worked together to describe, identify, and place photo cards of mutual interest. Feasibility was evaluated through card-placement accuracy, task completion time, changes in referencing expressions, and conversational repetition of referential labels. Results: Findings demonstrated the feasibility of G-CRI and successful collaboration among participants. High card-placement accuracy (99.72%) was maintained across sessions, while reductions in task completion time and progressive simplification of referential labels reflected increasingly efficient coordination and the establishment of common ground. Additionally, conversational repetition was observed for more than 90% of target photo cards, indicating successful referential learning through repeated collaborative engagement. Implications of the Study: Findings provide preliminary support for G-CRI that promotes complex everyday communication through meaningful social interaction and warrants further evaluation in controlled efficacy studies.