Understanding practices of speech-language pathologists in aphasia rehabilitation: a grounded theory study
Bibliographic record
Abstract
Background: Social participation is the stated ideal end purpose of rehabilitation, however people with aphasia often have limited social participation following rehabilitation. Despite growing evidence regarding the importance of addressing social participation issues in aphasia rehabilitation, it is unknown how much these issues are considered by speech-language pathologists. More importantly, it is unclear what aphasia rehabilitation practice includes.Aim: The aim of this study was to understand speech-language pathology practice in aphasia rehabilitation by means of a theoretical model.Methods & Procedures: Grounded theory was used to structure this research study. Seventeen speech-language pathologists working in different settings of the care continuum of aphasia rehabilitation in Quebec (Canada) were recruited to participate in individual, semi-structured interviews. They were questioned about the ideal end purpose of aphasia rehabilitation and the clinical activities performed in practice. Recorded interviews were transcribed and analysed following an inductive, constructivist-based approach. Categories were identified and a theoretical model was developed.Outcomes & Results: The main characteristic of the participants’ practice was that it included underlying questions. These questions were either related to the purpose of aphasia rehabilitation or to the clinical activities performed to achieve that purpose. Four central clinical activities were described: counselling; assessing needs and abilities; setting therapy goals; and conducting therapy. Two clinical activities were not systematically performed; thus, they were considered peripheral within practice: including relatives in therapy and considering other parties. The focus of practice was either on language impairment or on social participation of the person with aphasia. Participants expressed different perceptions about the ideal end purpose of aphasia rehabilitation and considered their workplace environment as constraining or encouraging professional autonomy, which had an impact on the focus of practice. Underlying questions led participants to express a need for guidance to orient their practice.Conclusions: Results contribute to a better understanding of aphasia rehabilitation practice. When deeply motivated by helping the person resume significant life habits, speech-language pathologists’ practice was more likely to be focused on social participation, but questions regarding clinical activities persisted. A future knowledge transfer strategy could help guide and orient speech-language pathologists.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.039 | 0.026 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.003 |
| Science and technology studies | 0.010 | 0.016 |
| Scholarly communication | 0.009 | 0.007 |
| Open science | 0.003 | 0.006 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".