A Survey on the Speech Therapy Rehabilitation Landscape for Aphasia in Brazil: Aphasiology: Vol 0, No 0

ABSTRACT

Purpose

to evaluate characteristics of aphasia rehabilitation, its barriers, and differences according to educational level (undergraduate level in speech-language pathology (SLP) or otherwise, professional qualification, Master’s or Doctoral/Post-doctoral degree) and region of Brazil.

Methods

A cross-sectional, quantitative, exploratory, analytical survey study was conducted. Speech therapists who work with people with aphasia (PwA) were invited to answer the online survey. Participants were recruited through the Brazilian Society of Speech-Language Pathology and Audiology and by snowball sampling.

Results

Of the 103 participants, 55 (53%) were from the Southeast region, 55 (53.4%) held an SLP undergraduate or professional specialization degree only, 21 (20.4%) a Master’s, and 27 (26.2%) a Doctoral or Post-doctoral degrees. Standardized instruments for assessing aphasia were used by 51 (49.5%) respondents. Functional therapy was used in 99% of cases. Professionals holding Doctoral or Post-doctoral degrees had a greater level of engagement in conferences (p=0.014) and in professional associations/societies than therapists qualified with lower education degrees (p<0.001). The high-educated group worked more with PWA during the year (p=0.002) and with more public health system users (p=0.002). These professionals also made greater use of telerehabilitation (p<0.001), group therapy approaches (p=0.015), and Transcranial Direct Current Stimulation (p=0.009). Additionally, they charged higher private consultation fees (p<0.001) and were predominantly from the Southeast region (p=0.047). Professionals from the South region delivered more outpatient care to PwA (p=0.007). All participants from the Southeast region used a multimodal therapy approach (p=0.021). For chronic PwA, professionals holding a Doctoral or Postdoctoral degree (p=0.035), and those from the Southeast region (p=0.049) provided therapy for longer.

Conclusion

Results revealed differences in type of therapeutic approach, assessment instruments and duration of aphasia treatment, according to region and postgraduate level of education. Future studies should investigate the causes of these disparities, along with barriers or approach preferences that may stem from undergraduate training and impact aphasia treatment approaches in Brazil.

KEYWORDS:

Author contributions

English: RRL, RB contributed to the study design, data collection, and article writing, RB participated in data collection; RRL participated as the advisor, HNL in data analysis, interpretation, and article writing. MC and MIA provided article editing and writing.

Acknowledgments

The authors extend their thanks to the speech therapists in Brazil who participated in this research and whose commitment to advancing the field of aphasia rehabilitation is appreciated.

Disclosure statement

No potential conflict of interest was reported by the author(s).

QUESTIONNAIRE

In the last two years, have you participated in conferences or courses in the field of aphasia?

() yes () no

(2) Are you a member of any association/society/group related to aphasia?

() yes () no

2. If yes, which one?____________________

(3) In the last 12 months, have you treated any patients with aphasia?

() yes () no

3.1 If yes, how many patients, on average, have you treated in the last 12 months?

() 1 to 5 () 6 to 10 () more than 10

(4) Where do you care for patients with aphasia?

4.1. Hospital

() Yes () No

4.2. Outpatient care

()Yes () No

(5) Where do you usually see patients with aphasia the most?

5.1 Unified Health System (SUS)

() Yes ()No

Private

() Yes No

(6) How do you usually provide treatment to patients with aphasia?

6.1. Individual

() always () frequently () rarely () do not perform

6.2. In a group

() always () frequently () rarely () do not perform

6.3. Tele-rehabilitation

() always () frequently () rarely () do not perform

(7) On average, what is the cost of your private therapy per patient? BRL (USD)

() < 150 (30)

() 151 - 200 (31-41)

() > 210 (42)

(8) On average, how much do you receive for your health insurance plan holders? BRL (USD)

() 20 – 50 (4-10)

() 51 – 70 (10-14)

() 71 – 100 (14-20)

() >101 reais (>20)

() I do not accept the health insurance plan holders

In the following questions, I would like you to fill in the answers about the AVERAGE or MOST FREQUENT SITUATION of aphasic patients you treat.

(9) FOR ACUTE/SUBACUTE PATIENTS, how many sessions are performed weekly? (frequency)

() 1 sessions/week

() 2 sessions/week

() ≥3 sessions/week

9.1 FOR CHRONIC PATIENTS, how many sessions are performed per week? (frequency)

() 1 sessions/week

() 2 sessions/week

() ≥3 sessions/week

(10) FOR ACUTE/SUBACUTE PATIENTS, how long does a therapy session last? (intensity)

() <2 hours/week

() 2 - 3 hours/week

() >3 hours/week

10.1 FOR CHRONIC PATIENTS, how long does your therapy session last? (intensity)

() <2 hours/week

() 2 - 3 hours/week

() >3 hours/week

(11) FOR ACUTE/SUBACUTE PATIENTS, how long does treatment last? (duration)

() ≤6 months

() >6 months

11.1 FOR CHRONIC PATIENTS, how long does treatment last? (duration)

() ≤6 months

() >6 months

(12) Do you use any auxiliary resources in therapy?

() Software

() Applications

() Transcranial direct current stimulation

() Transcranial magnetic stimulation

()Others_________________

(13) How do you assess aphasia?

() Standardized instruments

() Discursive

() Others__________________

(14) Which form/test do you use for oral expression?

() Montreal Toulouse Language Assessment Battery (MTL)

() Boston Test for Diagnosis of Aphasia

() Aphasia Rehabilitation Test - Rio de Janeiro

() M1-Alpha

() Others___________

(15) What form/test for oral comprehension?

() Montreal Toulouse Language Assessment Battery (MTL)

() Boston Test for Diagnosis of Aphasia

() Aphasia Rehabilitation Test - Rio de Janeiro

() M1-Alpha

() Token Test

() Others___________

(16) What form/test for naming?

() Montreal Toulouse Language Assessment Battery (MTL)

() Boston Test for Diagnosis of Aphasia

() Aphasia Rehabilitation Test - Rio de Janeiro

() M1-Alpha

() Others___________

(17) What form/test for writing and reading?

() Montreal Toulouse Language Assessment Battery (MTL)

() Boston Test for Diagnosis of Aphasia

() Aphasia Rehabilitation Test - Rio de Janeiro

() M1-Alpha

() Word and Pseudoword Reading Task – TLPP

() Others___________

(18) Do you prepare/send any tasks for the patient to do at home?