One SLP To Another: Practical Aphasia Therapy Ideas And .
2/14/2020One SLP to Another:Practical Aphasia Therapy Ideasand ResourcesObjectivesJennifer Barry, M.S., CCC-SLPPi Beta Phi Rehabilitation InstituteVanderbilt Bill Wilkerson Center1 Identify resources to support meaningfulconversation Identify therapeutic activities to stimulatefunctional language Review evidence-based language treatments Identify recently released assistive technologiesfor AAC Identify functional home exercises2Aphasia TherapyAphasiaDefined “Aphasia is a language problem that masksinherent competence and that has its mostdramatic impact on conversational interaction(talking and understanding) Without the abilityto participate in conversation, everyrelationship, every life role, and almost everylife activity is at huge risk. With additionalreading and writing difficulties the impact isdevastating.” Approaches Impairment-based Functionally oriented Delivery methods Individual GroupKagan, A. & Simmons-Mackie, N.(2013). Changing the aphasianarrative. ASHA Leader, Nov 18, 6-8.341
2/14/2020American Speech-Language-Hearing opic.aspx?folderid 8589934663§ion Treatment#Treatment Approaches Treatment approaches Treatment options Treatment considerationsTreatment forAphasiaASHA Scientific px?id 8589936279 Systematic Reviews Guidelines Meta-analysesLingraphica Other aphasia treatment oach toAphasiaCore Values World Health Organization’s InternationalClassification of Functioning, Disabilityand Health (ICF) (WHO, 2000) Explicit goal is enhancement of life participation Services are available to all affected by aphasia Assessment and intervention targets personaland environmental factors Success is measured by documented life changes Services are available as needed at all stages The ICF components include: Body functions and bodystructures Activities andparticipation Personal factors Environmental factorsby the LPAA Project Group (in alphabetical order: Roberta Chapey, Judith F. Duchan,Roberta J. Elman, Linda J. Garcia, Aura Kagan, Jon Lyon, and Nina Simmons Mackie)Chapey et al. (2000)7Brown & Vickers (2000)82
2/14/2020 Relationship rolesVocational responsibilitiesSocial closenessLeisure activitiesVolunteer opportunitiesCommunity activities Social supportFriends’ attitudesand knowledge Therapist’sperspectives/beliefs Supports andbarriers tocommunicationA-FROM (Kagan et al., 2008) Study interviewed 50 participants with aphasiainterviewed post-stroke 2011 study by Worrall andcolleaguesConfidenceInsightSelf-esteemIdentity andautonomyExpectations ofPWAWhat DoPatients withAphasiaWant? Return to pre-stroke life Communicate opinions, not just basic needs Information about aphasia, stroke, and available services More speech therapy Greater autonomy Dignity and respect Engagement in social, leisure and work activities Regaining physical healthLanguage and cognitionStrengthsLanguage activities tosupport specific rolesMeaningful vocabularyScripts for specific activities Help othersLinked to Participation domain of the WHO modelWorrall et al. (2011)Image retrieved 2/13/20 from: a/8b/5a7a8bfda03065cc0214711a4132b1f7.png910Where tobegin LPAA Assessment What matters to the PWA? Focus on participationoutcomes Beginning at the EndAssessment ofInterests andValues Aphasia Needs Assessment (Garrett andBeukelman, 1997) Communication History Form (Kathryn Cann) Life Interests and Values (Haley et al., 2010) Aphasia Topic Interest Inventory (tobii dynavox)Kagan & Simmons-Mackie (2007)11123
