Aphasia Intervention (2)

Successful living w aphasia

1. Doing things- continuing activities from before stroke, finding new activities, adapting activities, w/o talking, leisure activities etc

2. Meaningful r/s- living successfully, friends, fam impt, other ppl w aphasia, stroke. Support from fam, friends, acceptance from fam, friends, friendship and peer support from other PWA (networks-group Tx, Australian Aphasia Association etc). Consider SLP's role in doing these.

3. Communication: Integral role of comm across many areas of life, interactional components of comm, impacts on friendship. SLP's role in exploring comm across all areas of client's life, working w friends, others

4. Positive way of living: positive attitude, perseverance, acceptance, focusing on impv, sense of humour, moving on w life, looking into future. SLP's role in thinking positive, max strength.

Group Tx in aphasia mgt

Focus: impv comm, living w aphasia on 1 or more levels. Impairment at specific speech/lang skills. Activity and participation --> everyday comm activities, life participation approach. Impv confidence, QOL, life satisfaction, well being

Can extend, enhance: ling skills, convo, story telling, commenting, discussing, pragmatic skills

Why consider: ppl who had withdrawn from fam, friends began to renew ties, ppl who had been fearful to go out into community started to use public transport, ppl who thought were alone learned that others have experienced the same thing before. Support, hope, info, forum for exchange of experiences, ideas, supportive, safe env for convo, enjoyment, humorous exchange, opportunities to prac comm strategies, social contacts, opportunity to express feelings, confidence, increased assertiveness, unds of self advocacy, empowerment, adaptation to life w aphasia

Role of leader: facilitates, observes, coordinates, enables time to reiterate, clarify, summarise, models positive communicative behaviours (active listening, turn taking, encouragement), has presence, caring and sense of humour

Training the group therapist: Obsv of experienced SLP, supervision, peer review, keep data, analyse group dynamics before and after, commitment to self-dev., reflect, review and critically evaluate (stop, keep, start), learn from experience

Challenges in group: no. of members, dynamics, aphasia accessible resources, ways of resolving conflicts and having plan of action, mgm dominant group member, the PWA

Candidacy: PWA has reliable yes/no, way of conveying basic info to Tx staff, group, demonstrates cognitive skills that are compatible w participation in group, attendance, X receiving help elsewhere

Types of groups

Info groups

Convo groups

Book club groups

Dev personal portfolio

For fam and friends

Successful living w aphasia

Drawing what is aphasia/stroke

Quizzes on T/F qns

Treasure hunt video, aphasia movies to show client other POVs

Brochure, CPT

Guest speakers to share info/experiences

Set topic for group session, encourage PWA to bring items/artefacts

Food, travel, hobbies, going out, education, politics, current events, TV shows

Let's talk discussion and prompt cards-read/distribute to ppl

Reading ramps: content review of chapters, worksheets, guidelines, audio version

Make ppt slides or photo album: documents, certs, letters, cards, newspapers, magazines, photos

Set topics for each week

Share portfolio to tell other ppl what you do, personal record, strengths-based to remind of achievements

My biggest achievement before my stroke

My biggest achievement after stroke

What I have learnt, tips for helping others

Provide chance to tell their story

Opportunity for family friends to share advice

Probe for positives, acknowledge expertise of living w aphasia

Measuring outcomes of aphasia

Obsv outcomes: an index of convo partner's skill in providing conversational outcome, index of participation in convo by PWA

Acknowledging competence: natural adult talk appropriate to context, sensitivity to partner

Revealing competence: ensures that PWA unds, has means of responding

Client specific goals (GAS), consumer satisfaction measures, service stats, social network (does the person feel more/less isolated), AusTOMS (tool for ICF, distress, wellbeing), formal, informal Ax used to inform ratings

QOL, wellness, adjustment measures: SAQOL-39, burden of stroke scale, Quality of Communication Life Scale, visual analogue self-esteem scale. AFROM