No abstract

No abstract

Background: Gesture frequently accompanies speech in healthy speakers. For many individuals with aphasia, gestures are a target of speech-language pathology intervention, either as an alternative form of communication or as a facilitative device for language restoration. The patterns of gesture production for people with aphasia and the participant variables that predict these patterns remain unclear. Aims: We aimed to examine gesture production during conversational discourse in a large sample of individuals with aphasia. We used a detailed gesture coding system to determine patterns of gesture production associated with specific aphasia types and severities. Methods & Procedures:We analysed conversation samples from AphasiaBank, gathered from 46 people with post-stroke aphasia and 10 healthy matched controls all of whom had gestured at least once during a story re-tell task. Twelve gesture types were coded. Descriptive statistics were used to describe the patterns of gesture production. Possible significant differences in production patterns according to aphasia type and severity were examined with a series of analyses of variance (ANOVA) statistics, and multiple regression analysis was used to examine these potential predictors of gesture production patterns. Outcomes & Results: Individuals with aphasia gestured significantly more frequently than healthy controls. Aphasia type and severity impacted significantly on gesture type in specific identified patterns detailed here, especially on the production of meaning-laden gestures. Conclusions: These patterns suggest the opportunity for gestures as targets of aphasia therapy. Aphasia fluency accounted for a greater degree of data variability than aphasia severity or naming skills. More work is required to delineate predictive factors.

This paper examines the evidence for community and outpatient aphasia groups using the International Classification of Functioning, Disability and Health (ICF) framework. A systematic search of the literature using eight electronic databases was completed; 29 studies met inclusion and exclusion criteria. Level of evidence and methodological quality was assessed and effect sizes calculated where possible. Evidence favouring community and outpatient groups centred on four level ii and level iii-i studies that examined the efficacy of highly structured group activities for improving specific linguistic processes with five medium-large effect sizes calculated. Medium and large effect sizes were also calculated on a level iii-i study examining number of friendships and community access. No effect sizes were available for level ii or level iii studies examining communication activity and participation. Overall, the results indicate that community and outpatient group participation can improve specific linguistic processes. There is also some evidence that group participation can benefit social networks and community access. However, there is limited evidence demonstrating improvement in functional communication as a consequence of group participation. The current evidence is not comprehensive. Further well-designed studies, particularly examining activity and participation, and contextual factors are required to advance community and outpatient aphasia group practice and participation.

No abstract

Background: Community aphasia groups (CAGs) for people living with chronic aphasia are known to be efficacious for improving various aspects of communication and psychological functioning based on empirical quantitative evidence. However, the specific mechanisms and processes involved are not well understood and only a small number of groups exist. Further, there is a paucity of evidence on this topic from consumers, potentially limiting the development and uptake of these services. In order to proliferate and maintain groups of high quality, a deeper understanding of the potential mechanisms of positive outcomes is required. Aims: The aim of this study was to investigate consumer (people with aphasia (PWA) and family member) experiences of CAGs within the qualitative literature in relation to the theoretical construct of psychological well-being. Methods & Procedures: An extensive review of qualitative research relating to consumer views of CAGs was conducted in a systematic fashion. Study quality was evaluated using the Critical Appraisal Skills Programme, and content was interpreted in the context of a theoretical model for psychological well-being. Outcomes & Results:Eleven key studies and 35 secondary studies were found to include consumer perspectives of CAGs. The findings of the 11 key studies are presented as a narrative literature review. Overall, evidence suggests CAGs contribute positively to the psychological well-being of PWA and their caregivers. Outcomes relate to forming positive relations with others, purpose in life, environmental mastery, autonomy, personal growth, and self-acceptance. CAG characteristics and mechanisms proposed to mediate psychological well-being are discussed. However, the review is limited by a range of methodological issues in the literature. Conclusions: In order to optimise CAGs in practice, clinicians should consider group characteristics and aim to manipulate the possible mechanisms underlying positive outcomes. Further research is needed to understand the long-term lived experience of CAGs members, including those currently under-represented in the literature.

No abstract

People with aphasia perceive community aphasia-group participation to be beneficial to their ability to live well with aphasia. However, a range of challenges to successful participation are also evident. Inputs such as peer-to-peer communication strategies, shared roles and responsibilities, and consultation with regard to group objectives and processes provide group members with the opportunity to become active contributors, demonstrate competence and have influence over the group. When inputs are poorly implemented or absent, people with aphasia are at risk of feeling disabled and marginalized by the group experience.