For Aphasia Clients, a Marked Improvement
The six-week program with SLP and OT students shows promise of longer-term improvement.
By John Shaw
It was only six weeks, but for Jane Meehan Lanzillo, it proved the most motivating, empowering and impactful stretch of care her husband Dana had received since having a stroke 16 months earlier.
Dana Lanzillo had just completed Spaulding-IHP’s Intensive Comprehensive Aphasia Program. Known as S-IHP’s CAP, the interprofessional therapy initiative matches clients who have aphasia with MGH Institute speech-language pathology and occupational therapy students, IHP faculty, and clinicians from Spaulding Rehabilitation Hospital, for intensive daily sessions focused on life participation activities.
“It was amazing to see Dana’s progress,” says Lanzillo. Her husband is one of two million Americans living with the language impairment called aphasia, a condition most often caused by a stroke or traumatic brain injury that prevents a person from communicating clearly and is often accompanied by physical disabilities that limit mobility and function. “The students were truly invested in him improving, and by the last day you could really feel the connection between the clients and the students.”
During the program’s first few days, teams with SLP and OT students assess clients and jointly write an individualized treatment plan, taking a holistic approach to therapy that focuses on clients’ communication and life participation goals. Students identify each client’s top five desired life activities to establish goals to target during the program’s remaining five weeks. Clients spend mornings on the Institute campus doing speech and occupational therapies, followed by afternoons at Spaulding for a social lunch, adaptive sports, group swims, music therapy, and mindfulness exercises.
While the program provides students with a practical appreciation for the interplay between communication disorders and the activities of daily living, faculty and practicing clinicians from the IHP and Spaulding have begun presenting preliminary research results in their respective fields. Intensive comprehensive aphasia programs such as S-IHP’s CAP have emerged as an alternative to the traditional twice-weekly one-hour outpatient sessions that occur until a person’s insurance runs out, typically after just a few months. Programs such as this show promise for longer-term improvement of participants’ language impairment and community participation.
The IHP - Spaulding initiative is beginning to make its mark. After completing its third year, it received an Honorable Mention for Public Health Infrastructure in the 2018 Excellence in Interprofessional Education Collaboration Award competition from the U.S. Public Health Service and the Interprofessional Education Collaborative. The two agencies annually recognize interdisciplinary work, including research, community practice, and/or public health education, that significantly impacts clients and communities. MGH Institute team leaders are Marjorie Nicholas, chair of the Department of Communication Sciences and Disorders; Rachel Pittmann, coordinator of the Aphasia Center; and Mary Hildebrand, associate professor of occupational therapy.
If the clinicians have any doubt about the impact of their efforts, they only have to listen to clients’ loved ones like Jane Lanzillo to be energized.
“It was so encouraging to see the changes in the way Dana communicated with me, our children and our friends,” she says, noting that prior to starting the program Dana had worked with a private-pay therapist several times a week. “The group setting made all the difference. The participants motivated each other and the students were a talented, driving force. I truly believe people with aphasia can continue to improve for years if they receive this type of treatment.”