2/14/2020AphasiaNeedsAssessment*Free *Free ssessment/aphasianeeds.pdf14Communication History FormFunctional Vocabulary Inventory*Free Resource* aphasiafriendly.com (Kathryn Cann) Have familiar communication partners list off: 15People – family, friends, neighbors, doctors, individuals in the communityPetsPlaces around town (e.g. Walgreens, Publix, barbershop, place of worship, gym)RestaurantsWork historyHobbiesPreferred food and beverages (breakfast/lunch/dinner, snack, dessert options)Medical164
2/14/2020Aphasia Topic Interest Inventory*Free Resource* tobii dynavoxLife Interestsand ValuesCardsHaley et al. (2010) LIV Cards are a nonlinguistic, picture-based instrument designed forcommunicating directly with PWA about their current and desired lifeactivities Sort functional activities into “current activities” and “activitypreferences”Retrieved on 2/10/20 from: .amazonaws.com/Snap/Training/Aphasia ion and ResourcesCONNECTINGPEOPLE WITHAPHASIAAUGMENTATIVE &ALTERNATIVECOMMUNICATIONPARTNERTRAININGEDUCATION ANDRESOURCES(Elman, 2013)19205
2/14/2020Educational VideosAphasia: The disorder that makes you lose your wordsVideosWhat is Aphasia?- Susan Wortman-Jutt Ted-Ed presentation5 minutes totalInitial 2 minutes 30 seconds describes non-progressive aphasiaIt’s Still Me National Aphasia Association 1 minute, 30 secondsThe Invisible Rain Cloud “Heart to Heart” is a song for the It’s Still Me video trailer TBI and aphasia Depicts how individuals experience aphasia 5 minutes 3 minuteshttps://www.youtube.com/watch?v e9 dpe9Rbvwhttps://www.youtube.com/watch?v -GsVhbmecJA&feature n-injury-andaphasia/22Educational WebsitePartner Training VideosAphasia EtiquetteAphasia: Supported Communication UK Stroke Association Stroke 4 Carers How to communicate with someone with aphasia Demonstrates supported communication techniques using AAC 2 minutes 7 minutes total Begin at minute 4:39https://www.youtube.com/watch?v rs.org/?p 5390246
2/14/2020Videos about Communication After AphasiaWhat to expect when working with a speech-language you-treat-aphasia/Multimodal communicationhttps://www.youtube.com/watch?v KWVoqM9jmEMCommunication Tips for areAphasia Wallet CardsFor communication partners - Adjusting Your Talkinghttps://vimeo.com/137513438*Free Resources*2526Supported Conversation for Adults with Aphasia Acknowledge Competence Reveal Competence Techniques to ensure the PWA Can accurately comprehend messages Express messages VerifyPartner Training27287
2/14/2020Conversational CoachingRating Support and Participation in Conversation Measure of Skill in SupportedConversation Measure of Level of Participation inConversation (for PWA) Teaching effective verbal and non-verbal strategies PWA Partner Social Interaction Transaction Measuring Number of main concepts PWA – Frequency of functional communication (multi modal strategy use) Partner – Frequency of supportive techniquesKagan, A. et al (2004)(Hopper, Holland & Rewega, 2002)Kagan, A., Simmons-Mackie, N., & Shumway, E. (2018)*Free aTopics – AACby Tactus 4.99 iOS/Android 3-in-1 Letter board Topics grid WhiteboardAugmentative and AlternativeCommunication31328
2/14/2020Low-tech AAC in AphasiaWriting and DrawingWriting TabletDry Erase boardWhiteboard App Drawing Writing (pencil/paper, white board, boogie board) Word lists (pocket notebook, spiral-bound index cards, miniPowerPoint slides laminted and placed on a keychain) Scripts Communication book Communication boards Picture dictionaries Gesture (universal)3334ScriptsMicrosoft Office Word OneNote Edge web-browserWord lists35369
