A pilot study on how speech-language pathologists include social participation in aphasia rehabilitation

Abstract

Background: People with aphasia have trouble achieving satisfying social participation. Despite recommendations to include social participation in rehabilitation, it is unknown how speech-language pathologists (SLPs) integrate it in their practice.

Aim: The goal was to explore factors that influenced how SLPs included social participation in rehabilitation of people with aphasia.

Methods and procedures: A group interview was conducted with three SLPs working in a rehabilitation centre of Quebec, Canada. The transcript of the interview was analysed using qualitative content analysis.

Outcomes and results: Participants described their practice as mainly based on assessing and reducing language impairment. Social participation was perceived as the underlying, implicit goal of speech-language therapy. Participants tried to integrate non-traditional strategies and principles to foster patients’ social participation in a more explicit manner, but reported being limited by numerous social and organisational factors.

Conclusions: In the setting studied, speech-language therapy practice appeared to be anchored in a traditional medical model. Changes in healthcare organisation and university curricula seem necessary for SLP practice to follow a social participation-based model. On a personal level, it seemed SLPs also needed to develop the motivation for transforming their practice.

KEYWORDS:

• social participation
• aphasia
• speech-language therapy
• speech-language pathology
• rehabilitation

Acknowledgements

The authors wish to express their gratitude to the participants who took part in this study. They also wish to thank Dr Eva Kehayia, researcher at the Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), for her help and advice. The authors also wish to thank Jennyfer Trépanier, Master’s Student in Speech-Language Pathology, Carole Anglade, PhD student, and all the other members of the research laboratory. This study was part of the PhD project of the second author and of the Master’s research project of the first author.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. In Quebec, a province of Canada, stroke patients follow a three-stage continuum of care in their rehabilitation process. At first, they are admitted in an acute care hospital, where they mainly receive healthcare and early short-term rehabilitation services. About 60% of patients return home after acute care. Only about 17% of all stroke patients access inpatient rehabilitation, where they receive intensive rehabilitation services, usually 5 days a week. When back in their home, only a small number of patients have access to outpatient rehabilitation (INESSS, 2012).

Additional information

Funding

The authors acknowledge the financial support of the Fonds de recherche du Québec – Santé (FRQS), through the Rehabilitation Living Lab (MALL) Project and the salary grant from the Jewish Rehabilitation Hospital in Laval (Quebec, Canada) awarded to the second author.