Treating Attention and Language in Post-stroke Aphasia Using a Music-based Intervention.

Participants: Participants will be 45 people with aphasia (PWA) who are a representative sample of the diversity of the Lafayette, Indiana area, and broader United States. We will recruit PWA from the PI's research registry, which includes ~60 PWA, Purdue's in-house Speech, Language, and Hearing clinics, local assisted living and rehabilitation hospitals, public community centers, and online. The PI has extensive experience recruiting from these sources and recently recruited 43 PWA for a similar study in one year. PWA will be included in the study if they are 18+ years of age, had a stroke at least 6 months prior to study enrollment, have normal or corrected to normal hearing and vision, no history of an attention disorder pre-stroke, and at least a mild aphasia on the Western Aphasia Battery Revised (WAB-R). Hearing acuity will be screened using pure tone audiometry at 500-4000 Hz. Vision will be assessed using self assessment Randomization to Study Arms: Participants will be randomly assigned to either the experimental arm, active control arm, or the no-contact control arm (n = 15 per arm). The study arms are adapted from a previous study in which acute stroke survivors listened to music, an audiobook, or no prescribed auditory material daily over an 8-week period. However, PWA are a distinct clinical population from acute stroke warranting a specific investigation into whether the MBI similarly impacts attention in PWA, and subsequently their language abilities and quality of life.

Experimental Arm: Receptive Music-Based Intervention In an initial one-hour meeting, a board-certified music therapist will work with each participant to assess their music preferences and curate two playlists using the Spotify Music app. One playlist will include highly energizing pieces. The second playlist will include relaxing pieces. The playlists will include music selected by the participant and music by the same or similar artists, instrumentation, or genres, and will be chosen in consultation with the music therapist. The lists will be of sufficient length to allow the selections to be shuffled for listening each day without repetition based on the previous day's listening.

In a second one-hour meeting, the music therapist will teach the participant listening techniques to help them attend closely to the music and observe its effects on their mind and body, including movements, associations, memories, images, breathing rate, and levels of relaxation or tension. The music therapist will also demonstrate how to enter these effects into their daily music listening journal, which will be completed after each listening session.

Participants will be instructed to maintain their usual activities each day, except we will ask them to select a time of day, a comfortable and distraction free environment, and an apparatus for regular music listening (earbuds, headphones, speakers). Participants will listen mindfully to randomized selections from the playlist that meets their needs that day (i.e., energizing or relaxing). Participants will listen to their music selections on shuffle for 30 minutes per day for 8 weeks using the strategies provided by the music therapist. The target listening duration is 30 minutes as it is a common target for time spent on task before taking a break. Participants will complete their daily journal entry immediately after music listening.

The music therapist will make a weekly telephone call to each participant in the experimental arm. The telephone call will last ~30 minutes. During this telephone call, the music therapist will update the music playlists for the following week based on participant feedback. The music therapist will also inquire about the participant's daily music listening journals and help them submit their listening logs.