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Why consider: ppl who had withdrawn from fam, friends began to renew ties, ppl who had been fearful to go out into community started to use public transport, ppl who thought were alone learned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