Date of Award

2012

Document Type

Thesis

Publisher

Edith Cowan University

Degree Name

Bachelor of Speech Pathology (Honours)

School

School of Psychology and Social Science

Faculty

Faculty of Computing, Health and Science

First Supervisor

Dr Erin Godecke

Second Supervisor

Dr Natalie Ciccone

Abstract

Background: Current research highlights the significance of providing early and intensive aphasia therapy to maximise neural plasticity and enhance communication gains. Acute speech pathology service delivery in Australia does not consistently meet best practice standards recommended by the National Stroke Foundation. Aims: This study aimed to: i) investigate the incidence of post-stroke aphasia in the acute setting; ii) determine the referral rate to speech pathology for patients with aphasia; iii) investigate the amount of language therapy provided to people with aphasia and iv) explore the relative proportion of aphasia service delivery within the overall caseload management of speech pathologists. Method & Procedure: People admitted to an acute-care Australian hospital with confirmed stroke were screened for aphasia using the Frenchay Aphasia Screening Test (FAST) (Enderby et al., 1987) and a clinical diagnosis. Speech pathology management was recorded for all occasions of service, together with the time spent in assessment, treatment and overall management for all people with a confirmed stroke for the duration of their inpatient stay. Results: Thirty-one people were admitted with a confirmed stroke, 23 were screened for aphasia and nine patients were diagnosed with aphasia. Of the nine people with aphasia, eight of these were deemed to be candidates for therapy and received aphasia assessment and four went on to receive aphasia therapy. Seven participants without aphasia were referred to speech pathology and received a dysphagia assessment. Four of these people subsequently received dysphagia treatment. Across all the time managing people with stroke, equal proportions of speech pathology time was spent in aphasia and dysphagia management. Conclusion: Speech pathology management in the acute hospital setting is not yet being delivered according to best clinical practice standards. Although speech pathologists are spending an equal amount of time providing dysphagia and aphasia services, a greater amount of time is spent providing dysphagia treatment. Further research is needed to examine why the prescribed intensity of aphasia therapy is not being delivered in the early phase of recovery.

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