A Brief History of Aphasia Centers
by Roberta J. Elman on June 15, 2011
Many Aphasia Centers have a philosophy of service delivery consistent with a social model of healthcare. Pioneers of social approaches to aphasia treatment included Martha Taylor Sarno and Audrey Holland, but it wasn’t until the 1990s that a growing number of aphasiologists began to focus their attention on social approaches to aphasia assessment and intervention. The Life Participation Approach to Aphasia (LPAA), a social model framework proposed by Roberta Chapey, Judith Duchan, Roberta Elman, Linda Garcia, Aura Kagan, Jon Lyon, and Nina Simmons-Mackie, had its start during informal discussions and meetings in the early-to-mid 1990s, followed by a formalized working meeting in 1999. LPAA was an independent effort, and, in part, a response to those in the United States who were stating that aphasia therapy was “dead.”
Aphasia Centers are a fairly recent addition to the continuum of services for people with aphasia. They are a logical extension of aphasia group programs. Although not created as an Aphasia Center, the Residential Aphasia Program (RAP) was established in 1947 at the University of Michigan in Ann Arbor to help World War II veterans. The RAP combined intensive individual and group treatment for people with aphasia, and began to serve non-veterans with aphasia after the war. RAP participants received treatment for six weeks at a time, thereby creating a “short term” Aphasia Center.
In 1979, Pat Arato founded the first independent, community-based Aphasia Center. Located in Toronto, Canada, and now called the Aphasia Institute, Arato desired services for her husband whose stroke had left him with aphasia. Inspired by actor and stroke survivor Patricia Neal, Arato and three other volunteers worked with a group of seven adults to reduce language barriers and enable communication. Today, the Aphasia Institute serves as a local, provincial, national, and international resource for those affected by or working with aphasia. Information about the Aphasia Institute’s programs, aphasia friendly resources, and training programs is available at its website.
The Aphasia Center of California (ACC) was the first independent, community-based Aphasia Center created in the United States. My visit to the Aphasia Institute in 1989 served as a catalyst for the 1994 group treatment efficacy research that established the foundation for the ACC. The ACC currently provides more than 4000 annual visits to 160 people with aphasia and their family members. In addition to the services provided in California, the Aphasia Center’s Book Connection™ manual and materials have been used by other speech-language pathologists to start their own aphasia book clubs. In addition, its service delivery model has served as an example for creating other Aphasia Centers. Information about the ACC’s programs and the Book Connection™ is available on its website: www.aphasiacenter.org
The 1990s and early 2000s saw a dramatic growth in the creation of independent, community-based Aphasia Centers. There are currently eight active, independent Aphasia Centers recognized by the federal government as 501(c)(3) charitable organizations in the United States. The ACC was founded in 1996; five years later, in 2001, the Stroke Comeback Center in Virginia received IRS approval, followed in 2002, by the Aphasia Center of West Texas, and, in 2003, by the Triangle Aphasia Project in North Carolina and the Adler Aphasia Center in New Jersey. The remaining three Aphasia Centers have started since 2008: the Snyder Center for Aphasia Life Enhancement (SCALE) in Maryland, the Houston Aphasia Recovery Center in Texas, and the Aphasia Community Friendship Center in Michigan.
In addition to these independent Aphasia Centers, the National Aphasia Association website currently lists more than 300 aphasia groups and programs that meet on a regular basis in the United States and Canada. This number has grown dramatically over the past 20 years.
Aphasia Centers provide participants with a range of programs as well as a place to meet others who are living with similar concerns. Given the current momentum and increasing number of Aphasia Centers, it is anyone’s guess how many Aphasia Centers there will be in another ten years. My dream is that every community will eventually have an Aphasia Center available to its members living with aphasia. Here’s hoping that dreams do come true!
Portions of this article also appear in Elman, R. J. (in press). Starting an Aphasia Center? Seminars in Speech and Language.