Descriptive Analysis: Survey of Direct and Indirect Interventions for Persons With Dementia-Based Communication Disorders

Results of a survey made available to SIG 2 and SIG 15 affiliates via the SIG listservs revealed information on direct and indirect interventions utilized for persons with dementia-based communication disorders. Fifty-eight practicing speech-language pathologists (SLPs) participated and reported using the following direct interventions most frequently: specific verbal instruction, cognitive stimulation, memory wallet, spaced retrieval, and errorless learning. The overwhelming majority of participants utilized caregiver training as the most frequent indirect technique. Barriers and facilitators to providing intervention for persons with dementia-related communication disorders were identified.

Direct and Indirect Interventions for Cognitive-Communication Disorders of Dementia

The dementia syndrome is characterized by cognitive and behavioral deficits that affect daily life functioning, including communication. Speech-language pathologists (SLPs) will see increased numbers of adults with dementia in the coming years, as the incidence and prevalence of diseases that cause dementia continue to grow. In this article, the authors provide an update on the syndrome of dementia and its most common cause, Alzheimer's disease. A framework for interventions is provided, along with a discussion of research evidence for specific treatment techniques. The article concludes with case studies of person-centered assessment and intervention for individuals with mild and moderate dementia severity.

SIG 2 Perspectives Vol. 25, No. 4, October 2015

Download the CE Questions PDF from the toolbar, above. Use the questions to guide your Perspectives reading. When you're ready, purchase the activity from the ASHA Store and follow the instructions to take the exam in ASHA's Learning Center. Available September 19, 2018.

Dementia Management: A Practice Update for Speech-Language Pathologists

Most clinicians working with older adults have assessed and treated patients with cognitive-communicative deficits associated with dementia. Dementia management can be challenging at times, even for the most seasoned clinician. This article will provide a framework for dementia management focusing on assessment, treatment, and documentation to ensure that speech-language pathology services are reimbursable by meeting Medicare's definition of reasonable and necessary services as set forth by the Medicare Benefit Policy Manual. The goal of sharing this information is to help clinicians shape management programs to meet the needs of their patients with dementia and ensure compliance with current healthcare regulations.

Patient Reported Outcome Measures in Neurologic Communication Disorders: An Update

In her seminal book on outcome measurement in the field of communication disorders, Carol Frattali (1998) set the path for outcomes research and clinical application in the field of speech-language pathology. In particular, she defined the many possible outcomes that can be measured to examine the influence of an intervention and the ways in which these measures can inform public policy. Of these, patient or client centered measures, which index outcome based on the patient's and family's or caregiver's perspective, have received increasing attention in recent research and clinical practice. These measures examine a variety of patient reported outcomes (PRO) associated with health. PRO measures are being used more commonly in clinical practice and as end points in medical and rehabilitation outcomes research. This perspective reflects the shift in medicine and rehabilitation toward patient-centered care. In this article, we will examine the rationale for using PRO measures, the advantages and challenges for using these tools, and current use of PRO measures in neurological communication disorders.

SIG 2 Perspectives Vol. 25, No. 3, June 2015

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The ICF, Relationship-Centred Care and Research Outcome Measurement: Carol Frattali's Impact on Aphasia Research

Outcome measurement was a major focus of Carol Frattali's work. This article describes three aphasia research initiatives that have followed from her early publications. The first is the application of the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) to aphasia. The Living with Aphasia: A Framework for Outcome Measurement (A-FROM) is a reinterpretation of the ICF specifically as it applies to aphasia. The Assessment for Living with Aphasia (ALA) is an assessment that is derived from the A-FROM. The second initiative is the program of research that has described aphasia and aphasia rehabilitation from the patient perspective. Using qualitative methodologies, this research has highlighted the need for relationship-centred care in aphasia services. Finally, a current project is described that seeks to gain international consensus on a core outcome set for aphasia treatment research. This will help researchers combine data in effectiveness studies. To achieve the best outcomes for people with aphasia, there is a need to realize Carol Frattali's vision and ensure the continued use of unifying frameworks, relationship-centered practice, consumer-focused research, and consistent outcome measurement practices.

Outcomes and Quality: Key Characteristics of a Successful SLP Value Journey

We are living in a challenging era of healthcare reform marked by dramatic change and unprecedented political and legal turmoil surrounding this reform. Healthcare reform in the name of the Patient Protection and Affordable Care Act (PPACA, 2010) is becoming “hardwired” over the five years since its inception, yet as recently as March of 2015, the Supreme Court of the United States heard arguments to roll back subsidies for the Federal Health Exchanges which if approved could increase insurance rates by nearly 75% on over 8 million subscribers. The national healthcare landscape including reforms, changes, wins, and losses to date will be described. The “secret sauce” for meeting these challenges is to embrace value in healthcare which can be defined as outcomes over cost. In the context of our current levels of care, an inexorable movement away from volume to value will be described focusing on outcomes. The challenges we face especially in reporting outcomes and shifting from volume to value are described. Finally, arguments and illustrations are provided for how speech-language pathologists (SLPs) can continue to espouse value in becoming critical players in the value-based healthcare economy.