Shill M A
J Commun Disord. 1979 Nov;12(6):503-17. doi: 10.1016/0021-9924(79)90013-3.
Following Wepman (1953), the process of recovery from aphasia is seen as involving stimulation, motivation, and facilitation. The most adequate studies of aphasia therapy outcome focus on facilitation to the virtual exclusion of stimulation and motivation, although clinical experience suggests their importance. Motivation includes both the subjective and experiential aspects of the patient's response to aphasic disablement (anxiety, feelings of inadequacy) and the quality of the speech-therapist/patient alliance during the treatment. Retrospective studies utilizing sufficiently improved aphasics and ratings of the patient-therapist alliance are suggested as preliminary means of defining "motivation" in this context more accurately. Research approaches are also outlined which would assess the importance of and interaction between the three factors implicated in recovery for therapeutic outcome.