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Wednesday, March 7, 2007

Newsletter Vol.6 Jan/Feb 2007

aphasiatoolbox.com
Newsletter Vol.6 Jan/Feb 2007
Tip of the Month
An attitude of self-reliance is critical to overcoming aphasia and reaching a New Normal Level of Communication.  While it is certainly important to work with your medical professionals, be they physicians, speech/language pathologists, or physical therapists, self-reliance plays a critical role in improving the communication skills of a person with aphasia. 

It is up to the aphasia patient and their caregiver to summon within themselves the self-reliance to continually search for innovative, effective treatment methods and try them.  Translating an attitude of self-reliance into a self-help action plan requires investigation and experimentation.  Sometimes new methods will fit neatly into an existing treatment framework but often the new methods require a shift in perspective and plan of treatment.  Sometimes new methods need to be brought to the attention of and discussed with medical professionals that the aphasia patient and caregiver trust.  If significant progress is to be made toward assisting the aphasia patient reach his/her New Normal Level of Communication, it is ultimately up to both the aphasia patient and his/her caregiver to look within themselves and take charge of the process and outcome.  Supplying the ideas, materials and tools is what aphasiatoolbox.com is all about.
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Support Group of the Month 
Our Support Group of the Month for this newsletter is the Chippewa Valley Aphasia Group(s) in the Eau Claire, WI area.  This Support Group has been assisting support group members since 1997.  They meet every Friday from 1:30pm – 3:30pm at Bethesda Lutheran Church in Eau Claire and Bloomer Medical Center in Bloomer, WI.

While Speech Pathologists are involved in setting meeting agenda and assisting support group members with meeting activities, both support group members and their caregivers are actively involved in both planning and taking part in meeting activities.  The idea of self-help is fostered within this setting with the goal of assisting support group members in returning to prior activities, new activities, and promoting a sense of group ownership and community.  Typically, these weekly meetings begin with 15 – 20 minutes of socialization before the opening large group meeting.  After the opening meeting, the group separates into smaller groups to engage in the activities they have chosen which can include theatre, scripting, role playing, music, or anything at all.  The group members finish each meeting with a closing large group meeting in which activities are discussed and presented.  This group also actively promotes the sharing of information and new ideas relative to aphasia therapeutic techniques.  Support Group members and their caregivers are exposed to multi-modal strategies and often develop life history books and other support mechanisms.  Clearly, the emphasis within this group is on therapists, support group members, and caregivers helping each other.
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The Aphasia Center of Innovative Treatment Scholarship Recipient
The Board of Directors of The Aphasia Center of Innovative Treatment is pleased to announce the winner of its Young Person with Aphasia Scholarship award for 2007.  She is Shiloh Hendricks of Columbus, GA.   Shiloh attended 3 days of intensive aphasia therapy in Pittsburgh provided by Bill Connors and Heather Mackey, a graduate student in Speech/Language Pathology at the University of Pittsburgh.  Shiloh also attended the monthly meeting of the Aphasia Support Group of Western PA and several small, self-help group sessions with other patients.  She will receive an additional three days in an environment of intensive aphasia therapy as well as ongoing assistance.  Shiloh’s thoughts about her experience will be available at http://www.aphasiatoolbox.com/. 
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Description of Simply Smart Aphasia Therapy (SSAT)
As we produce Volume VI of our ACIT Newsletter and move ever closer to launching our self-help website, aphasiatoolbox.com, it should be apparent that at the Aphasia Center of Innovative Treatment we are committed to helping aphasia patients and their caregivers help themselves.  There is a reason for our self-help approach.

We have proven over the course of years of treatment, and demonstrate with some of Bill Connors’ therapy session videos on our website, that the answer to each aphasia patient’s achievement of their New Normal Level of Communication ultimately lies within the patient and their caregiver.  Both the person dealing with aphasia and the person closest to them who is serving as their caregiver many times know better than the medical professionals to whom they turn for assistance the source of the aphasia.  The thoughtful medical professional listens carefully to each patient and caregiver before embarking on a plan of treatment.  It is a grave mistake to use a “one size fits all” approach.   Unfortunately, we have heard many stories of medical professionals either trying to shoehorn an aphasia patient into a plan of treatment that clearly does not work or, perhaps worse, giving up on the aphasia patient.  That is why we continually stress that aphasia affects each patient differently and that each patient’s aphasia disorder is at some level unique to them.

To this end, Bill Connors has developed protocols and materials that give aphasia patients and their caregivers the self-help tools for great flexibility and expansion of the plan of treatment.  This is why each protocol can be Vertically Tweaked and Horizontally Stepped to be expanded into multiple protocols that more readily move in the direction in which the aphasia patient’s progress travels.  This is why each set of materials can be expanded to take advantage of the protocol’s Vertical Tweaking and Horizontal Stepping.  We know from experience that for an aphasia patient to successfully reach their New Normal Level of Communication, each patient and their caregiver must at some point look to themselves and take responsibility for their success.  This leads to a wonderful feedback loop between the patient, their caregiver, and any medical professionals involved if all cooperate.  When the patient and their caregiver take charge and have access to effective tools. great things can happen.
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Free SSAT Treatment Protocol Sample (will be available at aphasiatoolbox.com)
This protocol description is part of the Simply Smart Aphasia Therapy program.
To learn how to make optimal use of any protocol, visit aphasiatoolbox.com 

Protocol:  Number Concept Coaching.    Many of our patients complain of difficulty saying the names of numbers.  Therefore, we felt compelled to create a treatment activity that combined all three elements of the 3 Cs of an effective aphasia drill with work on this problem (see Newsletter #1 for detailed description of the 3Cs).  This protocol demonstrates how a patient and his/her caregiver can incorporate self-help action successfully into the efforts to improve word recall and naming.  Numbers play a vital role in everyday communication be it routine conversation ( “I have three children.”, “I want six donuts, please.”) or during work activities, (“We need seven new employees.”; “The interest rate is 14%.”).  One patient I saw recently used a not-so-normal counting in sequence strategy to say numbers.  For example, when asked what time it was she would say, “one, two, three, four….four o’clock.”  This patient mistakenly thought she needed to use this strategy in order to say numbers but in realty she did not.  She was able to begin saying numbers correctly within three days using this Number Concept Coaching practice and several other practice techniques/protocols.  She was able to say number names by helping herself to trust her word recall, practice concept-number relationships, and work from her memory rather than using external or outdated cues.   This protocol shares an important feature with other aphasiatoolbox.com protocols; it springs from a smart, therapy rationale but is simple enough to be performed by anyone in his/her self-help program.

