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Aphasia, an acquired communication disorder that impairs the ability to process language, speak and understand others, affects 21% to 38% of stroke survivors (Lazar et al. 2017). Aphasia is associated with increased length of hospital stay, inpatient complications, overall neurological disability, mortality and discharge disposition (Lazar et al. 2017). Due to its impact on communication skills, recovery and reintegration to the community, aphasia therapy is an important component of both acute and post-acute rehabilitation. A Cochrane review (Brady et al. 2016) included 57 randomized controlled trials (RCTs) comparing speech- language therapy (SLT) for aphasia after stroke with no SLT, social support or stimulation, or another SLT. In total, 74 randomized comparisons, consisting of over 3,000 participants were included in the review. Speech language therapy was associated with a significant improvement in functional communication (standardized mean difference (SMD) 0.28; 95% confidence internal (CI) 0.06 to 0.49, p = 0.01), compared with no SLT, along with significant improvements in reading comprehension (SMD: 0.29; 95% CI: 0.03 to 0.55), general expressive language (SMD: 1.28; 95% CI: 0.38 to 2.19) and written expressive language (SMD: 0.41; 95% CI: 0.14 to 0.67) after SLT. The positive effects were no longer evident at 6 months. No significant differences in outcomes were found between SLT and group therapy, computer-assisted therapy, and cognitive-linguistic and communicative treatments; (Brady et al. 2016) while results were inconsistent for constraint-induced therapy (Brady et al. 2016, Zhang et al. 2017). A recent systematic review examining the use of training communication partners or significant others found that while there was an increase in communication activities and participation between the participant and communication partner, there was insufficient evidence of its effect on language impairment, psychological adjustment and quality of life. (Simmons-Mackie et al. 2016). The impact SLT has on communication outcome appears to be mediated by the intensity and duration of the therapy. A systematic review authored by Bhogal et al. (2003) found that studies that demonstrated significantly improved outcomes following SLT provided on average 8.8 hours of therapy per week for 11.2 weeks; totalling an average of 98.4 hours of therapy. In contrast, there was no effect of SLT treatment in studies that provided only an average of 2 hours of therapy over 22.9 week; totalling an average of 43.6 hours of therapy. Similarly, Brady et al. (2016) noted that functional communication, and severity of impairment, significantly improved after high-intensity, long duration therapy compared to low-intensity, short duration therapy.