Date of Award

2010

Degree Type

Thesis

Degree Name

Master of Science

Program

Health and Rehabilitation Sciences

Supervisor

Dr. Robert Teasell

Abstract

Introduction: With 21% to 38% of individuals experiencing aphasia post stroke, language

and communication impairments are major issues for clinicians working with stroke patients. To identify, assess, and treat language and communication impairments, speech-language pathologists (SLPs) use a wide variety of tools and interventions. However, the degree to which common screening, assessment, and treatment practices are supported by the evidence is unclear.

Method: This study (1) examined the actual screening, assessment, and treatment practices of 435 SLPs (as part of a cross-Canada survey); (2) identified best practice (via the consensus opinions of a clinician focus group); and (3) compared actual practice with best practice for aphasia and cognitive-communication impairment(s) post stroke. Results: Survey respondents (N=435) indicated 18 to 33 different screening and assessment tools, 27 to 33 additional methods or domains of screening and assessment, and 28 to 30 unique interventions as actual practice. Focus group participants (N=8) identified 20 to 22 different screening and assessment items, and 14 to 20 intervention items as best practice. The survey respondents provided vague descriptions of actual practice, whereas the focus group identified specific tools and interventions. This only allowed for general between-group comparisons. Conclusion: The actual screening, assessment, and treatment practices of SLPs for individuals with aphasia and cognitive-communication impairment(s) post stroke are diverse. The consensus opinions on best practice with this population identified the use of outcome measures with strong psychometric properties, as well as informal screening and

assessment approaches. Both informal and evidence-supported interventions were also

Best Practice Use

Best Practice Use identified. The focus group noted best practice should be informed by the latest evidence,

and be flexible to accommodate changing patient needs.

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