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Delivering for aphasia
Aphasia is the term for problems people have with communicating, usually as a result of a stroke. They may have trouble speaking, trouble understanding or trouble with both and it can range from mild to very severe. These problems can be very disabling, and effective treatment is needed to avoid the devastating effects aphasia can have on people’s lives.
The paper is mainly a tribute to the work of Professor Pam Enderby who has done many studies in this area over more than 30 years. She has looked at: how many people have aphasia; how much treatment they get; how much treatment they need; and how we could make better use of other resources to bridge the gap.
We found that average hours of treatment in the developed world ranges between 1 and 5 hours whereas recent research suggests that around 9 hours is the minimum needed to be effective. We also found that the proportion of time therapists spent treating aphasia was actually reducing as other demands on their time increased.
It is not all doom and gloom however. Whilst treatment by trained therapists is very expensive they could maximise their impact by using other means to deliver high volumes of treatment under their overall supervision. The most promising of these include using volunteers and also delivering treatment by computers or other electronic devices.
We concluded that there is a need to continually monitor the amount of treatment available compared with the latest evidence on the amount of treatment needed to be effective. We argue that this must lead to a rethinking of the role of therapists, and better use of resources such as volunteers and computer technology.