When a loved one suffers a stroke, one of the more common aftereffects is aphasia. What we’re going to talk about today is a relatively new approach to aphasia treatment: The Life Participation Approach to Aphasia (LPAA).
What is aphasia?
Aphasia occurs as the result of a stroke or other brain injury. While there are a number of aphasia types, what’s common to all of them is a loss in the ability to communicate.
As soon as the patient is able, a speech and language pathologist will assess the damage and map out a treatment plan. Sometimes, two or three months of aphasia treatment is all the patient needs to recover. All too often, though, that window is not enough. When it closes, the patient – and their friends and family – have to begin the difficult process of accepting that this might be a very long haul.
Traditional Treatment of Aphasia
For the most part, treatment of aphasia concentrates on assessing what the patient can’t do – express herself? comprehend the other? – and then building a treatment plan to help them improve as much as possible.
So, for example, you might come to pick up your loved one from a speech therapy session and see a worksheet with pictures that have to do with clothing – like a skirt, a hanger, pants, etc. At first, the therapist will ask the patient to point to the picture when she herself says the appropriate word. When the therapist sees consistent improvement, she’ll begin asking the patient to point to a picture and say what it is.
Another popular exercise SLPs (speech and language pathologists) do is based on questions and answers. The therapist writes a list of common questions and “rehearses” the answers with the patient until they can answer correctly. The questions might be personal:
- What’s your name?
- Where do you live?
- How old are you?
- What is your husband/wife’s name?
- Do you have any children?
Other questions might be grouped by category, such as professions (what does a fireman do, what does a teacher do), meals (what is a breakfast food, what is a lunch food), or situations (what number do you dial if there’s an emergency? what do you do if you’ve run out of milk?).
While these and other methods of aphasia treatment are important and have met with significant success, the downside to them is that they’re done in isolation. The patient is still left, to a large extent, out of the loop of life. Because if you can’t communicate, how can you participate in…well, just about anything? That’s where LPAA was born.
What is the LPAA approach to aphasia treatment?
Well, the name pretty much says it all: the LPAA approach is an approach that focuses on practical participation in everyday life, rather than learning sets of words. Often done in a group setting, the idea is to get groups of aphasia-sufferers together to share what having aphasia is like, to exchange experiences, or to discuss a new book or have an exercise class together. Speech pathologists are on hand to facilitate communication between the participants so that therapy is done in real time. That makes it easier to carry over to everyday conversations.
Not all LPAA sessions are done in groups. Many speech and language pathologists are integrating the LPAA principles into their private sessions, too. So, for example, they might ask their client what it is they want to re-learn to do, based on which elements are most missing in their lives. One client might answer, “To play Monopoly with my grandson again.” Another might answer, “I want to be able to order in a restaurant again.”
“Great,” the therapist will say. “Let’s start playing Monopoly.” The short-term treatment plans and goals will revolve around re-learning the game. If the patient hits a brick wall, then the goal will be to figure out a way to work around it and keep playing. Same for ordering in a restaurant, participating in group activities, or any other facet of everyday life. Caregivers and family members are included in the treatment plan and given guidance on how to provide support.
Does LPAA show results?
The answer seems to be a resounding “yes.” While some in the SPL community were skeptical at first, the approach has been endorsed by ASHA, the National Aphasia Association and others. The emphasis on living successfully with aphasia, as opposed to constantly trying to fix it, gives aphasia sufferers a feeling of hope. They know that even though life might be different, it can still go on. As one professional put it:
The goal of LPAA is to make life the focus and minimize the influence of aphasia.
Do you think your loved one might benefit from the LPAA approach to aphasia treatment?