Speech Therapy in the Pasc/long Covid Population: Implementation of a Structured Treatment Approach to Improve Quality of Life in Cognitive Communication Impairments

Research Objectives: To protocolize the application of a novel speech therapy intervention within the post-acute sequelae of SARsCoV-2 (PASC) population.

Design: The intervention was tailored based on symptoms reported as primary concerns and cognitive testing.

Setting: Treatment occurred in-person in an outpatient therapy setting.

Participants: 39 participants with a history of Covid-19 and residual cognitive symptoms were included.

Interventions: The 3-visit intervention, which extended over 6 weeks, prioritized education and meta-cognitive awareness of cognitive effort and fatigue. Multiple approaches were used, including the spoon theory and development of a cognitive rating scale. Roles of stress, sleep hygiene, and nutrition were introduced to address a holistic approach. Intervention was personalized based on pre-treatment testing, a cognitive questionnaire, and an algorithm highlighting participant-selected concerns, which ensures person-centered care. Established criteria determined when to advance skills or cognitive complexity while aiming to reduce post-exertional malaise/post-exercise symptom exacerbation (PEM/PESE). Examples of specific cognitive-communication targets include memory strategy development, attention re-training, and expressive/receptive communication tools. A protocolized approach allows for replication of an intervention which prioritizes effort and fatigue in conjunction with traditional speech therapy.

Main Outcome Measures: Final evaluation and 90-day post completion of intervention survey.

Results: The mean age was 54.5 years (SD =12.3). 56.4% were female and 43.6% were male and 7.7% were Black. All participants reported a positive impact on quality of life at their final evaluation and on their 90-day survey.

Conclusions: Speech therapy is an integral part of PASC treatment. Findings support the broader implementation of this speech therapy approach in PASC treatment.

Author(s) Disclosures: The authors declare they have no competing interests. Funded by NIH grant R01-HD108312-01A1.