Glossary

Aphasia: is a loss or impairment of the ability to produce and/or comprehend language, due to brain damage. It is usually a result of damage to the language centres of the brain.

Attention Control: This is the comparison or ‘control’ intervention in the ACT NoW Randomised Control Trial. Participants in this intervention will receive a specified number of visits from a hospital / home visitor who is not trained in speech and language therapy. The length of time spent with this visitor will be comparable to the length of time spent with a speech and language therapist for participants in the therapy arm. Visitors are paid part-time staff who are trained to deliver a manualised attention control and are regularly monitored to ensure adherence to the research protocol. This attention control condition will provide a benchmark for improvement against which the therapy arm will be measured.

Dysarthria: is a speech disorder resulting from brain injury. Any of the speech subsystems (respiration, phonation, resonance, and articulation) can be affected. This is due to some disorder in the nervous system, which in turn hinders control over for example the tongue, throat, lips or lungs. Swallowing problems are often present in dysarthric patients.

Ethics Committee: This is an independent group of people that includes doctors, nurses, medical staff, members of the public and sometimes lawyers. This committee considers and decides if proposed clinical trials are ethical: that is, they verify the integrity of the study and ensure the safety, integrity and human rights of the study participants. An ethics committee considers the details of a proposed trial and  ensures the research is looking at an important question that cannot be answered through existing information.

Health Economics: Health economics is a branch of economics concerned with the formal analysis of costs, benefits, management and consequences of health care.

HTA: The Health Technology Assessment (HTA) programme is part of the National Institute for Health Research and works to provide all those who make decisions in the NHS with high-quality information on the costs, effectiveness and broader impact of health care treatments and tests. They do this by funding research projects such as the ACT NoW study.

Pilot / Feasibility Study: A small study carried out before a large-scale study in order to try out a procedure, to test a principle and general assess how 'feasible' a larger-scale study would be. Pilot and feasibility studies ensure that a large scale study runs as efficiently as possible.

Quantitative: Involving the measurement of quantity or amount; quantitative studies involve numerical data. By contrast, qualitative studies involve non-numerical data (see below). 

Qualitative: Relates to the quality or kind; qualitative studies often involve the analysis of spoken or written words to try and understand experiences and opinions.

Randomisation: is the process of making something random; it is remarkably difficult to make anything truly random, as most physical processes and human thoughts and actions, whilst subject to randomness, are much less random than is commonly supposed. Randomisation can be carried out through a number of different means that create deliberately haphazard arrangements of variables so as to simulate chance i.e. random number generators. 

Randomised Control Trial (RCT): A study in which people are allocated at random (by chance alone), to receive one of several clinical interventions. One of these interventions acts as a comparison to provide a benchmark. Because the outcomes are measured, RCTs are quantitative studies.

Stroke: A stroke or cerebrovascular accident (CVA) occurs when the blood supply to a part of the brain is suddenly reduced or stopped. Reduction in blood flow means that the affected part of the brain can no longer function properly because the brain cells die. This stoppage in blood flow can occur as the result of a blood vessel that supplies the brain becoming blocked (occlusion - approximately 90% of strokes), or bursting (haemorrhage - less than 10% of strokes), or through some other cause.

Therapy Arm: This is the experimental condition in the ACT NoW study. Participants who are randomly allocated to this condition will receive Speech and Language Therapy of up to three sessions per week for a maximum duration of 16 weeks. This therapy is delivered by an experience Speech and Language Therapist and is manualised once developed according to 'Best Practice' standards.

User Group: The User Group is made up of people who have had a stroke and so have experience of dealing with the communication difficulties that arise from either aphasia or dysarthria. As a group, they consult with the research team to help devise materials that are suitable for use with people who suffer from communication difficulties. Specific tasks of the user group can be found on the web page.