Multi-Component Cognitive-Linguistic Intervention in a Persian-Speaking Patient with Fluent Aphasia: A Single-Case Study

Abstract

Introduction: Fluent aphasia following hemorrhagic stroke can severely impair language, literacy, and cognitive functions; however, evidence regarding intensive multicomponent interventions in Persian-speaking populations remains limited. This single-case study aimed to describe pre- to post-intervention changes following a 10-week multicomponent cognitive-linguistic intervention in a 41-year-old Persian-speaking man with fluent aphasia after a left-hemisphere hemorrhagic stroke, with particular attention to language, literacy, memory, speech rate, and lexical diversity. Case Presentation: The patient received 10 weekly 2.5-hour sessions integrating Oral Reading for Language in Aphasia (ORLA), Multiple Oral Re-reading (MOR), Semantic Feature Analysis (SFA), Phonological Components Analysis (PCA), Schuell's stimulation approach, working-memory training, and verbal short-term memory training. Assessments included the spoken subscale of the Persian Diagnostic Aphasia Battery, using the Aphasia Quotient-2 (AQ2); the Persian version of the Montreal Cognitive Assessment (P-MoCA); verbal fluency; digit span; auditory-verbal memory; speech rate; and Type-Token Ratio (TTR). Cognitive reserve was measured using the Cognitive Reserve Index questionnaire (CRIq = 229). Post-intervention, the AQ2 score exceeded the stated clinical cutoff. Reading, writing, repetition, and auditory comprehension reached or approached ceiling levels; verbal and working-memory measures improved; spontaneous speech rate approached the normal range; TTR exceeded the respective cutoffs in both contexts; and previously absent literacy skills reached maximum scores. No decline was observed. The AQ2 change should be interpreted as a change in test classification rather than evidence of complete clinical resolution of aphasia. Conclusions: This case report documents broad improvements from pre- to post-intervention following an intensive, multicomponent, family-supported cognitive-linguistic intervention in post-stroke fluent aphasia, including improvements in literacy and lexical diversity. Given the single-case pre-post design and the absence of a control condition, these findings do not establish a causal treatment effect.