Current Clinical Practice of Speech-Language Pathologists who Treat Individuals with Aphasia: A Grounded Theory Study
Issue: Vol 6 No. 1 (2015)
Subject Areas: Linguistics
Little is known about the current practices of speech- language pathologists working with people with aphasia in rehabilitation settings, or to what extent speech-language pathologists incorporate evidence for aphasia in clinical practice. This systematic grounded theory study described how speech- language pathologists treating individuals with aphasia understood the major processes of their current practice. Ten speech- language pathologists were interviewed. A theory emerged demonstrating a process of connecting with patients with aphasia to meet their communication needs to develop treatment strategies. This process evolved as the clinician gained experience from empirical evidence, client perspectives, and clinical expertise. During their graduate programs, participants obtained knowledge related to evidence-based practice but reported difficulty implementing evidence during actual practice. Participants reported limited time to locate and read literature. Understanding the process speech- language pathologists used to select treatment for people with aphasia may influence the role of evidence in clinical practice.
Author: Christen Page, Dana Howell
Ahern, K. J. (1999). Ten tips for reflexive bracketing. Qualitative Health Research, 9 (3): 407–411. http://dx.doi.org/10.1177/104973239900900309
Bauer, K. and Schultz, A. N. (2010, March). Clinical Application of Evidence-Based Practice: Mission Impossible or Mission Accomplished? Presentation at the annual meeting of the Georgia Speech–Language-Hearing Association, Atlanta, GA
Bero, L. A., Grilli, R., Grimshaw, J. M., Harvey, E., Oxman, A. D. and Thomson, M. A. (1998). Closing the gap between research and practice: An overview of systematic reviews of interventions to promote the implementation of research findings. British Medical Journal, 317 (7156): 465–468. http://dx.doi.org/10.1136/bmj.317.7156.465
Byng, S. and Black, M. (1995). What makes a therapy? Some parameters of therapeutic intervention in aphasia. European Journal of Disorders in Communication, 30 (3): 303–316. http://dx.doi.org/10.3109/13682829509021444
Ciccone, N., Armstrong, E. and Hersh, D. (2012). Speech pathologists’ clinical decisions in the provision of services to people with aphasia. Poster presented at the International Aphasia Rehabilitation Conference, Melbourne, Australia.
Corbin, J. and Strauss, A. (2008). Basics of Qualitative Research Techniques and Procedures for Developing Grounded Theory (3rd edn). London: Sage Publications.
DiLollo, A. and Favreau, C. (2010). Person-centered care and speech and language therapy. Seminars in Speech and Language, 31 (2): 91–97. http://dx.doi.org/10.1055/s-0030-1252110
Duffy, J., Fossett, T. and Thomas, J. (2010). Aphasia Care in the Acute Hospital: Challenges and Opportunities. Paper presented at the Clinical Aphasiology Conference, Isle of Palms, SC. Retrieved 3 February 2014 from
Foster, A. M., Worrall, L. E., Rose, M. L. and O’Halloran, R. (2013) Turning the tide: Putting acute aphasia management back on the agenda through evidence-based practice, Aphasiology, (27) 4: 420–443. http://dx.doi.org/10.1080/02687038.2013.770818
Fucetola, R., Tucker, F., Blank, K. and Corbetta, M. (2005). A process for translating evidence-based aphasia treatment into clinical practice. Aphasiology, 19 (3/4/5): 411–422.
Godecke, E., Hird, K., Lalor, E. E., Rai, T. and Phillips, M. R. (2012). Very early poststroke aphasia therapy: A pilot randomized controlled efficacy trial. International Journal of Stroke, 7 (8): 635–644. http://dx.doi.org/10.1111/j.1747-4949.2011.00631.x
Goodglass, H., Kaplan, E. and Barresi, B. (2001). Boston Diagnostic Aphasia Examination (3rd edn). Philadelphia, PA: Lippincott Williams & Wilkins.
, , and (2012). SMARTER goal setting in aphasia rehabilitation. , 26 (2): 220–233. http://dx.doi.org/10.1080/02687038.2011.640392
Kagan, A., Simmons-Mackie, N., Rowland, A., Huijbregts, M., Shumway, E., McEwen, S., Threats, T. and Sharp, S. (2008). Counting what counts: A framework for capturing real-life outcomes of aphasia intervention. Aphasiology, 22 (3): 258–280. http://dx.doi.org/10.1080/02687030701282595
Kaplan, E., Goodglass, H. and Weintraub, S. (1983). The Boston Naming Test. Philadelphia, PA: Lea and Febiger.
