Current Clinical Practices in Aphasia Therapy in Finland: Challenges in Moving towards National Best Practice

Abstract

Aims: The objective of this article is to discover and document the state of clinical practices for aphasia therapy in Finland and to gather information for developing national best practice. Methods: Two surveys were administered in Finland that explored current clinical practices in aphasia rehabilitation and the resources available to speech and language therapists (SLTs). We integrated and compared the results of these surveys. The results are based on the responses of the 88 (45 + 43) returned questionnaires from SLTs. Results: Four principle themes were identified: planning the aphasia therapy, measures and assessment methods, current therapy service provision, and development suggestions and barriers to change. The results of this study showed considerable consistency in clinical practices among the respondents to the surveys. However, we noticed that there are some discrepancies between the recent research findings and present clinical practices. Conclusions: The findings from this study indicate that there are many challenges in clinical decision-making at the moment in Finland. The article helps clinicians to evaluate the practices they use and to execute justified modifications in order to implement more effective models of practice. It is evident that national best practice guidelines for aphasia therapy would support SLTs in clinical decision-making.

Impact of Combined Transcranial Direct Current Stimulation and Speech-language Therapy on Spontaneous Speech in Aphasia: A Randomized Controlled Double-blind Study

“…For now, only speech rehabilitation proved its efficacy on discourse recovery but the effect size of the positive studies is quite low (Brady et al, 2016;Yu et al, 2017). Nevertheless, the previous research found that the intensity of rehabilitation and the specialization of the therapist were more important than the rehabilitation technique used (Klippi et al, 2012). Therefore, there is an urgent need to develop new approaches to reduce aphasia in patients with stroke.…”

Enhanced patient involvement in Swedish aphasia intervention

“…By and large, goals of speech and language intervention in Sweden still seem to primarily be based on formal tests of the patient's linguistic ability, and focus on the areas that the patient has particular difficulties with, as demonstrated by these tests. The same seems to be true also in other Nordic countries, for example Finland (Klippi, Sellman, Heikkinen and Laine 2012). The outcome of the intervention is mainly measured in terms of improved test results over time, and after a certain amount of intervention.…”

Which treatment outcomes are most important to aphasia clinicians and managers? An international e-Delphi consensus study

“…In recent years, approaches to aphasia treatment have broadened from traditional impairment-based language interventions to include approaches which focus on participation in communication activities and life roles; psychosocial well-being; and the impact of aphasia on significant others. Studies from around the world have shown that clinicians use an eclectic mix of aphasia treatment approaches often within an analytic model of treatment (Guo et al, 2014;Johansson, Carlsson, & Sonnander, 2011;Klippi, Sellman, Heikkinen, & Laine, 2012;Rose et al, 2014;Verna, Davidson, & Rose, 2009). However, in parallel with research outcome measurement, there is often a mismatch between the treatment approaches favoured by clinicians and the outcome measures used to gauge their effectiveness (Guo et al, 2014;Johansson et al, 2011;Klippi et al, 2012;Verna et al, 2009).…”

“…The mismatch is further demonstrated by Klippi et al (2012) who conducted surveys with SLPs in Finland to examine aphasia clinical practices. In this study, 75% of respondents identified the primary aim of aphasia therapy to be the enhancement and improvement of everyday communication and interactional skills of the person with aphasia.…”