Occupational Therapy in an Intensive Comprehensive Aphasia Program: Performance and Satisfaction Outcomes

Escher, Anne; Amlani, Aditi M.; Viani, Angela; Berger, Sue

doi:10.5014/ajot.2018.026187

Cited by 16 publications

(16 citation statements)

References 23 publications

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“…Outcome measures used to determine change in IADL, including communication management, varied as well. One study used the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (Escher et al, 2018) to measure progress in reaching individualized goals which included some IADL goals. A few studies used reading comprehension or internet skills and usage as their outcome measures (Brennan et al, 2005; Egan et al, 2004; Wilson and Read, 2016), while others used standardized self-report measures to assess communication management, such as the Communicative Effectiveness Index (Attard et al, 2018; Van der Gaag et al, 2005; Worrall and Yiu, 2010), the SQoL-39 - communication domain (Mumby and Whitworth, 2012; Van der Gaag et al, 2005; Worrall and Yiu, 2010), the Communication Confidence Rating Scale (Attard et al, 2018; Cherney et al, 2011), and the ASHA FACS (Hoover et al, 2017; Worrall and Yiu, 2010).…”

Section: Methodsmentioning

confidence: 99%

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Effective interventions within the scope of occupational therapy practice to address participation for adults with aphasia: A systematic review

Escher

McKinnon

Berger

2021

British Journal of Occupational Therapy

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Introduction Occupational therapists work with clients with impaired communication to re-engage in valued occupations. This systematic review seeks to answer the question: What are effective interventions within the scope of occupational therapy practice to address participation for adults with aphasia? Method A systematic review of the literature was completed using PubMed, PsychInfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Cochrane Database of Systematic Reviews, and OT Seeker databases. Intervention studies within the scope of occupational therapy practice with a participation outcome, and published in peer reviewed journals from 2000 to 2019, were included. The quality of each study was assessed using the Mixed Methods Appraisal Tool. Findings Thirteen articles fit the inclusion criteria. Categories of interventions that emerged from the data include community-based groups, individually tailored programs, adaptation/presentation of materials, interprofessional interventions, and psychoeducation. Conclusion There is evidence to support the use of interventions within the scope of occupational therapy practice to increase participation for people with aphasia. Specifically, the use of community-based groups and adaptation of materials are effective to facilitate participation. Most of the studies were pre-post one group design; however, they demonstrated positive results for participation outcomes. More research is needed on people with aphasia that focuses on participation in meaningful occupations.

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Section: Methodsmentioning

confidence: 99%

“…Seven articles evaluated the effectiveness of community-based group interventions (Attard et al, 2018; Cherney et al, 2011; Escher et al, 2018; Hoover et al, 2017; Mumby and Whitworth, 2012; Van der Gaag et al, 2005; Vickers, 2010). All of these studies provide Level III evidence except Vickers (2010), which provides Level II evidence.…”

Section: Methodsmentioning

confidence: 99%

Effective interventions within the scope of occupational therapy practice to address participation for adults with aphasia: A systematic review

Escher

McKinnon

Berger

2021

British Journal of Occupational Therapy

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“…It is assumed the participants were not constantly engaged in therapy for the entirety of the day without any breaks and it is not clear how this calculation was managed in some reports. Sometimes there was an issue calculating therapy hours when other professionals were involved, for example, on InteRACT [107] or in Boston [102] where it was unclear how hours were counted for joint sessions across professions. The Big Sky Montana ICAP [111] indicated a tendency to increase their hours over time, for example, from 36 h over three weeks in 2014 (which would not reach current standards of ICAP intensity [69]) to 72 h over four weeks in 2017.…”

Section: What (Materials)mentioning

confidence: 99%

“…Dignam et al [103] reported that all 16 completed LIFT3 with a mean therapy attendance rate of 47.7 h (of a possible 48). Escher et al [102] reported only on the occupational therapy aspect of the Boston ICAP but detailed that 18 of 19 attended at least 85% of OT sessions. One participant had considerable health problems and missed a full week of the programme.…”

Section: What (Materials)mentioning

confidence: 99%

Intensive Comprehensive Aphasia Programmes: a systematic scoping review and analysis using the TIDieR checklist for reporting interventions

