Aphasia Institute – Life Participation Approach to Aphasia: A Statement of Values for the Future (Part 4)

The Core Values Of LPAA

LPAA is structured around five core values that serve as guides to assessment, intervention, and research.

The Explicit Goal Is Enhancement of Life Participation

In the LPAA approach, the first focus of the client, clinician, and policy-maker is to assess the extent to which persons affected by aphasia are able to achieve life participation goals, and the extent to which the aphasia hinders the attainment of these desired outcomes. The second focus is to improve short-term and long-term participation in life.

All Those Affected by Aphasia Are Entitled to Service

LPAA supports all those affected directly by aphasia, including immediate family and close associates of the adult with aphasia. The LPAA approach holds that it is essential to build protected communities within society where persons with aphasia are able not only to participate but are valued as participants. Therefore, intervention may involve changing broader social systems to make them more accessible to those affected by aphasia.

The Measures of Success Include Documented Life-Enhancement Changes

The LPAA approach calls for the use of outcome measures that assess quality of life and the degree to which those affected by aphasia meet their life participation goals.

Without a cause to communicate, we believe, there is no practical need for communication. Therefore, treatment focuses on a reason to communicate as much as on communication repair. In so doing, treatment attends to each consumer’s feelings, relationships, and activities in life.

Both Personal and Environmental Factors Are Targets of Intervention

Disruption of daily life for individuals affected by aphasia (including those who do not have aphasia themselves) is evident on two levels: personal (internal) and environmental (external). Intervention consists of constantly assessing, weighing, and prioritizing which personal and environmental factors should be targets of intervention and how best to provide freer, easier, and more autonomous access to activities and social connections of choice. This does not mean that treatment comprises only life resumption processes, but rather that enhanced participation in life “governs” management from its inception. In this fundamental way, the LPAA approach differs from one in which life enhancement is targeted only after language repair has been addressed.

Emphasis Is on the Availability of Services as Needed at All Stages of Aphasia

LPAA begins with the onset of aphasia and continues until consumers and providers agree that targeted life enhancement changes have occurred. However, LPAA acknowledges that life consequences of aphasia change over time and should be addressed regardless of the length of time post-onset. Consumers are therefore permitted to discontinue intervention, and reenter treatment when they believe they need to continue work on a goal or to attain a new life goal.

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