Aphasia intervention social functional 11/19/24

Aphasia Treatment Overview

• Focuses on functional, social, and compensatory approaches to aphasia therapy.

• some compensatory strategies are partner dependent, so teach the family to use gestures and facial expressions to compensate for speech

Social-Functional Approaches

• Medical vs. Social Models

  • Comparison between traditional medical approaches and newer social models.

  • medical model focuses on what is wrong anatomically, social model focuses on how they interact with others and if there are problems there

• Emphasis on Functional Communication

  • Importance of communication effectiveness in natural contexts rather than purely linguistic correctness.

• Communicative Value

  • Valuing overall communicative intent over grammatical accuracy.

• Compensatory Strategies

  • Strategies employed to aid communication effectiveness.

  • having a brain injury does not make you less intelligent!

Social Functional Approaches:

Life Participation Approach to Aphasia (LPAA)

• Life concerns are central in decision-making regarding treatment and interventions.

• Focus on the impact of aphasia on interpersonal relationships and everyday living.

• Recognizes the complexity and context of real-life communication.

ICF-Focused Approaches

• A-FROM (Living with Aphasia: Framework for Outcome Measurement)

  • Tool for intervention conceptualization based on the ICF framework.

  • Considers the following domains affected by aphasia:

    • Language and Related Processing

    • Participation

    • Personal Factors, Identity, and Feelings

    • The Environment

    • be well versed with this AFROM Model! slides 4-5

Outcomes and Measurements

• Focus on participation in various life situations and communication.

• The severity of aphasia impacts outcomes but should not restrict participation choices.

Underlying Values of A-FROM-slide 6

• Client-Centered Evaluation

  • Clients themselves should define meaningful life changes and outcomes.

• Universal Applicability

  • Can be applied to all severity levels of aphasia.

• Holistic Functioning

  • Participation should reflect actual functioning in life, considering roles, responsibilities, and relationships.

  • think of what can we role play that reflects their life? if they are the main bill payer, role play writing checks. if they are looking for a job, role. play calling and interviewing. consider their cultural and familial role, if they are the primary provider or cook or whatever other responsibilities they do daily.

Nine Principles of Social Approaches to Aphasia (Simmons-Mackie)

• Goals of Communication

  • Informational exchange and social relationships are complementary goals.

    • they are not mutually exclusive and they do not conflict with each other. both are important

• Dynamic and Collaborative Nature

  • Communication is flexible and requires collaboration.

• Natural Interaction Focus

  • Importance of conversation and social consequences of aphasia in interventions.

• Qualitative and Quantitative Measures

  • Evaluation should encompass multiple types of measurement.

Supported Communication-slide 8

• It is a therapy Philosophy, Not Method

  • A set of tenets that enhance communication access and participation.

• Strategies and Resources

  • Utilizing tools and strategies that assist communication for individuals with language disorders.

  • put the cat food out where you can see it so you won’t forget to feed it

  • different strategies or modifications to environment like the cat food example

Total Communication Approaches

• Encouragement of All Communication Means

  • No specific modality required; the focus is on content.

• Augmentative and Alternative Communication (AAC)

  • Use of various methods to support communication needs.

  • AAC supplements natural speech, adds to what little speech you have

  • total communication= any method of communication a person uses to get their point across. even miming, drawing, writing

  • what they say is more important than how they say it

Partner and Caregiver Training

• Educational Programs

  • Training volunteers and community members to support individuals with aphasia.

• Key Programs

  • Communication Partner Scheme, Conversational Coaching, Aphasia Couples Therapy.

Aphasia Mentoring Programs

• Peer Mentoring

  • Individuals with aphasia guide students in clinical education.

• Toastmaster Programs

  • Speech practice groups for individuals with language disorders.

• Humor as Therapy

  • Utilizing humor as a therapeutic tool to support individuals with aphasia.