30 / 156
132
JCPSLP
Volume 18, Number 3 2016
Journal of Clinical Practice in Speech-Language Pathology
participants and six family members the same set of 16
author-generated informal questions that focused on
obtaining each participant’s
general perceptions of the
impact of the group
, as well as their perceptions of any
social opportunities, self-confidence, communication
and/or
drawing skills
that they felt were related to their
art group participation. Because the PWCD had limited
expressive communication skills, most questions were
closed questions, asked orally via a multiple-choice format
with a large-font, written selection of simple, categorical
or descriptive ratings to simplify the communication task.
This informal, but systematic questioning also enabled the
authors to readily target and compare the respondents’
perceptions. In order to reflect on the effects of the Art
Group as a therapy process, some of the most frequent
and total group responses are reported here in a general
manner as our aim was to assess the effect of the group
from the PWCDs’ perspectives. They should be interpreted
as systematically acquired clinical information rather than
research data.
From the questioning, all PWCDs reported positive
feelings about attending the Art Group, and were
mostly keen to attend each week. Those with acquired
communication disorders liked that the Art Group gave
them a chance to meet and talk with other people. This
affirmed the clinicians’ aim for establishing the group as a
means for real-life socialisation.
The aspects of the group the participants spontaneously
reported they enjoyed most related both to communicating
and/or building their art skills. They typically liked to meet
with people with shared interests and said that it was good
to communicate in a cheerful environment. The clinicians
agreed with the PWCDs’ perceptions that Art Group
made the PWCDs feel happy. Similarly all appeared and
reported to be more confident when communicating. Family
members also observed that the PWCDs generally initiated
and engaged more in communication at home and with
others, and appeared less self-conscious and more joyful
as the group progressed. Several families also noted having
more calm communication interactions over time.
There was a general perception that learning new skills
to design and create art was most enjoyable. Participating
in independent activities and having communication with
others who listen have been associated with finding new
identity, self-esteem and living successfully after brain
injury (Brown, Worrall, Davidson, & Howe, 2012; Douglas,
2013). Clinicians and relatives typically observed that the
PWCDs had more self-confidence in general as the group
progressed and this was confirmed by the participants’
responses.
Our conclusion from the clinical appraisal of participants’
perceptions, which were affirmed by clinicians’ and families’
observations, is that participation in the Art Group provided
an opportunity for most of these PWCDs to interact socially
with others in natural and comfortable ways that appeared
to improve their self-esteem, general cheerfulness and
confidence. Learning new and creative skills and mixing
in a comfortable environment with peers appeared to give
participants an improved sense of personal well-being.
Our clinical observations and reports of the participants’
perceptions could reflect clinician bias or a desire of
the participants to please the first author. However, the
concurrence between the observations of clinicians,
relatives and participants suggests that the PWCDs’
perceptions of increased socialisation opportunities,
Development, these graduates have received continuing
professional development in their workplaces from visiting
lecturers and clinical mentors to develop their skills and
knowledge base, research capacity and culturally
appropriate resources in the Vietnamese language.
Vignette 2. Reflecting on the effects
of an art group for people with
brain dysfunction
Le Khanh Dien and Christine Sheard
People with communication disorders (PWCD) due to
stroke or other acquired or congenital brain dysfunction
often experience social exclusion (Dorze, Salois-Bellerose,
Alepins, Croteau, & Halle, 2014; Douglas, 2013). However,
by participating in groups run by speech-language
pathologists, PWCD can be assisted to engage with others
and increase their confidence (Ewing, 2007; Hawley &
Newman, 2010; Holland, 2007; van der Gaag et al., 2005).
Furthermore, making art also has been shown to help many
people with disability to express their ideas and emotions
via their participation in this meaningful life activity
(American Art Therapy Association, 2013; Kim, Kim, Lee, &
Chun, 2008; Parrish, 2014).
Combining the benefits of being in a group with other
PWCD, but with a focus on producing art, inspired the first
author during a visit to Sydney where he observed such
a group established for people with aphasia. He was so
impressed by the group’s apparent effects on participants’
attitudes and skills, he decided to establish one for a mixed
group of his current speech therapy clients in Vietnam.
With mentoring from the second author in Australia, he
developed an Art Group program to extend beyond the
existing impairment-focused speech therapy services at
An Binh Hospital in HCMC. The program’s aim was to offer
socially restricted PWCD with varying brain dysfunction an
opportunity to participate in a real-life social activity to learn
new artistic skills and have natural communication, rather
than remediation of their speech-language limitations. It
was hoped this might produce positive changes in some
factors (e.g., having good communication partners and
independence in some meaningful life activities) commonly
associated with quality of life (Douglas, 2013). This paper is
a reflection on some informal but carefully gathered clinical
data collected to assess the outcomes of the Art Group as
perceived by its participants.
The Art Group was established in December 2013 for
PWCD (including apraxia, aphasia, dysarthria, cognitive-
communication difficulties and intellectual disability) who
were also receiving concurrent speech therapy treatment.
The invited participants were all known to have much
restricted or virtually no meaningful social inclusion or
communication beyond daily routine interactions with family
or clinical appointments for their health needs. Art students
from Sai Gon University were recruited to facilitate 2 hour,
weekly art lessons and the program was overseen by
the hospital speech therapists. Activities included simple
colouring, painting and collage. Drawings or greeting cards
were usually produced, with a focus on accepting and
extending participants’ free expression. Communicating
about their art and having occasional parties for special
occasions were also integral to this program.
Typically, six to 11 PWCD supported by up to six art
students participated in the program. After 23 weeks
the first author asked the seven regular long-term
Christine Sheard
(top), Le Thi
Thanh Xuan
(centre) and Trà
Thanh Tâm