A teaching model to improve nursing assistants’ knowledge of aphasia and communication strategies

It is common for people with aphasia, whether in the hospital, a nursing facility, or at home, to rely on nursing assistants for their health and personal care. This study presents results from a unique program to teach nursing assistant students about aphasia and communication strategies that is co-instructed by a person with aphasia and an SLP. Comparison of pre- and posttest results from 168 participating students indicates that nursing assistant students improved their knowledge of aphasia after participating in this 75-minute module. This has implications for both nursing assistants and people with aphasia

Assessing the long-term impact of aphasia center participation

Comprehensive aphasia centers are a growing trend in North America and have begun to influence service delivery for individuals with aphasia and their families. Such centers are grounded in group interaction and are intensive in terms of participation time. Consistent with principles of Life Participation Approaches (LPAA, 2001), centers incorporate programming across a range of experiences and activities, including conversation groups, technology and interactive programming (e.g., Skyping across centers), as well as outreach initiatives. Early examples include The Aphasia Institute in Toronto, the Aphasia Center of California, and Connect in London (Elman, 2007a). Simmons-Mackie and Holland (2011) conducted a survey that identified 33 such centers, with the majority opening in the preceding 10 years. Since that date, these authors estimate that at least 8 new centers have been developed and staffed. There are many obstacles to collecting effectiveness data in aphasia centers such as those described above. Heterogeneity of programming is an obvious one, compounded, in most cases, by limited professional staff and reliance on trained, but not necessarily equally talented volunteers for a substantial number of activities. Weather, transportation issues, self-selection of activities that are of interest to individual members, moving, illnesses and vacation schedules, as well as the very positive decision that members’ lives have moved beyond the type of support provided by Center programming, also contributes to heterogeneity. Finally, time and resources for collection of pre- and post-involvement data are typically limited, and research participation in most aphasia centers is voluntary. Nevertheless, we believe that, in much the same ways that data can be gathered across public schools to demonstrate their effectiveness, consistent data can be gathered to support the value of aphasia centers. It seems reasonable to assume that the relatively well-documented benefits of participating in an aphasia group would apply to aphasia centers (Avent, 1997; Elman, 2007a, b; Elman & Bernstein-Ellis, 1999). However, direct research on the impact of aphasia centers is limited (Hoen, Thelander, & Worsley, 1997; Van der Gaag et al., 2005). This presentation will describe the long-term impact of participation in programming at two well-established1 community-based aphasia Centers, referred to here as Centers A and B. Both provide two full days of programming for 6-8 hours weekly, with additional time spent in socializing and operate on three fifteen week terms each calendar year. They share similar philosophies, and are of somewhat similar size in terms of participants and staff directly involved in their programs. A similar core assessment battery is used at both centers. This paper will present results of initial and one and two year follow-up data concerning the effects of involvement at both sites

Script training and its application to everyday life observed in an aphasia center

Script training focuses on improved production of personally relevant monologues and dialogues through intensive practice. Commonly reported components of script training include use of personally relevant or functional scripts, a structured cueing hierarchy, and intensive rehearsal of scripted lines to promote automaticity (Youmans, Holland, Munoz, & Bourgeois, 2005; Lee, Kaye, & Cherney, 2009; Youmans, Youmans, & Hancock, 2011; Goldberg, Haley, & Jacks, 2012; Fridriksson et al., 2012). Fridriksson et al. (2012) also trained a series of common scripts to study neurophysiological changes that result from such training. This proposal presents results from four persons with aphasia (PWA) who received script training in an aphasia center, where there is opportunity to observe the effect of that training on everyday life. A secondary goal is to examine what, if any, individual, intervention, or environmental factors might affect a PWA’s ability to benefit from such training

Treatment for Inference Impairment: A Case Study

Damage to either cerebral hemisphere may result in difficulty making inferences. Although suggestions for treatment exist in the literature, there are few, if any, outcome reports of such treatment. This case study reports the results of applying a treatment based on guided inference generation to a person with aphasia and inference impairment. The participant’s ability to produce accurate inferences about picture sequence stimuli improved, and this improvement generalized to probe stimuli. Discussion of this preliminary evidence includes the relationship of the outcome to potential sources of inference impairment and aspects of experimental control

Development of an aphasia training program for medical residents

Reports from people with aphasia (PWA) at a community-based aphasia center suggest that PWA do not receive the same access to medical professionals as people without language disorders. This study describes a training program for medical residents to increase sensitivity, awareness, empathy, and communication between them and their patients with aphasia. Preliminary results suggest that medical residents report such a training program to be beneficial. We anticipate that this increased aphasia awareness, sensitivity, and knowledge of communication strategies will translate into improved healthcare services for their future patients with aphasia

