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Aphasia Intervention (1) - Coggle Diagram
Aphasia Intervention (1)
Social model framework
Unds what aphasia means to the person w/i their community
Comm <--> social dynamics, identity, power, social expectations. Values that guide
Perspectives of PWA and fam
Consequences therapy, life participation approaches, functional comm approaches
Social approaches expand focus from transactional to interactional
Fnal approaches to Tx
Fnal comm approach: use of compensatory strategies to get around lang problem. Use other multimodal forms of comm
Recognise that PWA X need to be perfect speakers, listeners to comm adequately
Scaffolding to support successful convos
Communication
Transactional:
exchange of info, content based, focus on accuracy of info
Interactional:
establish, maintain social r/s, r/s based, connect, share opinions, thoughts, ideas, meaningful. Social affiliation
Social approaches principles
Comm should meet both goals of interaction, transaction--> plan client's goals around this
Comm should take place in personally relevant, naturalistic, authentic comm env-taking clients outside
Comm is flexible, creative: comm X need to be linguistically perfect to be effective, can just use gestures to interpret what person is saying
Comm is collaborative, focus beyond just PWA, rehearsing diff strategies, CPT
Tx should focus on adaptation, enablement
Activity, participation focused interventions
Rehearsal, real life prac of skills:
provide PWA with strategies, techniques to enhance success in daily life comm interactions. Tx can stimulate daily life situations, train PWA to use strategy/skill. Carryover tasks, give them backup order options although they might not need it
Use real life materials in Tx
eg. hospital, restaurant menus, shopping catalogues, forms, instruction sheets, recipe books, transport timetables, medication info, TV guides, cards, emails (unds, writing, typing)
Steps
Obtain baseline- writing, gesture see whether dominant hand is impaired, build on other strengths
Dev hierarchy to systematically move towards goal
Use role play, scaffold, use less cueing, more realistic
Measure fnal outcome- repeat after you first then remove support and become independent
A. PACE therapy
Principles:
equal participation (turn taking) SLP and PWA are senders, receivers of msgs ; exchange of new info (interaction incorporates exchange of new info b/w SLP, PWA) ; free to use any modality (gesture, writing, comm boards, drawing, computer aided communication, apps) ; natural feedback (based on PWA's success in comm a msg)
Barrier task:
cannot see stimuli. Like charades but can be verbal/non-verbal cues
Purpose: focus on changing comm behaviour of PWA, augmenting verbal skills w non-verbal behaviours
B. Script training
Vary difficulties, scaffold. Word, sentence length, grammatical complexity
Facilitates automatic spoken production of indv trained scripts in specific functional contexts.
Best for ppl w expressive difficulties but relatively OK comprehension
Training to phone 000 in emergency, hosting a party
Hello thank you for coming. Can I offer you a drink? We have...
Procedure:
generate personally meaningful topic, script written by clinician w client input (3-4 simple sentences). Using cueing hierarchy to train phrase repetition w written cue, choral reading w clinician, independent production, homework (record voice). Generalisation (clinician varied responses, aiming to make script more flexible)- How would you like that? instead of Y/N qns
Things to consider:
type of script (dialogue/monologue, telling a joke), no. of conversational turns, length of each turn, grammatical complexity, vocab selection. Can skip levels. Listen, tap along, chorale reading, record person's production
EBP:
showed impv on all measures (% script related words, rate of production, number of nouns, verbs, MLU) for learning script. Acq in trained script, generalisation to untrained script
C. Communicative, interactive drawing
Aim: PWA to convey information thru use of drawing, context makes diff in unds drawing, can be supplemented w verbal, print info
Draw distinctive features