Conversation Therapy for Aphasia: A Survey

There has been a growing interest in the engagement in and management of conversation in aphasia. The literature describes aspects of conversation in aphasia such as nonverbal communication and management of repair (e.g. Ferguson, 1994; Madden, Oelschlaeger & Damico, 2003). Research delineates strategies and resources employed to achieve conversation by people with aphasia and partners (e.g. Beeke, 2003; Beeke, Wilkinson & Maxim, 2001, 2009; Oelschlaeger & Damico, 1998; Wilkinson, Lock, Bryan & Sage, 2011). There is also growing interest in conversation as a target of aphasia treatment. Various approaches related to conversation have been reported such as multimodality training (Purdy & Van Dyke, 2011), discourse treatment for word retrieval (Boyle, 2011), group conversation therapy (Elman & Bernstein-Ellis, 1999; Simmons-Mackie, Elman, Holland & Damico, 2007), interaction-focused intervention (Wilkinson, Lock, Bryan & Sage, 2011), couples therapy (Boles, 2011) and partner training (Kagan et al, 2001). There has also been discussion of the impact of impairment-focused therapy on conversation (Carragher et al. 2012). Despite this growing knowledge base, there are no data regarding the translation of knowledge into clinical practice. Has conversation therapy become a routine aspect of clinical practice in aphasia? If so, what do clinicians do in conversation therapy for aphasia? In order to explore these questions, a web-based survey was initiated

Aphasia Centers in North America: A Survey

Aphasia management has traditionally targeted language impairments. However, programs have begun to address other consequences of aphasia such as social isolation, well-being, or participation. One means of addressing these consequences is via an “aphasia center.” An online survey was developed and distributed in order to learn more about aphasia centers in North America. Thirty one respondents provided information (e.g. demographics, mission/goals, admission and discharge criteria, funding sources, programming). The data were analyzed via frequency counts and charts, as well as qualitatively by identifying key themes that helped to describe characteristics of aphasia centers

Communication Partner Training in Aphasia: A Critical Review

This presentation describes the procedures and results of a systematic review of the literature on communication partner training in aphasia. A search of thirteen databases resulted in 28 relevant articles published in English between 1975 and April, 2008. These included 8 group studies varying from randomized controlled trials to uncontrolled pre-post studies, 7 single-subject experimental designs, 5 qualitative research designs and 8 case studies. Studies were independently reviewed by two reviewers. Results revealed a wide range of quality scores. Most studies fell in the weaker AAN evidence strength classes. However, 3 studies met the criteria for Class I research

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

Communicative Competence in Aphasia: Evidence from Compensatory Strategies

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Reviewing evidence for social approaches to aphasia intervention: An application of A-FROM

This presentation demonstrates an application of Living with Aphasia: Framework for Outcome Measurement (A-FROM) (Kagan, et al. in press) to the analysis of evidence for social approaches to aphasia. A-FROM is a conceptual framework adapted from the World Health Organization International Classification of Functioning, Disability and Health (ICF) (WHO, 2001). A-FROM provides a user-friendly graphic to guide research and outcome measurement and helps address the lack of an integrated approach across diverse aphasia interventions. Using examples from a literature review on social approaches, this method of organizing evidence will be described

How effective ‘Knowledge Transfer and Exchange’ can enhance aphasia research and clinical practice

This presentation examines the potential contribution of the emerging field of Knowledge Transfer and Exchange (KTE) and its implications for all stakeholders involved in clinical research and practice in aphasia, namely researchers and those who use research. The latter includes practitioners as well as policy and decision-makers. Issues presented will include the challenges of ensuring that research is relevant to practitioners, getting the message out to decision-makers and policy makers regarding the effectiveness of aphasia interventions, background and basic KTE principles; and possible next steps for the field of aphasia in relation to KTE

Communicative Access Measures for Stroke

Reducing communication barriers to ensure promotion of patients’ rights to have information presented in a way that it can be understood and the right to participate fully in decision-making is consistent with policies in the USA, Canada, UK and Australia. For example, the Joint Commission (the organization responsible for hospital accreditation in the US) now includes communicative access and health literacy within its standards

The experience of people with aphasia during the first three months post stroke: What facilitates successful living?

In order to identify factors that facilitate successfully living with aphasia during the first year post stroke a prospective mixed method, longitudinal study was undertaken. Thirteen participants with aphasia participated in the study. Participants were involved in qualitative interviews and measures of aphasia severity, quality of life and successful living were undertaken. Results from initial data at three months post onset highlighted that aphasia severity ratings did not always coincide with ratings of successful living and quality of life. Factors such as social support, rehabilitation, participation in meaningful activities, determination and optimism were identified as important facilitators

Fidelity protocol for the Action Success Knowledge (ASK) trial: A psychosocial intervention administered by speech and language therapists to prevent depression in people with post-stroke aphasia

Introduction: Treatment fidelity is a complex, multifaceted evaluative process which refers to whether a studied intervention was delivered as intended. Monitoring and enhancing fidelity is one recommendation of the TiDIER (Template for Intervention Description and Replication) checklist, as fidelity can inform interpretation and conclusions drawn about treatment effects. Despite the methodological and translational benefits, fidelity strategies have been used inconsistently within health behaviour intervention studies; in particular, within aphasia intervention studies, reporting of fidelity remains relatively rare. This paper describes the development of a fidelity protocol for the Action Success Knowledge (ASK) study, a current cluster randomised trial investigating an early mood intervention for people with aphasia (a language disability caused by stroke). Methods and analysis: A novel fidelity protocol and tool was developed to monitor and enhance fidelity within the two arms (experimental treatment and attention control) of the ASK study. The ASK fidelity protocol was developed based on the National Institutes of Health Behaviour Change Consortium fidelity framework. Ethics and dissemination: The study protocol was approved by the Darling Downs Hospital and Health Service Human Research Ethics Committee in Queensland, Australia under the National Mutual Acceptance scheme of multicentre human research projects. Specific ethics approval was obtained for those participating sites who were not under the National Mutual Agreement at the time of application. The monitoring and ongoing conduct of the research project is in line with requirements under the National Mutual Acceptance. On completion of the trial, findings from the fidelity reviews will be disseminated via publications and conference presentations. Trial registration number ACTRN12614000979651