Aphasia and occupational therapy: cracking communication codes in Aphasia Awareness Month.

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Aphasia and occupational therapy: cracking communication codes in Aphasia Awareness Month.

As the global aphasia community marks Aphasia Awareness Month this month, here’s a round-up of the latest occupational therapy-linked research into the communication disability that affects over 350,000 people in the UK.

 

   Training conversation partners of people with aphasia…is one method that can improve access to healthcare for people with aphasia. [1]   

 

Face-off

Virtual training went head-to-head with face-to-face for Australian occupational therapy students learning how to be conversation partners for people with aphasia.

In a pilot trial, researchers from The University of Sydney and the country’s Centre of Research Excellence in Aphasia Recovery and Rehabilitation wanted to determine if either of the training provision methods – online or in-person - was more effective.

Thirty student OTs from the university were enlisted to receive communication partner training (CPT) in three groups:

 

  • Online aphasia communication partner program.
  • Face-to-face training.
  • No training.

 

And when their knowledge was tested later, it was good news for the developers of the 45-minute online training program as it proved equally good as face to face. [1]

 

CPT 4 TBI?

Can communication partner training (CPT) improve interactions and outcomes for people with traumatic brain injury?

To find out, researchers in Ontario, Canada, carried out a systematic review of 11 worldwide databases from inception to 2019, eliciting 1088 articles from which 12 studies were deemed suitable for analysis.

And of those, three key areas were identified:

 

  • The benefits of CPT for TBI survivors.
  • The potential risks.
  • Ideas for improvements.

 

The evidence was ‘modest’ but, the study showed, CPT can boost community accessibility and participation for individuals with TBI. [2]

 

Yes to assess

Occupational therapy researchers linked arms with their speech and language peers in Pittsburgh, Pennsylvania, to pass their expert eyes over an aphasia-friendly tweak to a post-stroke upper extremity assessment.

Their interest was caught by a 74-year-old stroke survivor who had been taking part in a larger study of aphasia-friendly modifications to an occupational therapy home program.

They discovered that strategies such as gestures, visual aids, modified text, and conversational techniques supported participation in the program and reduced the cognitive load of exercises. [3]

 

   Communication partner training (CPT) of health professionals is recommended in several international guidelines for stroke and aphasia.[4]   

 

 

We are recruiting ...

 

Tool up

Hopes are high in Denmark that a new tool will ensure all healthcare professionals can effectively communicate with people with aphasia.

The Health Professionals and Aphasia Questionnaire (HPAQ) was designed for use in all medical and healthcare fields, including research, to provide reliable outcome measures.

It was recently trialled with 270 neurorehabilitation professionals, including occupational therapists, with contact with people with aphasia and achieved an ‘excellent’ result in test-retest reliability.

Overall, however, it proved more reliable when used by healthcare professionals of greater experience. [4]

 

People power

The American Journal of Occupational Therapy reports an investigation into the impact of social support on stroke survivors with or without aphasia.

Researchers from the MGH Institute of Health Professions in Massachusetts were specifically interested in the relationship between social support, communication and participation, as perceived by the survivors in the two groups.

Among the findings, they discovered that social support mitigated communication barriers to participation to a greater degree for those with aphasia than those without.

In conclusion, they suggested that occupational therapists might consider social support to facilitate community reintegration for people with aphasia. [5]

 

Brazilian nutshell

Putting ten years of global aphasia research, in a nutshell, saw a Brazilian tool hunting trio travel back in time from 2018 to 2008.

The research team, specialising in occupational therapy and human communication disorders at the Federal University of Santa Maria, were looking for best practice in aphasia assessments commonly used by occupational therapists, speech and language therapists and physiotherapists globally.

They scrolled through a decade of national and international data produced by professionals working in neurorehabilitation with adults with aphasia and found 26 studies of relevance.

And within those, they unearthed no less than 54 evaluation tools, 13 of which kept cropping up in practice worldwide. [6]

 

Aphasia friends

Tap into the lived experiences of people with aphasia who took part in a befriending trial at the City, University of London (CUL), as reported recently in the journal, Disability and Rehabilitation.

Peer-befriending, an intervention offering mutual support between people who share lived experience, may benefit people with post-stroke aphasia.

But to get a better idea of its impact, people with aphasia taking part in the UCL trial were invited to contribute their views on peer befriending during in-depth interviews.

Among the seven main themes that emerged, the participants cited the positive impact of the experience and the “secure” nature of challenges when they arose due to the training received. [7]

 

Aphasia aware

Aphasia Awareness Month is marked globally by the aphasia community to raise awareness of the condition, usually caused by stroke or brain injury.

Aphasia impacts communication skills, making it difficult to read, write, speak or use numbers.

Several UK organisations offer further information and support, including the Stroke Association [8] and Say Aphasia [9].

 

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References

 

​[1] Power, E. et al, “A pilot randomized controlled trial comparing online versus face-to-face delivery of an aphasia communication partner training program for student healthcare professionals,” International Journal of Language and Communication Disorders, July 2020.

​[2] Wiseman-Hakes, C. et al, “Examining the Efficacy of Communication Partner Training for Improving Communication Interactions and Outcomes for Individuals With Traumatic Brain Injury: A Systematic Review,” Archives of Rehabilitation Research and Clinical Translation, March 2020.

​[3] Wallace, S. E. et al, “Designing Occupational Therapy Home Programs for People With Aphasia: Aphasia-Friendly Modifications,” Perspectives of the Asha Special Interest Group, April 2020.

​[4] Randrup Jensen, L. et al, “Psychometric properties of the Health Professionals and Aphasia Questionnaire (HPAQ): a new self-assessment tool for evaluating health communication with people with aphasia,” Aphasiology, March 2021.

​[5] Fritz, K. et al, “Social Support Mediates the Relationship Between Communication Abilities and Social Participation Post-Stroke Only for People With Aphasia (PWA),” American Journall of Occupational Therapy, September 2020.

​[6] Borba da Silva, E. et al, “Assessment of individuals with aphasia: an integrative literature review,” Revista Cefac, 2020.

​[7] Northcott, S. et al, “For them and for me”: a qualitative exploration of peer befrienders’ experiences supporting people with aphasia in the SUPERB feasibility trial,” Disability and Rehabilitation, May 2021.

​[8] https://www.stroke.org.uk/what-is-aphasia

[9] https://www.sayaphasia.org/