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JCPSLP
Volume 18, Number 1 2016
Journal of Clinical Practice in Speech-Language Pathology
For the individuals with aphasia, the amount of time speech
pathologists allocated to aphasia management overall was
greater than the time allocated to the management of
dysphagia. Interestingly, speech pathologists delivered
three times more aphasia assessment than therapy. When
other services (counselling, education to individual or family,
planning) in the management of participants with aphasia
is outlined in Figure 3. The figure presents combined
data regarding the management of aphasia, dysphagia,
dysarthria, dyspraxia, and voice disorders.
Discussion and conclusions
Within this study just over one-third of patients admitted
with stroke over a 5-week period were diagnosed with
post-stroke aphasia. This incidence is similar to results from
previous research (Ciccone et al., 2015; Dickey et al., 2010;
Lalor & Cranfield, 2004; Law et al., 2009). All participants
with aphasia were referred to speech pathology by the
treating medical team and individuals tolerated
commencing therapy as early as 3 days post-stroke. These
individuals received a total average of 44 minutes of
aphasia therapy per week which is less than the 2 hours of
therapy per week recommended in the National Stroke
Foundation (2010) clinical guidelines for stroke
management. It is noted the rate of referral to speech
pathology is greater than the referral rate found in Lalor and
Cranfield (2004), which was less than 25%. Additionally, the
minutes of aphasia therapy provided per week is greater
than reported previously in Godecke et al. (2011) who
found people with aphasia received an average of 14
minutes of therapy per week.
Table 2. Average number of sessions and time
spent in assessment and therapy
M (range)
Aphasia Dysphagia Other
No.participantsassessed
8
4
2
No.assessmentsessions
3.13
(1–9)
3.75
(2–5)
3
(3–5)
Length of assessment
sessions (mins)
34.9
(8–60)
13.2
(5–20)
11.7
(5–10)
No.participantsreceiving
therapy
4
2
2
No. therapy sessions
2.5 (1–5)
5 (3–7)
4 (1–7)
Length of therapy
sessions (mins)
29
(10–60)
11
(5–20)
14.8
(10–30)
Note: Other = dysarthria, apraxia, and voice.
Patientsidentifiedover5weeks
n = 233
Not a stroke
n = 202 (86.7%)
Confirmed stroke
n = 31 (13.3%)
Confirmed stroke
Unable to be assessed
n = 8 (25.8%)
Reason for no assessment:
• Dischargedpriortoreview4(50%)
• Diagnoseddegenerativeneurological
condition 3 (37.5%)
• Stroke due to cerebral
metastases 1 (12.5%)
Confirmed stroke
Screened
n = 23 (74.2%)
No aphasia as
determined by FAST or
clinical diagnosis
n = 14 (60.9%)
Confirmed aphasia as
determined by FAST
and clinical diagnosis
n = 9 (39.1%)
Referred to speech pathology
n = 9 (100%)
Not appropriate for therapy
n= 1 (11.1%)
Reason for no therapy:
• Reduced alertness
Appropriate for therapy
n = 8 (88.9%)
Received no aphasia therapy
n = 4 (50%)
Reason for no therapy:
• Reducedmood&reducedparticipation
in session n = 2 (50%)
• No reason given 2 (50%)
Received aphasia therapy
n = 4 (50%)
Figure 1. Identification and screening results for all hospital admissions with a possible diagnosis of stroke, and speech pathology
management for participants with a confirmed stroke.