Introduction to therapy approaches in aphasia rehabilitation

Question 1

3 main areas of providing aphasia intervention

Answer 1

1. Access to aphasia therapy
2. Type of aphasia therapy
3. Service delivery options

Question 2

Access to aphasia therapy

Answer 2

• Should be offered therapy for receptive language, expressive language, and communication in everyday environments
• PWA post 1 month should receive intensive therapy if tolerable, and less than 1 month if tolerable
• People with chronic aphasia can also benefit from therapy

Question 3

Service delivery of aphasia therapy

Answer 3

• Benefits of high intensity and duration
• SLT better than no SLT
• Challenged reported in providing therapy in acute and residential care
• Group and intensive services under-utilised

Question 4

Functional reorganisation in aphasia

Answer 4

According to neuroimaging there can be:
1. Recruitment of residual left hemisphere structures
2. Recruitment of right hemisphere regions
Not well understood

Question 5

Focusses of assessment and interventions to PWA

Answer 5

• Focus on language impairment and processing (CNP approach)
• Functional communication focus (eg. conversation therapy)
• Participation focus (eg. group therapy)
• Psychosocial focus (consider contextual factors)

Question 6

2 approaches to aphasia intervention

Answer 6

1. Language impairment-based approach
   -Uses normal language and CNP to determine language breakdown and treatment
2. Consequences-based approach
   -Encompasses functional, social, participation, psychosocial approaches

Question 7

Language impairment-based aphasia intervention

Answer 7

Goal is to provide treatment for aspects of language that have been fractionated by brain damage
- Guided by underline deficit

Question 8

Consequences-based aphasia intervention

Answer 8

• The disability of PWA has an impact on them, their family, friends, community
• Disability may be associated with decreased QOL, depression, social isolation

Question 9

Goal setting for aphasia therapy

Answer 9

• Relationship-centred approach with PWA and family to decrease tension
• Shared decision-making to determine best approach
• Goals can be both specific and holistic
• Combination of ICF components
• Needs systematic measurement and documentation of progress
• Outcome measurement, eg. AusTOMs