Have you ever had a patient, client, or resident with aphasia who left you feeling stumped? You knew there had to be a way to help, but you didn’t know what it was?
Wendy Duke, a seasoned speech-language pathologist, felt that way. One of her clients was in a bad situation because of aphasia and concomitant social issues resulting from a stroke. She was sure some sort of app technology could help him improve, but she wasn’t sure what exactly that might be.
Local agencies that specialized in alternative augmentative communication (AAC) and assistive technologies could only provide a grid and symbol-based AAC app. But this man was resistant to anything that would speak for him. He had otherwise recovered well physically, and he wanted to speak for himself.
Wendy decided to pull together her own team of consultants to find a solution. She recruited experts in communication support, aphasia therapy, and technology, and they began developing an integrated approach.
“Our community—like most communities—didn’t have a resource that teaches front-line speech-language pathologists how to use technology for therapy,” Wendy explains. “We needed a model for consulting about technology that would meet the various needs of people with aphasia.”
If this worked, Wendy reasoned, other clients and speech-language pathologists could probably benefit from a service that offered consultation in both augmentative communication and therapy technologies.
Finding the Right Tools
Wendy’s team came up with several cost-effective recommendations to help her client achieve four goals:
- Increase the intensity of his therapy at home
- Improve his functional communication skills (using video-assisted script training)
- Learn to regulate his anger (using mindful breathing)
- Communicate over distance (using video and email applications).
The team’s recommendations were implemented through the Intensive Treatment for Aphasia in Western Canada (iTAWC) program, run by Columbia Speech & Language Services in Vancouver, BC.
In addition to Wendy Duke, the team consisted of:
- Anne MacCallum, SLP, GF Strong Rehab Centre, Assistive Technology;
- Megan Sutton, SLP, Tactus Therapy Solutions; and,
- Alisa Ferdinandi, SLP, Columbia Speech & Language Services.
The consulting team settled on a combination that produced encouraging results. The client used his iPad and iPhone to access the recommended therapy apps, while therapists and students helped to customize the apps and train him to use them.
Wendy finally felt assured that her client was getting the most from her work with him, because she had an expert team to support her. She didn’t have to spend countless hours doing research—she could simply ask the people who knew what she needed to know.
Consulting about Technology
Each person with aphasia is different, requiring different treatments and solutions. And technology is changing so fast that no single working clinician can be expected to keep up with everything.
Alternative augmentative communication and communication-enhancing technology are both specialized fields. The success of this team consultation shows it’s time to bring these fields together to support clinicians in service delivery.
“We need to start advocating for specialist support services in all regions,” says Megan Sutton, “with dedicated positions to support trained specialists in how technology of all sorts can help people with acquired communication disorders better communicate, improve, participate, and thrive.”
Sharing the Strategy
Each year, the Canadian Stroke Congress provides a venue for medical professionals to share their knowledge in specialized conference sessions about prevention, acute care, biomedicine, health systems, rehabilitation, and other topics pertaining to stroke.
In 2014, in the host city of Vancouver, researchers presented their findings on topics such as the impact of exercise on the brain, the timing and delivery of family education, arm exercises, post-stroke apathy, pain management, and aphasia treatment. More than 100 eye-catching posters lined the exhibit hall, allowing researchers and clinicians to detail exciting new programs, initiatives, research, and projects.
Among those posters was one by Wendy Duke and her integrated technology team. “A Technology Consultation Model for Aphasia Therapy: A Case Study of a Complex Client” outlined the team’s innovative approach and some of the challenges they encountered.
Although Wendy’s approach is promising, not every community has access to consultants with the requisite expertise. And at the moment there’s no funding for a technology-consultation service that includes assessment and ongoing consultation as clients’ needs evolve—and as technology evolves.
That needs to change.
“People with aphasia need access to funded, intensive aphasia therapy and long-term, community-based treatment,” Wendy emphasizes. “Learning to use new communication supports and therapy tools will help them continue to improve.”
What resources do you use when seeking technology options for your clients? What information do you wish you had? Please share your experience with us and keep the conversation going.
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