Behavioral Objective:
The patient will self-generate verbally out loud (say), from his/her verbal working memory, the names of numbers, from 1-20 that represent a concept that had been said aloud by the caregiver/therapy assistant/speech therapist.  An alternative for focusing on self-help by the patient is to have the patient say these number names aloud when reading the concept words from the Practice Materials.   [This is also an excellent exercise for English as a Second Language clients and as a complementary drill for patients with acalulia-see http://nanonline.org/nandistance/mtbi/ClinNeuro/acalculia.html]. This protocol uses the Number Concept Coaching Practice Materials and the Number Concept Coaching Demonstration Videos on http://www.aphasiatoolbox.com/ .  

Targeted Mental Processes:  Lexeme activation for numbers and numerical concepts; lexical to semantic area interaction (feed forward – feed backward); task focus to task shift; verbal working memory; turn taking; truly listening; and, sustained attention.

Easy Step-By-Step Directions: (in parenthesis is what the patient actually says out loud):

1.   The caregiver/therapy assistant/speech therapist says to the patient, “I want you to think of the number that represents a concept.  For example, if I say “twins” you would say “two”, if I say “quarter” you would say, “four.”  Now, first think of and then tell me the number for ‘triplets.” (the patient says “three”).

2.   The patient if able to [or the caregiver/therapy assistant/speech therapist if the patient cannot write] writes the word on the Number Concept Coaching Practice Sheet to anchor it.  (T H R E E).

3.   The caregiver/therapy assistant/speech therapist says to the patient , “Now create and say aloud a sentence using the word ‘triplets’ (“I saw triplets yesterday”).

4.   Continue with 1-3 above with additional concepts (dozen; octagon, etc.) Additional concepts will be available on www.aphasiatoolbox.com.

TO simplify beginning efforts, steps 2, 3 may be postponed until the patient is more fluent in completing the word-only portions of the task.

Horizontal Tweaking:  Impose delay in patient response that gradually increases;  additional concept words will be available at www.aphasiatoolbox.com

Vertical Stepping:  Gradually use higher numbers; additional concept words will be available at http://www.aphasiatoolbox.com/

Other tips and suggestions for innovative and helpful use of this protocol will be available at http://www.aphasiatoolbox.com/ .

   Copyright © 2005-2007 William A. Connors, M.A., CCC. 
All rights reserved.
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Quote of the Month
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“Our remedies oft in ourselves do lie.”  William Shakespeare The Bard was one of the most compelling thinkers and playwrites of his time, and for all time.  The themes of his drama and comedies were universal and dealt with the human condition.  This quotes speaks to the importance of self-reliance and emphasizes that self-examination followed by action will help us to resolve many of our own problems.

Will you dare to look inside yourself and then act in order to become an aphasia plateau buster?



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aphasiatoolbox.com update
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At the Aphasia Center of Innovative Treatment, we continue to make progress in the design and development of our website, aphasiatoolbox.com.  We are at the stage where we are actively loading protocols, materials, and videos.  We are also finalizing the administrative backend of our website so that, hopefully, all on-line and behind-the-scenes procedures will work flawlessly.  Stay tuned.


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Bill Connor’s Scheduled Public Events
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Thursday and Friday, 3/15 and 3/16/07:  Scheduled patient therapy appointments in Philadelphia, PA.  Bill will be available by appointment to meet with area Support Groups or to discuss how to start a Self-Help Group.

Tuesday, 3/20/07:  Scheduled patient therapy appointments in Erie, PA.  Bill will be available by appointment to meet with area Support Groups or to discuss how to start a Self-Help Group.

Thursday, 4/5/07: 1:00-3:00 p.m. 
Panera Bread, McKnight Road across from Ross Park Mall, Pittsburgh PA.  The monthly meeting of the Aphasia Support Group of Western PA will be held with a focus on how to accomplish effective self-help strategies; planning for the next Pittsburgh Aphasia Information Technology Club meeting; and sharing ideas for continued physical strength and coordination improvement.  Email information@
aphasiatoolbox.com
to confirm attendance. 

August 17 and 18, 2007:  Bill will present at The Stroke Survivors Association of Ottawa’s second Stroke Recovery Conference at the Hampton Inn and Conference Center in Ottawa (www.strokeconference.ca).  The conference highlights best practice and management of stroke in the community by featuring talks by leading researchers and therapists as part of the ongoing effort to empower people with stroke and their families to manage better.


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We Want To Hear From You
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To nominate a support group for our “Support Group of the Month,” simply send us the name of the group, some background information, and contact information to:information@aphasiatoolbox.com.


We select a Patient of the Month from among the members of our Support Group of the Month.  To nominate a Patient of the Month, simply send the information to:
information@aphasiatoolbox.com.


If you know of someone who would like to receive our newsletter, you or they can subscribe by visiting http://www.aphasiatoolbox.com.

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© 2007 Aphasia Center of Innovative Treatment
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