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How to Select the Best Therapy for Persons with Aphasia

presented by Jacqueline Hinckley, PhD, CCC-SLP

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Disclosure Statement:

Financial: Dr. Hinckley is employed by Nova Southeastern University. Dr. Hinckley received honoraria for this course.

Non-Financial: Dr. Hinckley is on the advisory board of the National Aphasia Association.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Accreditation Check:
Many therapies exist for treating patients with aphasia. Following the World Health Organization Classification of Functioning, Disability, and Health, treatment strategies and techniques can be broadly classified into two groups: impairment-focused techniques and participation-focused techniques. Evidence exists to show that treatments in each group can facilitate improvement in the communication status and abilities of a person with aphasia. Because treatment techniques tend to be identified as impairment-focused techniques and participation-focused, clinicians tend to consider selection and application for treatment techniques as an “either-or” decision, which may not be the most efficient way to select treatment. In this course two models for selecting therapies will be discussed: the additive model in which therapies are often delivered in a sequential manner, and the integrative model in which therapy decisions are functionally guided from a top-down goal decomposition approach.

Meet Your Instructor

Jacqueline Hinckley, PhD, CCC-SLP

Dr. Jacqueline Hinckley is currently Associate Professor in Speech-Language Pathology at Nova Southeastern University and Executive Director Emeritus at Voices of Hope for Aphasia. Dr. Hinckley is the author of two books, Narrative-Based Practice in Speech-Language Pathology and What Is It Like to Have a Communication Impairment? Simulations for Family, Friends, and Caregivers. She is…

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Chapters & Learning Objectives

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1. Introduction to Evidence-Supported Impairment and Participation-Focused Therapies

This chapter will define impairment and participation-focused therapies in aphasia treatment, with key examples of treatments for each category. The clinician’s challenge is to identify goals based on assessment and map appropriate treatment approaches to those goals. Resources from the ASHA Practice Portal will be highlighted as a guide for clinicians seeking to use evidence-supported therapies.

2. A Typical “Additive” Model to Selecting Therapies

A case example will be used to demonstrate how typical impairment-focused assessments drive us to write impairment-focused goals. Therapy is often initially impairment-focused. In order to achieve transfer and generalization, participation-focused therapies are often “added on” to an impairment-focused model.

3. An Integrative Model to Selecting Therapies

The same case example as in Chapter 2 will be used to contrast an integrative approach to treatment selection. First, the client’s priorities are used as a basis for assessment and goal formulation. A demonstration will show how this approach results in very different treatment selections than in the Additive Model described in Chapter 2.

4. How the Integrative Model Can Change Clinical Outcomes

Research and clinical examples will be used to highlight how clinical outcomes and clinical efficiency can be affected by using an integrative model. For example, when fewer treatment sessions are available, an integrative model focused on specific client goals may be more effective and efficient over the long term.

5. A Final Case Example and Conclusions

A different case example will be utilized to facilitate the transfer of learning from the previous case example to a different case. The integrative model will be highlighted and summarized.

More Courses in this Series

Engaging Persons with Aphasia in Community Resources

Presented by Janet Patterson, PhD, CCC-SLP and Jacqueline Hinckley, PhD, CCC-SLP

Engaging Persons with Aphasia in Community Resources

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The value of participating in group activities to an individual’s psychosocial and physical well-being is clear from research evidence. This is the case both for persons without and with aphasia. Gaps exist between the evidence base and implementing participation activities from the perspectives of community groups welcoming a person with aphasia (PWA), determining the interest or willingness of a PWA to participate in a group, and the strategies available to a PWA or caregiver to translate the desire into reality. This course will present the evidence describing the value of group membership to PWA and, through a series of case examples, will discuss the challenges faced by clinicians, PWA, and caregivers in accessing, joining, and sustaining membership in community groups.

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Evidence-Based Practice in Aphasia Treatment

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Evidence-based practice (EBP) relates to how clinicians make assessment and treatment decisions with patients and families. EBP is taught in graduate programs in speech-language pathology. However, as students become practicing clinicians working in fast-paced, contemporary clinical environments, obstacles arise that may prevent consistent, active engagement in EBP. The intent of this course is to discuss EBP and practice-based evidence, provide a model for how to find evidence and determine its quality and relevance, and present suggestions for using the evidence to support good clinical decisions. Several readily available, easy to use tools for finding and evaluating evidence will be demonstrated. At the end of this course, the learner will have knowledge and skills that are readily transferable to clinical practice in any contemporary clinical speech-language pathology’s practice in hospitals, rehabilitation facilities, skilled nursing facilities, or home health care settings.

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Selecting Aphasia Treatment: Case Examples

Presented by Jacqueline Hinckley, PhD, CCC-SLP and Janet Patterson, PhD, CCC-SLP

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The purpose of this course is to explore in detail the process by which a clinician selects a therapy based on treatment goals. We will do this by using three case examples of individuals with different types and severities of aphasia. The two presenters will also discuss each case in terms of impairment-focused and participation-focused treatment choices.

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