Monnelly

Marshall

Cruice

2021

Disability and Rehabilitation

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Purpose: Aphasia is an acquired language disorder that typically occurs as a result of a stroke. People with aphasia experience communication difficulties and risk secondary impacts, for example, affecting social and work life and mental health. Intensive Comprehensive Aphasia Programmes (ICAPs) aims to address the multiple consequences of aphasia using intensive intervention and a wide range of therapy approaches. Although basic parameters of ICAP intervention have been defined, a fuller characterisation is needed. This systematic scoping review aimed to determine what constitutes an ICAP. Methods: Peer-reviewed and Grey databases were searched for articles on ICAPs using Joanna Brigg's Institute methodology. Data was extracted following the Template for Intervention Description and Replication (TIDieR) checklist for reporting interventions and synthesised using a narrative synthesis. Results and conclusions: 17 ICAPs were reported in 20 peer-reviewed literature sources (9 ICAPs supplemented by Grey literature sources). There were high degrees of variation in dose, professionals involved, and no qualitative data from participants. Of note, ICAP intervention was highly tailored to individual participants on the same ICAP, and intervention content varied between ICAPs. ICAPs appear to be rationalised as intensive impairment-based programmes with other components added for comprehensiveness. Stronger rationale and a logic model are required to justify the core components of ICAPs. The input of stakeholders into designing future ICAP interventions is recommended.The ICAP model is in its infancy when it comes to mainstream clinical application as only the intensity component of the ICAP has clear theoretical underpinning as reported in the peer-reviewed literature.There have been clinical uptakes of the ICAP model which is likely to continue and is valid in the context of an under-researched area of aphasia therapy and on a background of a less than perfect relationship between evidence base and practice. Aspects of the ICAP model are valid for clinicians to implement, for example, intensive evidencebased aphasia therapy in combination with therapy which addresses some of the broader implications of aphasia, for example, social isolation. Clinicians can use the ICAP model to review their existing service provision and explore whether their service provides aphasia therapy that addresses the multiple aspects of aphasia (i.e., ensuring the focus is not only on impairment-based therapy).

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“…As noted above, depending on the complexity of the assessment or intervention being modified or supported with these strategies, they may not always reach the desired end goal. Also, while others have adapted the COPM using similar strategies (Coates et al, 2015;Escher, Amlani, Viani, & Berger, 2018), validation studies with the application of these techniques with this population using these communication strategies are limited. Although the findings from recent studies confirm the effectiveness of many of the aphasia-friendly modifications described within this article, additional research is needed to understand various factors that contribute to their effectiveness.…”

Section: Limitationsmentioning

confidence: 99%

Designing Occupational Therapy Home Programs for People With Aphasia: Aphasia-Friendly Modifications

et al. 2020

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Purpose The purpose of this article is to describe aphasia-friendly modification for occupational therapy assessments and home programs aimed at addressing upper extremity impairments for people post stroke. Method This article examines a case study example from a larger study (Wallace, Donoso Brown, Saylor, & Lapp, 2018 ) that implemented aphasia-friendly material modifications into an occupational therapy home program. The participant was a 74-year-old man who survived a left hemisphere cerebrovascular attack 6 years prior to the study. The participant experienced upper extremity hemiparesis and aphasia post stroke and was appropriate for an occupational therapy home exercise program with aphasia-friendly modifications to facilitate comprehension of the home program. Aphasia-friendly modifications (e.g., gestures and visual aids) were made to assessments to support comprehension and participation. To support reading comprehension deficits during completion of the home program, the program materials had aphasia-friendly modifications, such as modified text, supportive images, and reduced cognitive load of exercises. Finally, research team members used supported conversational techniques during all study procedures. Results At the end of the home program, an interview with the participant revealed several outcomes regarding the home program and the aphasia-friendly modifications. The participant reported pictures and reduced text to be beneficial in understanding the instructions. He also indicated that he enjoyed completing the exercises independently (i.e., outside of a therapy office). The participant's motor function demonstrated changes in a positive direction, although not greater than the minimally detectable change for performance-based measures. Conclusions Aphasia-friendly modifications (e.g., modifying text, adding supportive images, and using gestures) were found to be supportive of participation in assessments for and creation of an upper extremity home program. Speech-language pathologists can support the participation of people with aphasia through interprofessional collaboration and consideration of environmental adaptations.

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Occupational Therapy in an Intensive Comprehensive Aphasia Program: Performance and Satisfaction Outcomes

Cited by 16 publications

References 23 publications

Effective interventions within the scope of occupational therapy practice to address participation for adults with aphasia: A systematic review

Effective interventions within the scope of occupational therapy practice to address participation for adults with aphasia: A systematic review

Intensive Comprehensive Aphasia Programmes: a systematic scoping review and analysis using the TIDieR checklist for reporting interventions

Designing Occupational Therapy Home Programs for People With Aphasia: Aphasia-Friendly Modifications

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