2/14/2020Visual Scene Display(Print Materials)University of Nebraska-LincolnAugmentative and Alternative CommunicationAphasia TemplatesCommunication Book *Resource* aphasiafriendly.com (Kathryn Cann) *Resource* boardmakeronline.comboardmakeronline.com*Free ources/3738Communication BookCommunication BookRestaurantsPanera BreadChick-fil-AAround townChili’sYMCAKrogerPublixPinnaclePark CafeCoco’s Italian Market& EaterySam’sTargetLowe’sWalgreensCoscoTennessee Credit UnionMcDonald’sNewk’sBank39Cracker BarrelWendy’sBurger KingHugh-Baby’sWalmartRegions BankHome DepotFedExPost OfficeUPS4010
2/14/2020High Tech AACAphasia FriendlyMaterials Aphasia Friendly Resources aphasiafriendly.co UNC Aphasia Friendly Print Material co/supportingexpression.htmlVisual Scene Apps Scene and Heard (iOS) 84.99 Snap Scene (iOS/Windows) 49.99 Scene Speak (iOS) 18/02/C3.pdf The Aphasia Institute participics.ca UK Stroke Association www.stroke.org.uk/what-is-aphasia*Free Resources*(Brock et al, nsearch iles/4.stroke recovery passport final 161215.pdf4142Acute/Inpatient AACHigh Tech AACCommunication Apps Snap Core First with Aphasia Page Set (iOS) 49.99 AlphaTopics – AAC App2Speak (iOS/Android) 179.99 EESpeech (iOS/Windows) SpeechAssistant (iOS/Android)Up to 14.99 ChatAble 99.99 SmallTalk by Lingraphica (iOS)https://touchchatapp.com/pagesets#pageset communication journey aphasia Alexicom (iOS/Android) Touch Chat - Communication Journey: Aphasia (iOS) 149.9943Healthcare Communication AppTrach Tools App4411
2/14/2020mytobiidynavox.comYoDoc AppSnap Core First with Aphasia Page SetBy tobii dynavox4546Snap Core First with Aphasia Page SetSGD: LingraphicaTouchTalkAll TalkMini conditions/aphasiastroke/474812
2/14/2020Reading and WritingReading and Writing Spoken (iOS/Android app)https://spokenaac.com/www.callscotland.org.uk Clicker (Windows/Mac, iPad, Chromebook)https://www.cricksoft.com/us/clicker Ghotit Real Writer & l-writer-for-windows Snap and snap-read/ Read and write/ Kurweil view.html4950Reading Seeing AI (talking camera app for ing-ai Claro Apps (several platforms– read – write)https://www.clarosoftware.com/ Present Palhttps://presentpal.co.uk/ Capti Voice /entry/readers Reader Penhttps://www.scanningpens.com/ bookshare.org51 Verbal Expression (e.g. word retrieval, perseveration,organization etc.) Reading ComprehensionTreatment Written Expression Auditory Comprehension Multi-modal Communication Supported ConversationC-Pen Readerhttps://www.scanningpens.com/reading aids usa/c-pen reader.html5213
2/14/2020VerbalTreatmentProceduresMelodic Intonation Therapy Oral expression Response Elaboration Training Promoting Aphasics’ CommunicativeEffectiveness Verb Network Strengthening Treatment Phonological and Semantic Cueing Task Specific Training (phonological andsemantic cueing) Semantic Feature Analysis Melodic Intonation Training Script training Constraint-Induced Aphasia TreatmentLevel OneTap on client’s left hand or forearm. May use a metronome. Higher pitch for the emphasizedsyllables or words.1. Humming (x2) – no response required from patient2. Intone the target word/phrase (x2) – no response required3. Unison intoning - client joins in tapping and saying the target4. Unison intoning with fading5. Immediate repetition – intone and tap target while P. listens then patient immediately repeatstarget6. Response to probe – intone an appropriate question, “What did you say?”Hello(Hinckley, 2011; Salter et al, 2012; Allen et al, 2012)I am thirsty(Norton et al. 2009; Zumbansen et al. 2014)5354Response Elaboration Training55 Verbal material: numerous sentences of daily living Visual material: relevant picture for each sentence Intoned pattern: exaggeration of normal prosody ontwo notes Tapping with the left hand Lip-reading allowedSFA5614
