The Aphasiology Association of Ohio (AAO) began as a group of professionals interested in adult aphasia rehabilitation.. It began as a special interest group which first met in 1972. The scope and interest of the members has expanded to include work with other disorders of neurogenic origin affecting both pediatric and adult populations. The members are from all geographic areas of Ohio and from a variety of work settings.
Membership in AAO is open to all professionals interested in rehabilitation of neurologically impaired persons.
AAO:
If you are interested in applying for membership you may either contact the membership chairman for an application packet or you may apply online.
To request membership packet contact Melissa Price, Miami University, Dept. of Speech Pathology and Audiology, Bachelor Hall Rm 23, Oxford, OH, 45056-3414. (Click here to email request)To apply online and be billed later (click here).
Aphasia is a language disorder associated with brain damage. It is a breakdown in one's ability to use and/or understand language. It is symbolic in nature and affects the understanding and/or expression of previously learned language units in both spoken and written forms. Depending on the site and extent of the damage, memory for language symbols and/or recall of how to voluntarily produce language may be affected. In addition, there may also be difficulty with voluntary production of speech (apraxia or oral motor impairment affecting speech (dysarthria).
Speech-language pathologists utilize facilitation and compensatory strategies and non-verbal communication techniques to enhance the person's functional communication abilities. Family and/or support persons are counseled to enhance therapy and to aid all those affected in coping with an adjusting to the limitations imposed by the impairment.
Evaluation procedures are predictive of recovery patterns. Research shows that speech-language therapy is effective in promoting communication rehabilitation beyond the "spontaneous recovery" period.
Attention to only the literal the literal meaning for language and impairment in understanding other extra-linguistic aspects of communication.
The primary communication impairments seen in this population are due to specific attention, perceptual social judgment, reasoning, and/or memory deficits. Persons with this problem attend to the literal meaning of what is heard and misunderstand the subtle cues of facial expression, emotional tone of voice, meaning associated with changes in vocal inflection, verbal and visual social cues, idioms, and metaphors. There also may be difficulty with communication due to impaired organization of thoughts and integration of information. Visual perceptual problems associated with right brain injury can affect a person's ability to read or write functionally.
Successful communication consists of more than just recalling words and producing grammatically correct sentences. Speech-language pathologists help patients use subtle language cues and facilitate improvement of thought organization. They also help the patient identify environmental cues that facilitate effective functional communication. The speech-language pathologist assists these patients to regain functional reading and writing abilities.
Dysphagia is difficulty swallowing. The individual with dysphagia may have impairment(s) in chewing, maintaining control of substances (drooling), and propelling food/liquid through the mouth, pharynx and/or esophagus, and in protecting the airway. The ability to receive adequate nutrition and hydration may be compromised and the person may be at risk of aspiration.
Dysphagia often has neuromuscular origin, but can be due to anatomic abnormalities related to birth defects, aging, or injury.
The multidisciplinary team approach in resolving dysphagia is crucially important. The team includes patient, attending physician, speech-language pathologist, nursing staff, dietitian, radiologist, occupational therapist, respiratory therapist, and the patient's family. The need to maintain adequate nutrition and hydration during the evaluation and treatment program must be emphasized.
The speech-language pathologist and the radiologist may jointly conduct a diagnostic test called a Modified Barium Swallow study. This test allows determination of the source of the swallowing disorder as well as the patient's safety for oral feeding, the safest food consistency and the best positioning g of the patient to facilitate safe swallowing.
Following assessment by the speech-language pathologist and other team members, alternative nourishment sources (various types of tube feeding) may be recommended for short term uses in severe cases when the normal oral nutrition route is seriously compromised.
Since many of the same anatomic structures are used for both speech and swallowing, treatment is appropriately administered by a speech-language pathologist who has specific training in dysphagia. The speech-language pathologist instructs the patient and family in exercises to improve function of the mouth and tongue muscles. Various swallowing techniques may need to be taught to the patient and family.
