Speaking Out Conference…

Downtown Chicago

During the last weekend of June, on June 26th, a Speaking Out conference took place in Chicago. This year’s conference was organized at the Rehabilitation Institute of Chicago. Thumbs up to  Dr. Leora Cherney and her team from RIC, as well as Ellayne Ganzfried and her team from the National Aphasia Association for organizing this great event. In addition to the conference, RIC also organized a professional development event “Updates in Aphasia Rehabilitation for the Practicing Speech-Language Pathologist” on June 23rd and 24th. Below is a brief summary of these two events.

Dr. Pelagie M. Beeson Thursday, June 23rd

Pelagie Beeson is a professor at the University of Arizona, with joint appointments in the Department of Speech, Language , and Hearing Sciences, and the Department of Neurology. Dr. Beeson’s full biography is available here.

Dr. Beeson covered the following topics:

  • Naming impairments in Aphasia
  • Promoting self-cueing strategies (training sequence of self-cueing techniques for lexical retrieval)
  • Arizona Naming Cascade
  • Activating semantic information helps PWAs retrieve the word. Subjects who cannot identify a word, when prompted with semantic questions, described the word perfectly
  • Conceptual representation of a word includes information about attributes, function, contextually related items, superordinate category, members of the same category
  • These approaches can work well for anomic, mild-moderate Broca’s, or mild conduction aphasia. It doesn’t work well in cases of poor motor control for speech, phonemic paraphasia, impaired semantics
  • When spoken output is severely limited, non-verbal modalities should be considered (gestures, drawing)

Dr. Beeson provided information on several subjects with Progressive Primary Aphasia and the outcomes of the above language treatments for those individuals. Dr. Beeson also extensively covered the writing and reading impairments in aphasia:

  • treatments for reading and writing are typically deferred or never addressed
  • lexical, phonological, and interactive treatment approaches were covered
  • lexical writing treatment was done with 24 words using the Copy and Recall Treatment approach. Personally relevant words were used as well
  • for phonological treatment, “keywords” were established to provide letter-to-sound and sound-to-letter correspondence
  • non-words (20) were used for the advanced phonological treatment
  • interactive spelling treatment was done using a spell-checker: users first sound-out plausible spellings, try to identify and correct errors, and then when done use spell-checker to verify
  • a single-subject study was done using Copy and Recall Treatment with texting (as in text messaging / SMS on mobile phones)
  • text-level reading treatments were also covered

Numerous resources related to the above research are available at the Aphasia Research Project website.

Leora R. Cherney, Friday, June 24th

Dr. Leora Cherney is a Professor of Physical Medicine and Rehabilitation at Northwestern University, Feinberg School Of Medicine and a Senior Clinical Research Scientist at the Rehabilitation Institute of Chicago.

Dr, Cherney reviewed the four domains of living with aphasia: Framework for Outcome Measurement model (Kagan et al. 2008), reviewed the concepts of neuroplasticity and it’s implications on aphasia rehabilitation, and covered several aphasia treatment techniques focused on oral expressive skills.

  • Constraint Induced Language Therapy (CILT) was proposed by Pulvermuller et al., various studies were also done by Maher et al.; an evidence based systematic review is available for download on ASHA website
  • Studies on fMRI, trying to identify who the best responders to CILT are
  • “Scripts: Training Everyday Conversations for Individuals with Aphasia”: scripts are sequences of sentences spoken in routine communication situation (e.g. ordering food, making Dr. appointment, etc.)
  • Mild-to-moderate language deficits make good candidates for the script training; scripts are based on the instance theory of automatization
  • Scripts should focus on meaningful segments (not individual words) and use everyday life topics
  • When creating scripts: consider patients needs and interests, number and length of conversational turns, grammatical complexity, vocabulary selection
  • In dialogs, communication partner lines should be as short as possible (leaves more time to practice production for the PWA)
  • Grammatical complexity can be measured by morphemes
  • Script writing is an iterative process; a collaboration between the clinician and the person with aphasia
  • Aphasia Scripts is a software developed by RIC and the University of Colorado; it can be purchased here
  • Talking photo albums can also be used to facilitate scripts
  • Dr. Cherney covered Melodic Intonation Therapy and the research of Schlaug et al.
  • Advanced biological approaches to aphasia treatment that are based on cortical stimulation (epidural cortical stimulation, Repetitive Transcranial Magnetic Stimulation, and Transcranial Direct Current Stimulation) and pharmacological treatments
  • Life Participation Approach to Aphasia (more details on the ASHA website); RIC offers Conversation Group, Book Club, Topic specific groups. Book Club materials are based on the Aphasia Center of California Book Connection program.
  • Using techniques of Supported Conversation (for more details visit the Aphasia Institute website)

Speaking Out, Sunday, June 26th

Unlike the Thu/Fri event which was attended primarily by Speech and Language Pathologists, Sunday’s conference was attended primarily by people with aphasia, caregivers, and some professionals. Most of the attendees were local, although there were a number of people that traveled from New York, Massachusetts, California, Pennsylvania, etc.

The morning session covered several talks on aphasia research, supported communication techniques, the concept of the aphasia center, as well as an “EMPOWER” session which was presented by people who are living with aphasia. Afternoon sessions focused on recreational activities and covered musical therapy, art, theater, gardening, and reading.

During lunch, Ellayne Ganzfried provided an overview of the National Aphasia Association activities in the past year as well as their future plans. We also had an opportunity to present the Aphasia Corner Blog to the audience. In the late afternoon Dynavox and Lingraphica presented their technical solutions for people with aphasia.

Finally, at the end of the day, “Aphasia: The Movie – Hope is a Four Letter Word” movie had its mid-west premier in Chicago. Carl McIntyre gave another great speech after the movie. We have previously covered the movie as well as an interview with Carl and an interview his wife, Elizabeth McIntyre, on the Aphasia Corner Blog.

Carl giving a speech after the movie showing

The conference also featured an art exhibit “Beyond Stroke” by Len Upin. We hope to be able to showcase some of Len’s great artwork on the Aphasia Corner Blog sometime in the near future.

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