Wii™-habilitation and aphasia groups: Systematic observation of communicative acts during four aphasia Wii™ groups

The use of the Nintendo Wii™ gaming system in a rehabilitative capacity is emerging in physical therapy rehabilitation journals and in news articles and releases from rehabilitation departments and centers across the world (Deutsch, Borbely, Filler, Huhn, & Guarrera-Bowlby, 2008; Tanner, 2008; Coyne, 2008). The incorporation of an Aphasia Wii™ Group at a community based aphasia center is examined. Systematic observation of aphasia groups using the Wii™ Sports game demonstrates that it provides opportunities for a variety of communicative acts and psychosocial benefits. Qualitative methods are used to analyze and discuss identified benefits, and areas for further research are identified

Potential benefits of participating in an aphasia theater program

While there is substantial literature attesting to the benefits of music and art therapies for people with aphasia (PWA) (Hobson, 2006; Peterson, 2006), there is little concerning their participation in theater. Although the value of drama groups in increasing confidence, belonging, and group cohesion across a range of disabling conditions has been documented (Moreno, 1985; Landy, 1994), they are seldom undertaken with PWA. This paper describes a community based aphasia center’s theater program and provides qualitative data discussing the reasons PWA joined the program and the identified benefits gained from participation. Psychosocial, linguistic, and recreational/vocational benefits are discussed

Racial disparities of delay in diagnosis and dermatologic care for hidradenitis suppurativa

Hidradenitis suppurativa is a chronic, debilitating skin disease that disproportionately affects African Americans, and care-related factors may contribute to this disparity. In this study, we investigated delay in diagnosis and dermatologic care for HS at an urban Midwestern Academic Center. A retrospective chart review of 1,190 patients with 3 or more encounters for HS between 1/1/2002 and 3/19/2019 was conducted. A total of 953 patients were included in statistical analysis. A mean (standard deviation) delay in diagnosis was 4.1 ± 7.0 years. For white patients the delay in diagnosis was 3.2 ± 6.3 years, for Black patients 4.8 ± 7.0 years, for Hispanic patients 4.7 ± 5.8 years, and for other races 4.9 ± 7.4 years (p \u3c0.001). Among the 932 patients with known specialist visit types, 500 (53.6%) had seen dermatology including 222 (47.8%) of Black patients, 242 (59.5%) of white patients, 24 (64.9%) of Hispanic patients, and 12 (50%) patients of other races (p=0.003).White patients and Hispanic patients saw a dermatologist an average of 3.0 years after first presentation of HS and Black patients saw a dermatologist on average 5.0 years after first presentation (p=0.004). Of the patients who did see dermatology, 44.9% of Black patients, 31.6% of white patients, 23.1% of Hispanic patients, and 30.8% of other races saw surgery before dermatology (p\u3c.001). Our results indicate that non-white patients have a longer delay in diagnosis than their white counterparts and that Black patients do not see dermatology as early in their disease course as other racial groups. Black patients also see surgery more often than white patients before seeing dermatology, which could suggest greater disease severity at presentation and diagnosis or difficult access to dermatology

Assessing chronic stroke survivors with aphasia sheds light on prevalence of spatial neglect

Background: Stroke is a chronic disease. Standardized assessment is essential in order to determine areas for treatment. Individuals with aphasia are often excluded from research, because it is believed that their language impairments may impact their ability to provide informed consent. Thus, right spatial neglect could be underdiagnosed. Objective: This study was developed to (1) determine the frequency of spatial neglect in chronic left-brain stroke survivors with aphasia, (2) determine the clinical utility of an aphasia-friendly consent form, and (3) determine any differences between neglect and no-neglect groups regarding activities of daily living (ADL) performance and community independence. Methods: Forty-six people were consented at community center. Three were screen failures secondary to the exclusion criteria. A novel, aphasia-friendly consent form was developed to facilitate participation of individuals with aphasia. This enabled 93% or 40 out of the 43 recruited participants to be included in this study. The Behavioral Inattention Test-conventional and the Catherine Bergego Scale via Kessler Foundation Neglect Assessment Process (CBS via KF-NAP) were utilized to determine neglect. The Life Space Questionnaire was used to determine community mobility and independence. The Barthel Index (BI) was used for objective clarification of performance in ADL. Results: Successful use of the consent form resulted in determination that five out of 40 (12.5%) met criteria for spatial neglect; (on the CBS via KF-NAP). The neglect group had lower scores on the Life Space, suggesting less community mobility and independence, however, it was not statistically significant (p = 0.16). Differences in BI scores were also not significant (p =.013) but the neglect group did have reduced independence. Conclusions: This study demonstrates the need to administer functional neglect assessments in left-brain stroke and to include individuals with aphasia in research