2/14/2020Verb Network Strengthening TreatmentScript TrainingGood evening everyone.Welcome to ’s.It’s a pleasure to have you here.I’m .I want to thank my wife, , for helpingme to coordinate this event. She dideverything from making reservations,contacting our award recipients, reaching outand getting the auctioning items, andarranging the tables. Without her this eventwould not be possible this year.I have been singing at ’s for 5years.Tonight I am bringing you Rhythm andBlues.This song is called .(Hopper & Holland, 1998)57Hi , this is .I’d like to make an appointment.When can you take me?58Making an AppointmentEmployeeYouReading andWritingTreatmentProceduresI want to make an appointmentDr. Kirshner59 Oral Reading for Language in Aphasia (ORLA) Multiple Oral Re-reading Copy and Recall Treatment(Beason, P. & Egnor, H 2006; Hinckley, 2011; Salter et al, 2012;Allen et al, 2012)6015
cedures63 PACETask specific trainingCommunication partner trainingSpaced retrieval(Hinckley, 2011; Salter et al, 2012; Allen et al, 2012)6416
2/14/2020Home PracticeA Few Others to Consider Story Creator app (*Free) Animoto app (*Free) Honeycombspeechtherapy.com Microsoft Visual Action Therapy Gestural Verbal TherapyStory Creator Word PowerPoint One Note Reciprocal Scaffolding Treatment of Aphasic Perseveration (TAP)Animoto6566Computer-Based Practice TalkPath Therapy (*Free) Tactus Constant TherapyConnectinghttps://appsliced.co/app?n lingraphica-talkpath-therapy676817
2/14/2020Aphasia Group of Middle TennesseeReferencesBhogal S, Teasell R, & Speechley M (2003). Intensity of aphasia therapy, impact on recovery. Stroke, 34, 987-993.Brown, J. & Vickers, C. (2015). Are life participation goals reimbursable? ASHA Leader, Oct 20, 36-38.Chapey, R., Duchan, J.F., Elman, R.J., Kagan, A., Lyon, J., Mackie, N.S. (2000). Life participation approach to aphasia: A statementof values for the future. ASHA Leader, Feb 15 (3), 4-6Vanderbilt Pi Beta Phi Rehabilitation CenterMedical Center East – South Tower, 9th Floor1215 21st Avenue SouthNashville, TN 37232Cherney L, Merbitz C & Grip J. (1986). Efficacy of oral reading in aphasia treatment outcome. Rehabilitation Literature, 112-119.Cherney LR. (2004). Aphasia, alexia and oral reading. Top Stroke Rehabil, 11(1), 22-36.Cherney LR, Patterson J, Raymer A, Frymark T, & Schooling T (2008). Evidence-Based Systematic Review: Effects of Intensity ofTreatment and Constraint-Induced Language Therapy for Individuals with Stroke-InducedAphasia. J Speech Lang Hear Res, 51, 1282-1299.To learn more, contact our program coordinator, Dominique P.Herrington, CCC-SLP at (615) 936-5051.Elman RJ & Bernstein-Ellis E (1999). The efficacy of group communication treatment in adults with chronic aphasia. J SpeechLang Hear Res, 42: 411-419.Elman, R. (November, 2013). CAPE: Making Choices in Aphasia Intervention when Intensive Therapy is Not Possible. Presentedto the ASHA Convention, Chicago, IL.Elman, R. J. (2011, 2018). Social and life participation approaches to aphasia intervention. In L. LaPointe (Ed.). Aphasia andrelated neurogenic language disorders (5th ed). N.Y.: Thieme Medical Publishers.6970ReferencesReferencesGarrett, K. L., & Beukelman, D. R. (1997). Aphasia Needs Assessment.Koul, R. , Lloyd, L. , & Arvidson, H. (2011).Overview of AAC intervention approaches for persons with aphasia. InKoulR. (Ed.), Augmentative and alternative communication for adults with aphasia: Science and clinical practice (pp.47–64). Yorkshire, England: Emerald Group Publishing.Haley, K.L., Womack, J.L., Helm-Estabrooks, N., Caignon, D., McCulloch, K.L., (2010). The Life Interest and Values Cards. Chapel Hill,NC: University of North Carolina Department