Aphasia Institute – Life Participation Approach to Aphasia: A Statement of Values for the Future (Part 1)

LPAA Project Group (in alphabetical order): Roberta Chapey, Judith F. Duchan, Roberta J. Elman, Linda J. Garcia, Aura Kagan, Jon G. Lyon, and Nina Simmons-Mackie

Unprecedented changes are occurring in the way treatment for aphasia is viewed – and reimbursed. These changes, resulting from both internal and external pressures, are influencing how speech-language pathologists carry out their jobs.

Internal influences include a growing interest in treatments that produce meaningful real life outcomes leading to enhanced quality of life. Externally, we are influenced by disability rights activists encouraging adjustments in philosophy and treatment and by consumers frustrated by unmet needs and unfulfilled goals. Most recently, a strong external influence is emanating from the curtailment of funding for our work that has caused a significant reduction in available services to people affected by aphasia.

To accommodate these varied influences on service delivery, it is important to take a proactive stance. We therefore propose a philosophy of service delivery that meets the needs of people affected by aphasia and confronts the pressures from our profession, providers, and funding sources.

Our statement of values has been guided by the ideas and work of speech-language pathologists as well as by individuals in psychology, sociology, and medicine. We intend neither to prescribe exact methods for achieving specific outcomes, nor to provide a quick fix to the challenges facing our profession. Rather, we offer a statement of values and ideas relevant to assessment, intervention, policy making, advocacy, and research that we hope will stimulate discussion related to
restructuring of services and lead to innovative clinical methods for supporting those affected by aphasia.

Defining The Approach

The “Life Participation Approach to Aphasia” (LPAA) is a consumer-driven service-delivery approach that supports individuals with aphasia and others affected by it in achieving their immediate and longer term life goals (note that “approach” refers here to a general philosophy and model of service delivery, rather than to a specific clinical approach). LPAA of clinical practice and research on the consequences of aphasia. It focuses on re-engagement in life, beginning with initial assessment and intervention, and continuing, after hospital discharge, until the consumer no longer elects to have communication support.

LPAA places the life concerns of those affected by aphasia at the center of all decision making It empowers the consumer to select and participate in the recovery process and to collaborate on the design of interventions that aim for a more rapid return to active life. Theses interventions thus have the potential to reduce the consequences of disease and injury that contribute to long-term health costs.

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