Achieving real life goals

The field of aphasia treatment has experienced extreme pressure in the last decades from reductions in insurance reimbursement, shortened lengths of stay, plus increased demands on speech-language pathologists. Additionally, unmet needs from patients and families facing a lifetime of aphasia have spurred needed changes.  

Fortunately, the Life Participation Approach empowers SLPs and their patients (and families) at every step of aphasia intervention with goals that can be both relevant and reimbursable. Regardless of the stage of intervention (early post-onset through chronic stages), the overriding goal of all aphasia therapy is to improve communication when and where a person wants or needs to communicate. In other words, aphasia treatment should produce outcomes that achieve real life, individually meaningful goals. 

For instance, participation goals during acute hospitalization might involve the ability to summon a nurse. At a later stage, participation goals might relate to conversing with one’s spouse, going to dinner with friends, or reading to one’s grandchildren. 

Achieving meaningful outcomes requires attention to communication support at every stage. An apt analogy occurs in physical therapy when the person with hemiplegia is given aids to support safe walking such as a walker or cane while also participating in therapy to restore muscle strength coordination and tone. If fact, restoration of muscle tone and strength is often integrated with the practice in aided walking. A similar approach is appropriate in the management of communication.

Aphasia intervention and assessment are dynamic and interconnected processes. Through addressing a person’s language impairment, personal identity, activities of choice, and environment, speech-language pathologists and other providers looking at these domains together with their patients can produce extraordinary outcomes for living successfully with aphasia.