A Preliminary Model for Selecting Aphasia Treatment Type Based on Cognitive Profile

Implementation of evidence-based practices requires models and faciltiators that allow clinicians to efficiently select from the most appropriate evidence-supported treatments for their patients.  This paper presents a preliminary clinical-decision making model for selecting aphasia treatments, based on the scientific evidence.  The four steps of the model include considerations for cognitive profile, functional contexts, impairments and/or strategies, and a menu of evidence-supported treatments.  Each of these four steps are founded on a rigorous literature review. Two illustrative cases are presented and future requirements for further testing of the model are discusse

TREATMENT FIDELITY: ITS IMPORTANCE AND REPORTED FREQUENCY IN APHASIA TREATMENT STUDIES

Treatment fidelity is a measure of the reliability of the administration of an intervention in a treatment study, and has important linkages and implications for the ultimate implementation of evidence-supported interventions. In this study, we examined aphasia treatment studies published in the last 10 years for the reporting of treatment fidelity. We found that only 10% of studies over the last 10 years reported treatment fidelity, which is less than other related disciplines. We discuss the means by which we assess fidelity and recommend the consistent reporting of treatment fidelity in all treatment studies

The persistent needs of people living with aphasia: Results of a national survey

Our current knowledge about the information needs of people with aphasia comes primarily from small-scale qualitative studies. We distributed an electronic survey to consumers living with aphasia and professionals. There were 428 responses from across the United States. Both consumers and professionals rated information as “somewhat difficult to find”. The highest rated five topics were: how to keep improving; communication strategies; aphasia therapy techniques; coping strategies; and strategies for caregivers. There was an interest in receiving information through digital media such as webinars. The results have implications for national and regional efforts to provide information about living with aphasia

Investigating the predictors of lifestyle satisfaction among younger adults with chronic aphasia

Perceptions of lifestyle satisfaction are an important component of quality of life and handicap measurements. Thirty- one adults with aphasia completed a questionnaire in which they rated their Lifestyle satisfaction and reported other demographic, health, communication, social contact and Vocational information. Forty-six per cent of the respondents reported general lifestyle satisfaction. Logistic regressions were estimated to differentiate the effects of the predictor variables on the likelihood of a positive lifestyle- satisfaction rating. A negative effect of time post-onset was demonstrated. The results are discussed in the context of previous reports of lifestyle satisfaction in the general stroke population

Examining Treatment Components: Interviews about Group Aphasia Therapy

This is the first study since 1985 to explore the components of group aphasia therapies as identified by practicing clinicians.  In this pilot study, 10 American speech-language pathologists were given a standardized open-ended interview about clinical experiences.  General themes were found within common treatment components.  The findings of the current study provide a comparison to current theoretical discussions on group aphasia therapy and describe the protocols for current therapy approaches.  Additionally, the pilot study forms a foundation for a larger interview study aimed at examining what group aphasia therapies are most commonly used and how and why they are implemented

Person-centered care for people with aphasia: tools for shared decision-making

Shared decision-making is a fundamental aspect of person-centered care, and can and should be part of many different aspects of the rehabilitation process. Communication disabilities like aphasia, which affects people's ability to use and understand spoken and written language, can make shared decision-making especially challenging to the resources and skills of rehabilitation practitioners. The purpose of this narrative review is to provide a comprehensive description of tools that can support successful shared decision-making with people with aphasia in the rehabilitation environment. These tools and strategies are appropriate for use by physicians, nurses, social workers, physical therapists (also referred to as physiotherapists), occupational therapists, and other service or care providers. The important role of speech-language pathologists as consultants is also described. Case scenarios throughout the paper illustrate the application of recommended tools and strategies along with best practices

Aphasia United - A Unified Voice for Aphasia

Aphasia United is a new peak international organization that aims to bring together the global aphasia community and represent its voice to the World Stroke Organization. The aim of this paper is to describe the processes of development and the strategic direction of Aphasia United, and its proposed process for developing an international research agenda. Initial discussions and a summit have prioritized capacity building of consumer organization, building consensus around best practice, raising awareness and creating a governance structure as well as developing an international research agenda for aphasia. Opportunities for involvement are outlined