This disorder is one in which there are cognitive deficits which interfere with successful communication. There are difficulties with one or more of the following:
- Perception
- Attention
- Reasoning
- Organization
- Memory
- Use of socially appropriate language
- Control of expression of emotion
Among the causes are:
- Traumatic brain injury,
- Neuro surgery
- Dementia i.e. concussion
- Exposure to toxic substances
- Stroke
- Chronic drug or alcohol abuse i.e.lead
A team of healthcare specialists is essential for guiding rehabilitation. It may include family and significant others, physician, psychologist, nursing staff, occupational therapist, physical therapist and social worker. The speech/language pathologist works with this team when the cognitive deficits interfere with successful communication.
The speech-language pathologist's qualifications:
Special testing is a pre-requisite for designing appropriate treatment. The speech-language pathologist is uniquely qualifies to evaluate oral-motor, cognitive, and language function in the neurologically impaired person.
Based on the findings of the evaluation, facilitation techniques appropriate to the individual can be determined. These techniques can be used to take advantage of the redundance in our environment to modify and improve the communication of the affected person.
The speech-language pathologist treats disorders in attention, perception, m,emory, language organization, judgment, reasoning and social interaction skills. Therapy often involves teaching the person how to use specific strategies to compensate for these problems. In addition, the speech'language pathologist provides family education so the person's caregivers can increase their awareness and understanding of the problems and can facilitate the person's use of techniques learned in the therapy.
In working with neurologically impaired individuals, the speech-language pathologist rehabilitates oral motor function through treatment to improve strength, coordination and range of movement of the speech musculature. The speech-language pathologist also helps these people develop compensatory techniques that will improve intelligibility of speech, thus facilitation more effective speaker-listener interaction.
Some individuals may have such severe impairment in their ability to communicate verbally that they need an alternative or augmentative device to communicate effectively. The speech-language pathologist works with this person to select the appropriate communication device (ranging from a picture communication board through complete computer assisted voice output devices). They train the person and all those in the person's support system in the most effective use of the augmentative device.
The speech-language pathologist also works in rehabilitation of swallowing difficulty or dysphagia by outlining programs designed to rehabilitate the musculature used in oral ingestion of food,m as well as giving instructions in compensatory techniques to facilitate improved swallowing safety and nutritional intake.
The person's caregivers require intervention to safeguard their physical and emotional health. Therefore, speech-language pathologists often consult with other professionals, such as social workers and psychologists during the rehabilitation process.
Support groups, such as stroke clubs and maintenance therapy groups, can help to facilitate long term goals in total rehabilitation. The speech language pathologist is knowledgeable about directing the person and caregiver to appropriate community resources which may be of support and assistance.
Periodic reporting to referring agencies is part of the speech-language pathologist's responsibility. When the person no longer benefits from treatment, the speech-language pathologist will inform the patient, the significant caregiver, and the referring agent. Appropriate referrals will be made if supportive counseling is necessary following discharge from therapy.
Persons with communication and cognition problems due to neurologic impairment have a multiplicity of problems and challenges. The speech-language pathologist recognizes this and is committed to restoring a level of performance which will enable such individuals to function successfully in their daily lives.
There are many well-established speech and hearing clinics which are affiliated with local hospitals, colleges, and universities. Agencies of the state and federal government and community agencies are also able to supply information regarding services available. There is a growing number of speech-language pathologists who are in private practice.
The local county health department, the American Heart Association, the National Head Injury Foundation and the American Speech-Language Hearing Association at 1-800-638-TALK are usually the best sources of information about how to contact the appropriate individual or facility to provide services.
If you have any question, speech-language pathologists are most willing to talk to you. Please feel free to contact AAO, ASHA or your local speech-language pathologist.
The previous information is available in a brochure, "Rehabilitation of People with Neurogenic Disorders" provided by AAO.