Kay, J., Lesser, R. and Coltheart, M. (1992). Psycholinguistics Assessments of Language Processing in Aphasia (PALPA): An introduction. Aphasiology, 10 (2): 159–215. http://dx.doi.org/10.1080/02687039608248403
Katz, R., Hallowell, B., Code, C., Armstrong, E., Roberts, P., Pound, C. and Katz, L. (2000). A multinational comparison of aphasia management practices. International Journal of Language and Communication Disorders, 35 (2): 303–314. http://dx.doi.org/10.1080/136828200247205
Kertesz, A. (1982). Western Aphasia Battery. New York: Grune and Stratton.
LPAA Project Group (2001). Life participation approach to aphasia: A statement of values. In Chapey, R. (Ed.), Language Intervention Strategies in Aphasia and Related Neurogenic Communication Disorders (4th edn, pp. 23–245). Baltimore, MD: Lippincott, Williams & Wilkins (ASHA Leader, Volume 5, 2000).
Malterud, K. (2001). The art and science of clinical knowledge: Evidence beyond measures and numbers. The Lancet, 358 (9279): 397–400. http://dx.doi.org/10.1016/S0140-6736(01)05548-9
McCabe, P., Purcell, A., Baker, E., Madill, C. and Trembath, D. (2009). Case-based learning: One route to evidence-based practice. Evidence-based Communication Assessment and Intervention, 3 (4): 208–219. http://dx.doi.org/10.1080/17489530903399145
McIntyre, D. (2006). Bridging the gap between research and practice. Cambridge Journal of Education, 35 (3): 357–382. http://dx.doi.org/10.1080/03057640500319065
Modi, N. and Ross, E. (2000). The current practices, training and concerns of a group of hospital-based speech therapists working in the area of dysphagia. The South African Journal of Communication Disorders, 47: 3–14.
, A., , L., P. and Sellars, C. (2000). Barriers to achieving evidence-based stroke rehabilitation. Clinical Rehabilitation, 14 (6): 611–617. http://dx.doi.org/10.1191/0269215500cr369oa
Ratner, M. B. (2006). Evidence-based practice: An examination of ramifications for practice of speech-language pathology. Language, Speech, and Hearing Services in Schools, 37 (4): 257–267. http://dx.doi.org/10.1044/0161-1461(2006/029)
Rose, M., Ferguson, A., Power, E., Togher, L. and Worrall, L. (2013). Aphasia rehabilitation in Australia: Current practices, challenges, and future directions. International Journal of Speech-Language Pathology, [Early On-line], 1–12. http://dx.doi.org/10.3109/17549507.2013.794474
Roulstone, S., Wren, Y., Bakopoulou, I. and Lindsay, G. (2012). Interventions for children with speech, language, and communication needs: An exploration of current practice. Child Language Teaching and Therapy, 28 (3): 325–341. http://dx.doi.org/10.1177/0265659012456385
Sackett, D.L. (1997). Evidence-based medicine. Seminars in Perinatology, 21 (1): 3–5. http://dx.doi.org/10.1016/S0146-0005(97)80013-4
Schwandt, T. A., Lincoln, Y. S. and Guba, E. G. (2007). Judging interpretations: But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. New Directions for Evaluation, 2007 (114): 11–25. http://dx.doi.org/10.1002/ev.223
Scott, K.W. (2004). Relating categories in grounded theory analysis: Using a conditional relationship guide and reflective coding matrix. The Qualitative Report, 9 (1): 113–126.
Scott, K.W. and Howell, D. (2008). Clarifying analysis and interpretation in grounded theory: Using a conditional relationship guide and reflective coding matrix. International Journal of Qualitative Methods, 7 (2): 1–15.
Simmons-Mackie, N., Threats, T. T. and Kagan, A. (2005). Outcome assessment in aphasia: A survey. Journal of Communication Disorders, 38 (1): 1–27. http://dx.doi.org/10.1016/j.jcomdis.2004.03.007
Vallino-Napoli, L. D. and Reilly, S. (2004). Evidence-based health care: A survey of speech pathology practice. Advances in Speech-Language Pathology, 6 (2): 107–112. http://dx.doi.org/10.1080/14417040410001708530
Verna, A., Davidson, B. and Rose, R. (2009). Speech-language pathology services for people with aphasia: A survey of current practice in Australia. International Journal of Speech-Language Pathology, 11 (3): 191–205. http://dx.doi.org/10.1080/17549500902726059
Zipoli, R. P. and Kennedy, M. (2005). Evidence-based practice among speech-language pathologists: Attitudes, utilization, and barriers. American Journal of Speech Language Pathology, 14 (3): 208–220. http://dx.doi.org/10.1044/1058-0360(2005/021)