Abstract
Purpose The purpose of this article is to describe aphasia-friendly modification for occupational therapy assessments and home programs aimed at addressing upper extremity impairments for people post stroke. Method This article examines a case study example from a larger study (Wallace, Donoso Brown, Saylor, & Lapp, 2018 ) that implemented aphasia-friendly material modifications into an occupational therapy home program. The participant was a 74-year-old man who survived a left hemisphere cerebrovascular attack 6 years prior to the study. The participant experienced upper extremity hemiparesis and aphasia post stroke and was appropriate for an occupational therapy home exercise program with aphasia-friendly modifications to facilitate comprehension of the home program. Aphasia-friendly modifications (e.g., gestures and visual aids) were made to assessments to support comprehension and participation. To support reading comprehension deficits during completion of the home program, the program materials had aphasia-friendly modifications, such as modified text, supportive images, and reduced cognitive load of exercises. Finally, research team members used supported conversational techniques during all study procedures. Results At the end of the home program, an interview with the participant revealed several outcomes regarding the home program and the aphasia-friendly modifications. The participant reported pictures and reduced text to be beneficial in understanding the instructions. He also indicated that he enjoyed completing the exercises independently (i.e., outside of a therapy office). The participant's motor function demonstrated changes in a positive direction, although not greater than the minimally detectable change for performance-based measures. Conclusions Aphasia-friendly modifications (e.g., modifying text, adding supportive images, and using gestures) were found to be supportive of participation in assessments for and creation of an upper extremity home program. Speech-language pathologists can support the participation of people with aphasia through interprofessional collaboration and consideration of environmental adaptations.
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