Aphasia Intervention Overview
ASHA Aphasia Overview
https://www.asha.org/Practice-Portal/Clinical-Topics/Aphasia/
ASHA Aphasia Evidence Map
https://www.asha.org/EvidenceMapLanding.aspx?id=8589936279&recentarticles=false&year=undefined&tab=all
Scientific evidence available for assessment and treatment
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Australian Aphasia Therapy Pathway
http://www.aphasiapathway.com.au/
Eight steps to creating and implementing an aphasia treatment plan
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Aphasia Goals
https://www.med.unc.edu/ahs/sphs/card/resources/aphasia-goals/goal-pool/
Features actual aphasia goals, shared by participating SLP’s, based on the FOURC model
Four Steps
1. Create Communication Goal
2. Create client Solutions
3. Collaborate on a Plan
4. Complete and Continue
Four Prongs
1. Skills and Abilities
2. Intentional Strategies
3. Environmental Supports
4. Motivation and Confidence
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Aphasia Evaluations
The aphasia tests and screening tools described below are available for no cost online.
Aphasia Needs Assessment
https://cehs.unl.edu/documents/secd/aac/assessment/aphasianeeds.pdf
Questionnaire for people with aphasia on what communication situations they need to or want to work on
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ASHA Functional Communication Measures (FCMs)
http://docshare01.docshare.tips/files/7828/78286027.pdf
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Bilingual Aphasia Test
https://www.mcgill.ca/linguistics/research/bat
The Bilingual Aphasia Test is currently available in the following languages
Amharic | Arabic (Modern Standard) | Armenian (Eastern) | Armenian (Western)| Azari | Balochi| Basque | Berber | Bosnian | Brazilian Portuguese | Bulgarian | Cantonese | Carinthian | Castilian | Catalan | Croatian | Czech | Danish | Dholuo | Dutch | English | Farsi | Finnish | French (European) | French (Québécois) | Friulian | Galician | German | Gilaki |Greek | Hebrew | Hindi | Hungarian | Icelandic | Inuktitut | Italian | Japanese | Jordanian Arabic | Kannada | Korean | Kurdish | Latvian | Lithuanian | Luganda |Luri | Malagasy | Mandarin |Mazandarani (Eastern) | Norwegian | Oriya | Palestinian Arabic | Polish | Portuguese (European) | Romanian | Russian | Sardinian | Serbian | Shona | Slovenian | Somali | Spanish (American) | Swahili | Swedish | Tagalog | Talysh | Tamil | Tulu | Tunisian Arabic | Turkish | Ukrainian | Urdu | Vietnamese | Yiddish |
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Mississippi Aphasia Screening Test (MAST)
https://tbims.org/mast/index.html
A quick screening tool intended to be able to show progress over time
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The MultiModal Communication Screening Task
Evaluates client’s potential ability to use augmentative communication
MultiModal Communication Screening Task Picture Stimulus Book
https://cehs.unl.edu/documents/secd/aac/assessment/picture.pdf
MultiModal Communication Screening Task Scoring Form
https://cehs.unl.edu/documents/secd/aac/assessment/score.pdf
Assess ability to scan and locate words on a sheet as part of evaluation for augmentative communication
https://cehs.unl.edu/documents/secd/aac/assessment/wordscan.pdf
Evaluates the user’s independence in using augmentative communication
https://cehs.unl.edu/documents/secd/aac/assessment/aphasiachecklist.pdf
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Quick Aphasia Battery
https://aphasialab.org/qab/
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Specific Aphasia Therapies
Aphasia Groups
https://aphasia.community/resources/resources-for-aphasia-groups
Downloadable pdf with 12 weeks of session plans and therapy materials
How to Start an Aphasia Support Group from AphasiaToolbox.com
https://www.aphasiatoolbox.com/supportgroup
Six tips for starting an aphasia support group
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Computer Based Treatment
Using software to improve language
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Constraint Induced Language Therapy (CILT)
Therapy that encourages verbal responses, and discourages other forms of communication, e.g., gestures, writing. Use for clients who want to increase verbal language, and are willing to forego other communication modalities. Should only be used for those who are capable of expressing basic needs with speech.