Systematic Evaluation of the Evidence on Aphasia Group Treatments

A systematic review is one of the most important contributions to clinical decision-making for evidence-based practice (EBP). Studies focused on aphasia group treatment, published since 1981, were entered into a six-step systematic review (Dollaghan et al, 2007), to evaluate the overall quality and weight of the evidence. This review suggests that there are short-term impairment-level benefits of group aphasia treatments but that there is insufficient evidence to make conclusions about long-term outcomes or outcomes related to activities and life participation. Implications for practice and future research are discussed

Spitzer Follow-up of Extremely Cold Brown Dwarfs Discovered by the Backyard Worlds: Planet 9 Citizen Science Project

We present Spitzer follow-up imaging of 95 candidate extremely cold brown dwarfs discovered by the Backyard Worlds: Planet 9 citizen science project, which uses visually perceived motion in multiepoch Wide-field Infrared Survey Explorer (WISE) images to identify previously unrecognized substellar neighbors to the Sun. We measure Spitzer [3.6]–[4.5] color to phototype our brown dwarf candidates, with an emphasis on pinpointing the coldest and closest Y dwarfs within our sample. The combination of WISE and Spitzer astrometry provides quantitative confirmation of the transverse motion of 75 of our discoveries. Nine of our motion-confirmed objects have best-fit linear motions larger than 1'' yr⁻¹; our fastest-moving discovery is WISEA J155349.96+693355.2 (μ ≈ 2.”15 yr⁻¹), a possible T-type subdwarf. We also report a newly discovered wide-separation (~400 au) T8 comoving companion to the white dwarf LSPM J0055+5948 (the fourth such system to be found), plus a candidate late T companion to the white dwarf LSR J0002+6357 at 5 5 projected separation (~8700 au if associated). Among our motion-confirmed targets, five have Spitzer colors most consistent with spectral type Y. Four of these five have exceptionally red Spitzer colors suggesting types of Y1 or later, adding considerably to the small sample of known objects in this especially valuable low-temperature regime. Our Y dwarf candidates begin bridging the gap between the bulk of the Y dwarf population and the coldest known brown dwarf

Spitzer Follow-up of Extremely Cold Brown Dwarfs Discovered by the Backyard Worlds: Planet 9 Citizen Science Project

We present Spitzer follow-up imaging of 95 candidate extremely cold brown dwarfs discovered by the Backyard Worlds: Planet 9 citizen science project, which uses visually perceived motion in multi-epoch WISE images to identify previously unrecognized substellar neighbors to the Sun. We measure Spitzer [3.6]-[4.5] color to phototype our brown dwarf candidates, with an emphasis on pinpointing the coldest and closest Y dwarfs within our sample. The combination of WISE and Spitzer astrometry provides quantitative confirmation of the transverse motion of 75 of our discoveries. Nine of our motion-confirmed objects have best-fit linear motions larger than 1"/yr; our fastest-moving discovery is WISEA J155349.96+693355.2 (total motion ~2.15"/yr), a possible T type subdwarf. We also report a newly discovered wide-separation (~400 AU) T8 comoving companion to the white dwarf LSPM J0055+5948 (the fourth such system to be found), plus a candidate late T companion to the white dwarf LSR J0002+6357 at 5.5' projected separation (~8,700 AU if associated). Among our motion-confirmed targets, five have Spitzer colors most consistent with spectral type Y. Four of these five have exceptionally red Spitzer colors suggesting types of Y1 or later, adding considerably to the small sample of known objects in this especially valuable low-temperature regime. Our Y dwarf candidates begin bridging the gap between the bulk of the Y dwarf population and the coldest known brown dwarf.Comment: accepted for publication in The Astrophysical Journa