Providing Services to Individuals With Complex Communication Needs in the Inpatient Rehabilitation Setting: The Experiences and Perspectives of Speech-Language Pathologists

Gormley, Jessica; Light, Janice

doi:10.1044/2018_ajslp-18-0076

Cited by 18 publications

(23 citation statements)

References 22 publications

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“…Our trial is looking at the feasibility of scaling the intervention up for clinical implementation. Evidence suggests that PWA has decreased quality of life, poorer health outcomes, and limited participation in medical encounters due to their communication and language disabilities [9,29]. People with moderate to severe aphasia are more likely to experience adverse medical events (e.g., medication errors) than those without a communication disability [9,29,40].…”

Section: Discussionmentioning

confidence: 99%

“…", "Where is your pain?") in line with studies that apply AACT for PWA [5,9,34]. The communication board contains 45 icons designed for PWA to communicate with medical professionals and family members in the in-patient setting.…”

Section: Interventionmentioning

confidence: 94%

“…Therefore, aphasia is also related to greater emotional distress levels, like frustration and depression. It also can negatively impact the quality of life, health outcomes, and participation in daily and medical encounters [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…In in-patient rehabilitation settings, people with moderate to severe aphasia usually receive all-day care from an interdisciplinary team of professionals [9]. In these situations, PWA need to communicate effectively about goal setting, preferences, and medical decision making with health care providers [29].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, when PWA work with speechlanguage pathologists (SLPs), SLPs help PWA identify communication needs and introduce different communication strategies to maximize their communication skills within desired life roles [29]. SLPs teach PWA how to use available AAC systems (e.g., paper-based communication boards) to promote communication in daily activities [9,24]. However, little is known about the effectiveness of AAC practices in in-patient rehabilitation settings.…”

Section: Introductionmentioning

confidence: 99%

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Augmentative and Alternative Communication Intervention for in-patient Individuals With Post-stroke Aphasia: Study Protocol of a Parallel-group, Pragmatic Randomized Controlled Trial

Huang

Chen

et al. 2021

Preprint

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Background: People with post-stroke moderate to severe aphasia commonly receive speech-language therapy (SLT). However, the outcomes of SLT sometimes is limited. Augmentative and alternative communication (AAC) has been reported as an effective treatment approach to improve communication effectiveness, language performance, decreasing depression, and improving quality of life for this population. However, little evidence has demonstrated the use of AAC intervention (AACT) in early recovery from people with post-stroke aphasia in in-patient rehabilitation settings. Besides, only a few studies use a randomized controlled trial (RCT) to compare AACT with SLT to date. The present study focuses on the effect of including AACT in regular SLT for people with post-stroke moderate to severe aphasia (PWAs) in an in-patient rehabilitation setting. The present study aims to compare the potential effectiveness of AACT combined with SLT on communication effectiveness and language recovery with SLT alone for PWAs in in-patient rehabilitation settings.Methods: We strive to include 30 PWAs, enroll in an in-patient program, a single-blind, randomized controlled trial with two parallel groups, and a 2-week follow-up. Patients receive a one-hour treatment session, including either both AAC and SLT or SLT alone daily for ten consecutive sessions. Three assessment points include baseline, after intervention sessions, and after the 2-week follow-up to compare the two groups' intervention effectiveness. The primary outcome measure is the score differences on the Communication of Basic Needs of Functional Assessment of Communication Skills for Adult (FACS) pre- and post- intervention. The secondary outcome measures include the results of the Chinese Standard Aphasia Battery (ABC), the 10-item Hospital version of the Stroke Aphasic Depression Questionnaire (SADQH-10), and the Stroke-Specific Quality of Life Scale (SS-QOL) as well as a patient and caregiver satisfaction questionnaire.Discussion: This RCT of AACT in an in-patient rehabilitation setting will contribute to new scientific evidence to the field of aphasia rehabilitation in early recovery during the in-patient period. The paper describes the trial, which will explore the effect of combining AACT and SLT and SLT only, our choice of primary and secondary outcome measures, and proposed analyses. The study results will provide information for implementing AACT in the regular in-patient SLT of future RCTs.Trial registration: This trial is registered in the Chinese Clinical Trial Registry database (ChiCTR) as ChiCTR2000028870. Date registered: 5 January 2020.

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Section: Discussionmentioning

confidence: 99%

Section: Interventionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Augmentative and Alternative Communication Intervention for in-patient Individuals With Post-stroke Aphasia: Study Protocol of a Parallel-group, Pragmatic Randomized Controlled Trial

Huang

Chen

et al. 2021

Preprint

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Opportunity Barriers and Promising Practices for Supporting Individuals with Complex Communication Needs

Johnston

Blue

Gevarter

et al. 2020

Curr Dev Disord Rep

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Child–Parent–Provider Interactions of a Child With Complex Communication Needs in an Inpatient Rehabilitation Facility: A Pilot Study

Gormley

Light

2021

Am J Speech Lang Pathol

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Purpose Children with complex medical needs often require extensive hospitalizations in the first years of life. Many of these children also experience complex communication needs and use augmentative and alternative communication (AAC) strategies to interact with health care staff. Unfortunately, suboptimal communication experiences have been reported among these children, their families, and hospital staff; however, no studies have described the patterns of interactions beyond measures of self-report. The purpose of this study was to describe child–parent–provider interaction patterns that occurred in an inpatient unit. Method Observational techniques were used to systematically describe the interactions of a 28-month-old child with complex communication needs, her parents, and 26 health care providers on an inpatient rehabilitation unit over 10 days. Results Results indicated that substantial variability in the child's routine occurred across days and providers. Interactions were generally short and occurred for only a small proportion of the child's waking hours. The child and her mother actively communicated to varying degrees across sessions, yet health care providers often dominated interactions. The child used multiple modes of communication in each interaction; however, no aided AAC systems were used despite availability. Conclusions Training is urgently required to equip health care providers to (a) incorporate the use of aided AAC strategies during inpatient interactions and (b) increase the active participation of both children with complex communication needs and their parents during these interactions. Supplemental Material https://doi.org/10.23641/asha.13345187

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Providing Services to Individuals With Complex Communication Needs in the Inpatient Rehabilitation Setting: The Experiences and Perspectives of Speech-Language Pathologists

Cited by 18 publications

References 22 publications

Augmentative and Alternative Communication Intervention for in-patient Individuals With Post-stroke Aphasia: Study Protocol of a Parallel-group, Pragmatic Randomized Controlled Trial

Augmentative and Alternative Communication Intervention for in-patient Individuals With Post-stroke Aphasia: Study Protocol of a Parallel-group, Pragmatic Randomized Controlled Trial

Opportunity Barriers and Promising Practices for Supporting Individuals with Complex Communication Needs

Child–Parent–Provider Interactions of a Child With Complex Communication Needs in an Inpatient Rehabilitation Facility: A Pilot Study

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