Article

Application of the ICF in aphasia.

Department of Communication Sciences & Disorders, Southeastern Louisiana University, Hammond, Louisiana, USA.
Seminars in Speech and Language 12/2007; 28(4):244-53. DOI: 10.1055/s-2007-986521
Source: PubMed

ABSTRACT The aim of this article is to describe aphasia using the framework provided by the World Health Organization's International Classification of Functioning, Disability and Health (ICF). The key constructs of ICF are described in relation to the ultimate goal of intervention in aphasia-maximizing quality of life. Aphasic impairments as well as activity limitations and participation restrictions are discussed. In addition, the impact of contextual factors on the experience of aphasia and participation in life are addressed. Finally, a case example is presented to depict the use of the ICF as an organizational framework for approaching management of impairments and consequences of aphasia.

45 Followers
 · 
1,101 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this essay is to explore several first-person narratives that chart the experience of a stroke, namely Jean-Dominique Bauby's The Diving-Bell and the Butterfly, Robert McCrum's My Year Off: Rediscovering Life After a Stroke and Jill Bolte Taylor's My Stroke of Insight: a Brain Scientist's Personal Journey. The author uses her own invested viewpoint as a stroke survivor, as well as her memoir Hemispheres: inside a stroke as a point of departure for a study of stroke memoir. The link between illness narratives and narrative medicine, and their reciprocal aims of augmenting and humanising limited medical views of stroke, are considered. The paper argues that the crucial connection between coming to terms with a stroke, and finding terms for it, has implications for the voice, selfhood and power of those seeking these terms. The key argument is that stroke results in shifts of language for many survivors. The writers in question manifest a fragmentation in language which is superceded by narrative strategies which attempt to reassemble sense. An exploration of writing as a bulwark against deficits and a loss of order is therefore central to the piece. With the exception of Bauby, who does not survive, all the writers discussed in this article use narrative to document recovery. They do so employing language that is richer, more allegorical and more compelling than that of neuroscience.
    English Studies in Africa 06/2012; 55(1):64-76. DOI:10.1080/00138398.2012.682465
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Objectives: To review the literature on the specific role of the right cerebral hemisphere during recovery from aphasia in order to address the lack of consensus among authors. To derive a theoretical model reconciling the controversial findings in the literature. Methods: Initial PubMed, MEDLINE (1946 to 5 May 2012) and PsycINFO (1806 to first week June 2012) searches on recovery mechanisms from aphasia, whether treatment-related or not, retrieved a total of 35 English language articles. Articles, cross-referenced in this initial set were also reviewed if they met the inclusion criteria, thus resulting in a total of 42 articles included in this review. Main outcomes: Recruitment of the right hemisphere during recovery from aphasia can be effective if it occurs during a critical time window post-stroke. The recruitment's effectiveness will depend on the lesion's location, extent and permanence. Preservation of core language processing areas will generate minimal right hemisphere recruitment and vice versa. Some experimental studies seem to suggest that the improvement linked to a particular hemisphere can be modulated by specific therapy methods. Conclusion: The specific conditions in which effective right recruitment takes place may have important implications for rehabilitation treatment. These findings could lead to improved recovery in people suffering from aphasia. However, more research with non-invasive brain stimulation is needed.
    Brain Injury 02/2014; 28(2):138-45. DOI:10.3109/02699052.2013.859734 · 1.86 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Intensive comprehensive aphasia programs (ICAPs) are gaining popularity in the international aphasia rehabilitation community. ICAPs comprise at least three hours of treatment per day over at least two weeks, have definable start and end dates for one cohort and use a variety of formats including individual treatment, group therapy, education and technology to improve language and communication. While intensive treatment approaches have demonstrated equivocal results on impairment-based measures, positive changes on activity/participation measures provide support for ICAPs in rehabilitation of chronic aphasia. Aphasia Language Impairment and Functional Therapy (LIFT) is a research-based ICAP developed for the purpose of evaluating treatment outcomes across the International Classification of Functioning, Disability and Health (ICF) domains.Aims: The aim of this study was to estimate the magnitude of treatment effects yielded by Aphasia Aphasia LIFT in the domains of language impairment, functional communication and communication-related quality of life (QOL).Methods & Procedures: Eleven individuals with chronic post-stroke aphasia (mean = 26.9 months) completed Aphasia LIFT. The programme comprised individual impairment-based and functional treatment, group therapy, and computer-based treatment for 40 hours over two weeks (n = 4, LIFT 1) or 100 hours over four weeks (n = 7, LIFT 2). Assessments of confrontation naming, discourse production, functional communication and communication-related quality of life were completed at pre-treatment, immediately post-treatment and six to eight weeks following treatment termination.Outcomes & Results: Group-level analyses revealed acquisition and maintenance of treatment effects, as evidenced by significant improvement on at least one outcome measure at follow-up in all domains. The most consistent pattern of improvement at an individual level was observed on measures of functional communication and communication-related QOL.Conclusions: Aphasia LIFT yielded positive outcomes across ICF domains, and in many cases the treatment effect was enduring. These results demonstrate that Aphasia LIFT was successful in meeting the overarching goal of ICAPs, to maximise communication and enhance life participation in individuals with aphasia. Further research into ICAPs is warranted.
    Aphasiology 11/2013; 27(11):1339-61. DOI:10.1080/02687038.2013.825759 · 1.73 Impact Factor