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Why we believe in "working outside of the workbook" in Aphasia recovery…

Limitations of Traditional Workbooks

I have been wanting to create some sort of app or home practice program for individuals with Aphasia, and caregivers, for years. However, every time I started creating it, or had an idea of what I wanted, I ran into a roadblock, finding it difficult to incorporate principles of neuroplasticity and evidence-based practice into an actual workbook. I am personally not a huge fan of the typical workbook for Persons with Aphasia (PWA), as I feel they are often too stagnant, one-dimensional, and difficult to personalize to the individuals’ interests and deficits.


And how transferrable is working in a workbook to being able to successfully participate in a conversation with another human being? THERE IS NO ONE PERSON WITH APHASIA WHO IS ALIKE – so how can a paper/pen workbook allow for those adaptations, and allow for us to manipulate the stimuli in order to meet the ever changing needs and performance of our PWA? I think we have finally begun to crack the code


A Potential Solution

We have started to create our concept of “Working outside of the workbook.” This is not a paper and pen workbook. Many of the tasks require a “helper,” who can be ANY communication partner. This allows for practice with an actual person, rather than a piece of paper, allowing for more natural and realistic practice. Ok, this sounds great, but lets face it, our caregivers often have their hands more than full, and not everyone with Aphasia is willing to or interested in working with their significant other on speech and language tasks…understandably so.


So here is my proposed alternative…my hopes are that you are able to recruit a network of friends and family members who are also willing to work on these tasks, allowing you to build a robust home practice treatment program. And guess what? Every single one of these tasks can absolutely be implemented virtually – because that’s how we do it here at Integrative Reconnective Aphasia Therapy! So setup a zoom chat with your daughter in California, or facetime with your friend in Texas, and let the games begin. Have fun and get on a better pathway to recovery…all at the same time!


So how will this work?

There will be step-by-step instructions on how to implement each task. These instructions are simple enough that anyone can practice the tasks with an individual who has Aphasia – you don’t have to be a Speech Language Pathologist or medical professional. Ok, so anyone can implement the task, but what happens when the PWA struggles with a response, or doesn’t provide the targeted response, which of course is inevitable, right? The biggest challenge for those who have not been professionally trained is less about implementing a task and more about what to do when the PWA doesn’t respond with the appropriate response – how do we provide enough support to avoid frustration but also maintain an appropriate level of challenge in order to help them rebuild connections in their brain. This is when it truly becomes a “therapeutic” task. So, there will also be step-by-step examples of how someone with Aphasia might respond, and ways to cue and provide support to the individual depending on how he/she responds. Also, as the person progresses and gets better, or if the PWA seems to be struggling with the current task, the task will need to be adjusted accordingly. Therefore, we will be providing specific ways to make each task easier, and ways to make the tasks harder.


Again, workbooks can be valuable for certain practice in certain populations, but when it comes to truly helping an individual with Aphasia recover their speech and language abilities, I think we need to venture outside the pages of traditional workbooks. This proposed resource might be a game-changer for those who are living with Aphasia. I have no doubt that many of the tasks will be unlike anything you’ve done before in traditional speech and language therapy sessions.


A HUGE "thank you" to those I can't thank enough

Before ending this blog, I want to acknowledge and thank my amazing patients and their loved ones, as they are the ones constantly helping me to learn more about what they’re going through, pushing me to find different, effective approaches to help the PWA regain their language function, and have instilled a strong sense of drive in me to never settle for what already exists, but rather strive to find new directions and new methods to change the Aphasia recovery path. I wish you all the best of luck with whatever stage of recovery you are in, and hope that you will consider giving this a try. And please, don't hesitate to share your thoughts on other ways we can help you!


Stay tuned for the release of our resource “Working outside of the workbook” – coming soon!


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