COMMUNICATION MANAGEMENT FOR APHASIC PATIENTS

Abstract

Twenty aphasic patients were asked to give descriptions of their communication difficulties in daily communication situations. Their responses were analyzed and the implications for communication management at 1) the immediate post-onset stage, and 2) the post-plateau stage were discussed.
Problems encountered by the patients in the immediate post-onset period included psychological instability such as anxiety, solitude, disorganized thought processes, difficulty in concentration and in learning new materials, decreased memory span, and lack of motivation in addition to communication problems per se.
On the basis of these findings, it was suggested that although it is necessary to take preventive measures, formal aphasia examination and therapy should be deferred until the patient's physical-psychological stability is obtained. The speech therapist's role at the immediate post-onset stage includes gathering information through frequent, informal observation of the patient, providing psychological support for the patient and his family, finding out the most effective communication method with the patient and helping the family and the ward staff to use this method.
Communication difficulties experienced by the patients in the post-plateau stage included the following:
a) Residual organic signs of aphasia: Short auditory memory span, figure-ground disorder, persisting difficulty in articulation and prosody, etc. tended to remain in many patients even after intensive language therapy.
b) Undesirable attitude toward communication: Many patients exhibited anxiety and avoidance reactions in communication situations, which seemed to stem from the organic signs enumerated in a).
Taken together, these findings were interpreted as indicating the necessity for a systematic program aimed at enhancing communication abilities in post-plateau patients. This type of program seems to be of special importance for patients with a good possibility of returning to former employment.
It was further suggested that a modified framework for stuttering therapy (which makes use of identification, desensitization and modification procedures) would be profitably applied to the aphasic patients at this stage of rehabilitation.