of Allied Health Sciences.Kris Brock, Rajinder Koul, Melinda Corwin & Ralf Schlosser (2017) A comparison of visual scene and grid displays for people withchronic aphasia: a pilot study to improve communication using AAC, Aphasiology, 31:11, 12821306, DOI: 10.1080/02687038.2016.1274874Krista M. Wilkinson, Janice Light & Kathryn Drager (2012) Considerations for the Composition of Visual Scene Displays: PotentialContributions of Information from Visual and Cognitive Sciences, Augmentative and Alternative Communication, 28:3, 137-147, DOI:10.3109/07434618.2012.704522Laska AC, Hellblom A, Murray V, Kahan T, von Arbin M. Aphasia in acute stroke and relation to outcome. J Intern Med 2001; 249: 413–422.McNaughton, D. , & Light, J. (2013). The iPad and mobile technology revolution: Benefits and challenges for individuals who requireaugmentative and alternative communication. Augmentative and Alternative Communication, 29(2), 4930Miechelle L. McKelvey, Hux, K, Dietz, A, & Beukelman, D.R. (2010) Impact of Personal Relevance and Contextualization on WordPicture Matching by People With Aphasia. American Journal of Speech-Language Pathology, Vol. 19, 22-33. doi:10.1044/10580360(2009/08-0021)Kagan, A. (1998). Supported conversation for adults with aphasia: Methods and resources for training conversation partners.Aphasiology, 12(9), 816-830.Kagan, A., & Simmons-Mackie, N. (2007). Beginning with the end: Outcome-driven assessment and intervention with life participationin mind. Topics in Language Disorders, 27(4), 309-317.Kagan, A. & Simmons-Mackie, N. (November 2013). Changing the aphasia narrative. ASHA Leader, Nov 18, 6-8.Kagan A., et al. (2001). Training Volunteers as Conversation Partners Using Supported Conversation for Adults With Aphasia (SCA): AControlled Trial. Journal of Speech, Language and Hearing Research, (44): 624-638.Kagan, A., Winckel, J., Black, S., Duchan, J.F., Simmons-Mackie, N., & Square, P. (2004). A set of observational measures for ratingsupport and participation in conversation between adults with aphasia and their conversation partners. Topics in StrokeRehabilitation, 11(1), 67-83.Kagan, A., Simmons-Mackie, N., & Shumway, E. (2018). A set of observational measures for rating support and participation inconversation between adults with aphasia and their conversation partners. Toronto, ON: Aphasia Institute.Kagan, A. (1998). Supported conversation for adults with aphasia: Methods and resources for training conversation partners.Aphasiology, 12(9), 816-830.71Milman, L. (2016). An integrated approach treating discourse in aphasia: Bridging the gap between language impairment andfunctional communication. Language Disorders, 36, 80-96.7218
2/14/2020ReferencesSimmons-Mackie, N., & Kagan, A. (2007). Application of the ICF in aphasia. Seminars in Speech & Language, 28,244-253.Steele, R & Woronoff, P. (2011)Design challenges of AAC apps on wireless portable devices for persons with aphasia.Perspectives on Augmentative and Alternative Communication. Volume 20, Issue 2: 41-51.Sabine Heuer (2016) The influence of image characteristics on image recognition: a comparison of photographs and linedrawings, Aphasiology, 30:8, 943-961, DOI: 10.1080/02687038.2015.1081138Taylor, S,. Wallace, S.J., & Wallace
Identify functional home exercises Aphasia Defined “Aphasia is a language problem that masks inherent competence and that has its most dramatic impact on conversational interaction (talking and understanding) Without the ability to participate in conversation, every relationship, every life role, and almost every
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