Aphasia-Diagnostic Challenges and Trends: Speech-Language Pathologist’s Perspective

Objectives: To explore current aphasia assessment practices and barriers among Pakistani speech language pathologists. Methods: Descriptive study design with qualitative parameters was used. Participants were identified using purposive sampling over a period of eight months from 1st December 2018 to 31st July 2019. Sample comprised of ten speech-language pathologists with least five years’ experience of working with aphasic clients from four major cities of Pakistan including Islamabad, Karachi, Lahore and Peshawar. Study included in depth interviews using a self-structured interview guide with probe questions. Data recorded was transcribed and thematic analyses were drawn manually. Results: Thematic analysis revealed that most Speech language pathologists rely heavily on informal assessment techniques. With no aphasia assessment tool available in Urdu language, no consensus as to the optimal evaluation strategy or tool for aphasia assessment was noted. However, need for such tool was highlighted by all participants. Hence, non-availability of standardized and culturally appropriate assessment tool in “Urdu” language turned out to be the major barrier in adopting formal assessment for aphasic clients, while time consumed in formal testing remained second most reported issue. Conclusion: There is a dire need of quick aphasia assessment tool in Urdu language with established psychometric properties and culturally appropriate norms. doi: https://doi.org/10.12669/pjms.37.5.2314 How to cite this:Badar F, Naz S, Mumtaz N, Babur MN, Saqulain G. Aphasia-Diagnostic Challenges and Trends: Speech-Language Pathologist’s Perspective. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.2314 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Multidisciplinary Evidence to Treat Bilingual Individuals with Aphasia

The steady increase in linguistic and cultural diversity in the country, including the number of bilingual speakers, has been predicted to continue. Minorities are expected to be the majority by 2042. Strokes, the third leading cause of death and the leading cause of long-term disability in the U.S., are quite prevalent in racial and ethnic minorities, so population estimates underscore the imperative need to develop valid clinical procedures to serve the predicted increase in linguistically and culturally diverse bilingual adults with aphasia in post-stroke rehabilitation. Bilingualism is a complex phenomenon that interconnects culture, cognition, and language; thus, as aphasia is a social phenomenon, treatment of bilingual aphasic persons would benefit from conceptual frameworks that exploit the culture-cognition-language interaction in ways that maximize both linguistic and communicative improvement leading to social re-adaptation. This paper discusses a multidisciplinary evidence-based approach to develop ecologically-valid treatment strategies for bilingual aphasic individuals. Content aims to spark practitioners' interest to explore conceptually broad intervention strategies beyond strictly linguistic domains that would facilitate linguistic gains, communicative interactions, and social functioning. This paper largely emphasizes Spanish-English individuals in the United States. Practitioners, however, are advised to adapt the proposed principles to the unique backgrounds of other bilingual aphasic clients.

Identifying Behavior Associated with Verbal Self-Corrections of Aphasic Clients

The purposes of this study were to define certain behaviors associated with verbal self-correction efforts of aphasic clients and to determine the accuracy with which these behaviors might be identified by clinical observers. Seven explicit definitions were written for behaviors associated with aphasic clients' self-correction attempts on single-word and short-answer language production tasks. To determine the accuracy with which defined behaviors could be identified, observers (N=7) were asked to view 400 randomly selected speech samples and to code the type of self-correction event for each sample. The accuracy of these judgments was ascertained by calculating the percentages of observers' agreements with judgments made previously by the experimenters. Results showed observers were able to identify explicitly defined behaviors at levels of accuracy ranging from 73%–99%. When observers' judgments did not agree with those of the experimenters, inaccuracies tended to be logical and to cluster in particular categories. Findings suggest a need for further study of behaviors associated with aphasic individuals' self correction efforts, particularly with reference to the significance of these behaviors to recovery from aphasia, and to aphasic symptomatology in general.