Why Personalized Treatment Matters

“How can the SLP/rehab facilities gear or personalize therapy and rehabilitation towards the person with aphasia’s prior interests/hobbies/vocations?”

“How can the SLPs engage the person with aphasia, not just do rote exercises but rather connect with the aphasic as a personality, tailor the therapy to the individual needs?”

“What is the effect on the person with aphasia if they do not like their SLP or the SLP doesn’t understand the patient’s needs or doesn’t customize the therapy towards them?”

These are questions raised by the members of an aphasia support group. And they are on to something. It is important for therapists to gear activities toward the person’s interests. Here are some reasons why it is important.

  • It is effective. The skills you need to do real-life activities like riding the bus independently or leading a prayer at church can transfer to other situations. The words and phrases you memorized for these activities can “pop” out in other situations when you need them. Also, personalized cueing strategies are usually more effective than strategies created for you by someone else.
  • It is efficient. Learning strategies that help you do things like ordering from a catalog or explaining your stroke to others through a practiced script can be done in relatively few therapy sessions.
  • It helps you continue to improve. When a friend regularly takes you out to do something you enjoy, like bowling or golfing, you will be practicing your language skills while you are chatting and keeping score. If you join a book club, you will benefit from friendships, support, and also improve your reading skills. These activities help you stay healthy and active in the future.

If you are a speech-language pathologist working in a facility where you do not have the time or resources to focus on community-related activities, do not despair! There are many things that you can do.

  1. Start with the end in sight. Think about the activities that the person actually does everyday or what they will be doing once therapy ends. For example, you can work on activities like greeting people in the hall, requesting meal preferences, complaining about TV volume, or starting up a conversation with the neighbor.
  2. Think about the component skills that are necessary for these activities, and produce your documentation accordingly. Yes, you can track the number of times the person successfully uses word-finding strategies in a conversation with their roommate, or calculate the percentage of opportunities in which the person used their communication notebook to order a meal or talk about their favorite TV show.
  3. Make sure you provide oral and written information to the person with aphasia and their family about local and national resources, including the National Aphasia Association, local aphasia community groups, nearby aphasia centers, or local university clinics that offer aphasia services.

Are you a person with aphasia or know someone with aphasia? Are you frustrated that your therapy seems rote and is not oriented personally to you?

  1. Discuss the situation with your speech-language pathologist. You might need some help from a family member or friend.
  2. Ask the speech-language pathologist to read this blog and access some of the readings.
  3. When all else fails, remember that you have a right to receive appropriate services. (You can download the Aphasia Bill of Rights from National Aphasia Association) Discuss your situation with a supervisor, or request to work with a different speech-language pathologist.

So, yes! Therapists should personalize the therapy towards the individual. It is better for the person with aphasia, their family, and their community.

For more information:

Hinckley, J. J. & Carr, T. H. (2005). Comparing the outcomes of intensive and nonintensive aphasia treatment. Aphasiology. 19, 965-974.

Holland, A. L., Halper, A. S., & Cherney, L. R. (2010). Tell me your story: Analysis of script topics produced by persons with aphasia. American Journal of Speech Language Pathology, 19, 198-203.

Kagan, A. & Simmons-Mackie, N. (2007). Beginning with the end: Outcome-driven assessment and intervention with life participation in mind. Topics in Stroke Rehabilitation, 27, 309-317.

Kagan, A., Simmons-Mackie, N., Rowland, A., Huljbregts, M., Shumway, E., Threats, T. & Sharp, S. (2008). Counting what counts: A framework for capturing real-life outcomes of aphasia intervention. Aphasiology, 22, 258-280.

Simmons-Mackie, N. (2001). Social approaches to aphasia. In: Chapey, R. (Ed.), Language Intervention Strategies in Aphasia. Boston: Williams & Wilkins.

Worrall, L. & Frattali, C. (2000). Neurogenic communication disorders: A functional approach. New York: Thieme.

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