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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