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Gestural Facilitation of Naming (GES)
Pairs naming with an associated gesture to stimulate language in a holistic context. Raymer, Rose and colleagues have published research studies on this approach.
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Life Participation Approach to Aphasia (LPAA)
This is a philosophy that focuses on helping the person with aphasia engage in meaningful life activities, rather than structured exercises to improved language. Typical activities include conversation groups, cooking, photography, using the computer, music, theater, trips.
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Melodic Intonation Therapy
Produce phrases by singing them. Uses two tones – the stressed syllable is higher, the unstressed syllables are lower. The singing is gradually approximated to normal speech. Useful for client who can sing better than they can speak.
Training program by Nancy Helms-Estabrooks, one of the original developers of the MIT program
https://www.proedinc.com/Products/9040/mit-melodic-intonation-therapy-kit.aspx
Here is a further description of the program
https://tectustherapy.com/mit-melodic-intonation-therapy-how-to/
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Multiple Oral Re-reading (MOR)
Reading a passage multiple times to increase whole word recognition
The program was originally developed for a client with pure alexia (Moyer, 1979)
For a description of the protocol, see
https://tectustherapy.com/mor-multiple-oral-rereading-how-to/
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Oral Reading for Language in Aphasia (ORLA)
Reading sentences aloud with the clinician (choral reading) to improve oral comprehension (Cherney 1995, 2010, Cherney et al. 1986)
This approach has been used in clinical settings, by telehealth, and using computer software.
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Promoting Aphasics’ Communication Effectiveness (PACE)
The client and clinician take turns describing pictures using any modality of communication – words, gestures. A barrier may be used to make the task more challenging. (Davis & Wilcox, 1981)
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Reciprocal Scaffolding Treatment (RST)
The person with aphasia teaches a skill to others who do not know as much about the topic. A functional task suitable for aphasia groups that promotes confidence in communicating (Avent and Austerman, 2003, 2010; Avent et al. 2007)
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Response Elaboration Therapy
A behavioral program that elicits and reinforces responses that convey more information (Kearns, 1985).
There is a description of the protocol at
https://tactustherapy.com/response-elaboration-training-ret/
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Script Training
Teach phrases and dialogues that are useful in everyday interactions, such as telephone conversations or ordering in a restaurant.
There have been multiple studies of the effectiveness of this therapy approach.
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Semantic Feature Analysis Therapy (SFA)
Naming therapy that primes naming by asking the client to describe the item to be named, and then name the item.
Examples of semantic features that can be used to describe an object are:
What is is made of
What is it used for
What does it do
Who uses it
Where can you find it
What does it look like
It is a kind of (category)
It has (parts)
It goes with (association).
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Sentence Production Program for Aphasia (SPPA)
Structured program to improve sentence production by eliciting the production of target sentences, after hearing the target sentence in a paragraph, and after listening to a paragraph without the target sentence.
This is a revised and updated version of the Helm Elicited Language Program for Syntax Stimulation (HELPSS) by Nancy Helm-Estabrooks.
This is a structured program. The official version of the program is available here.
https://www.proedinc.com/Products/9085/sentence-production-program-for-aphasia-formerly-the-helpss-program.aspx
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Supported Communication Intervention (SCI)
Teaches co-survivors how to improve communication using
Tell the person you need to talk
Acknowledge competence “I know that you know what you want to say”
Accept responsibility for communication breakdown
- Short simple sentence
- Writing key words
- Gestures
- Photos or drawings
- Avoid distractions such as TV
- Allow plenty of time to respond
- Confirm that the person got the message
- Ask one question at a time
- Proceed from general questions to specific questions
- Ask yes/no questions
- Offer choices
- If the person is able, as them to use gestures, point, or write a word
Basic tips for supported communication
https://www.aphasia.ca/communicative-access-sca/
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Supported Reading Comprehension
Improve reading comprehension by using aphasia friendly reading materials, that incorporate drawings or photos and an easy-to-read format.
Aimee R Dietz in conjunction with her colleagues carried out multiple research studies evaluating the effectiveness of this approach.
