Interprofessional Collaboration and Aphasia Therapy
Interprofessional collaboration involves using the strengths of each profession to design a treatment approach that is effective and founded upon the best available research. It involves creating an environment that is based on shared values while fostering an inclusive team culture. While interprofessional collaboration has been associated with a number of benefits for clients and clinicians, it is often easier said than done. The relationship between Speech-Language Pathologists (SLPs) and Board Certified Behavior Analysts (BCBAs) has been particularly contentious. Generally speaking, there appears to be a fear of encroachment, stereotyping, and a lack of understanding about relative scopes of practice between the two professions.
The intensive aphasia programs that exist are facilitated by SLPs and supportive personnel and follow a linguistic interpretation of language and communication. Traditionally, a linguistic interpretation of aphasia describes the individual’s deficits as being in either oral or written language, and either in expression or understanding. For individuals with aphasia, it is often not the entire receptive or expressive repertoire that is impacted (e.g. can respond to an intraverbal question about an item but cannot tact the item). Therefore, using the expressive/receptive dichotomy to assess and treat aphasia symptoms does not account for all aspects of the person’s language profile. Given that aphasia is an idiosyncratic condition, using a behaviour analytic interpretation to define communication impairments provides a more accurate description of the person’s communication profile. Further, the use of stimulus control transfer procedures, systematic teaching, and ongoing data analysis are critical components of any intensive therapy program.
Evergreen Communication Therapy was established in 2021 by Brittany and Shawna to focus on interdisciplinary treatment of complex communication disorders. The intensive aphasia program at Evergreen is a 12-week program, consisting of 12 hours per week. During the first week of the program, the SLP conducts and interprets standardized assessments to determine baseline scores and abilities, the Behaviour Analyst interprets the assessments and further assesses skills across verbal operants, and together they develop an individualized curriculum targeting functional goals. The following weeks are primarily administered by supportive personnel (e.g. Communicative Disorder Assistants and Behaviour Technicians), with the SLP and BCBA both providing 1-hour of direct therapy per week, supervision, and team meetings.
Interprofessional collaboration can improve client outcomes and advance our understanding of complex disorders. At Evergreen, we see the value of interdisciplinary practice every day in the outcomes from our clients. We continue to learn and grow together, and are all better clinicians because of it!