There are no standard materials for this therapy approach
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Treatment of Underlying Forms (TUF)
Program to increase the complexity of sentences in agrammatic aphasics by targeting complex sentneces before simple sentences. Production of complex sentences primes the production of simple sentences. Both comprehension and verbal expression can be targeted. (Thompson & Shapiro, 2005).
There have been a number of research articles on this approach, a software/app called Sentactics has been developed to provided a computerized version of the program.
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Visual Action Therapy (VAT)
Using gesture to communicate ideas. Usually used with clients with global aphasia. Protocol is carried out without using words.
Detailed protocol available at Helms-Estabrooks, Fitzpatrick, & Barresi (1982). Visual Action Therapy for Global Aphasia
https://pubs.asha.org/doi/10.1044/jshd.4704.385
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V-Nest Protocols
https://tactustherapy.com/vnest-verb-network-strengthening-app/
Protocol for incorporating a target verb into multiple Subject-Verb-Object sentences to strengthen word recall. When these are mastered, phrases can be added, for example “The farmer drove the tractor to the field.”
This protocol was developed by Lisa Edmonds and colleagues.
Verbs should be fairly common (for example, teach, cut, dig), but not too general (for example, get, have, want). In a single session, the verbs targeted should not be too close in meaning.
There is a YouTube video of Dr. Edmonds explaining the protocol at
https://youtube.com/watch?v=Ayx60174bmo
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Word Retrieval Cuing Strategies
Improving word retrieval by providing phonological cues (initial sound) or semantic cues.
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Aphasia Software
Aphasia Software Finder
https://www.aphasiasoftwarefinder.org/
Site sponsored by the Tavistock Trust for Aphasia
Comprehensive list of aphasia software and apps
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Augmentative/Alternative Communication
Augmentative/alternative communication includes
Gestures
Writing
Pointing to written words
Pointing to photos, drawings or symbols
Aided communication may be
Paper and pencil
Electronic
Lingraphica
https://www.aphasia.com/
Tobii Dynavox
https://www.tobiidynavox.com/en-US/
Workbooks and Worksheets
Worksheets
Automatic sequences – days of the week, months of the year, familiar songs
https://www.ozarkspeechpathologist.com/home/automatic-sequences-for-individuals-with-aphasia
by Jessica Danley
Includes YouTube links to familiar songs
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Low cost or free aphasia worksheets
https://medicalslps.com/speech-therapy/worksheets/MedicalSLP.com
Automatic speech worksheets, picture naming flashcards, semantic feature analysis worksheets, and more
Free brochures and worksheets are gathered on this page
https://medicalslps.com/speech-therapy-materials/free/
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Reading Resources
For those who are able, reading aloud is an excellent way to get plenty of practice speaking.
Here are some resources that are helpful.
NewsELA
https://newsela.com/ is a website that takes articles from various news sources, and rewrites them at four or five different levels of reading difficulty, from Level 3 up to the original article. Aimed at school age children from 3rd grade to 12th grade, many of the articles are of interest to adults. You have to sign up to use the articles, but there is no cost to use the site.
Poetry
Poetry is good for people with aphasia, because there is meaning in even a few lines.
The best poems are familiar ones, and ones that have a lot of repetition. Here are a few favorites.
https://www.theodysseyonline.com/best-famous-poems-ever-written
https://www.ranker.com/list/best-poems-of-all-time/ranker-books
Short poems https://www.poeticous.com/poems
Let America Be America Again by Langston Hughers
https://100.best-poems.net/let-america-be-america-again.html
The Bells by Edgar Allen Poe (lots of repetition) https://poets.org/poem/bells
Como Pajaros en el Aire by Peteco Carabajal
https://lyricstranslate.com/es/peteco-carabajal-como-pajaros-en-el-aire-lyrics.html
Free Language Stuff
https://freelanguagestuff.com/
Free downloadable pdf language worksheets
These worksheets seem to be aimed at kids, so use judgement when selecting for aphasia therapy.
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Teacher Pay Teachers
https://www.teacherspayteachers.com/
Buy or sell teacher made resources
Includes aphasia materials
https://www.teacherspayteachers.com/Browse/Search:aphasia
Materials are free or low cost
Must create a free membership to join
NYC Aphasia Groups 