Katarina Haley, professor in the Division of Speech and Hearing Sciences, is conducting research to create treatment and diagnostic programs that improve communication outcomes for people with aphasia and apraxia of speech.
FOURC and ActionSC
Speech-language pathologists know they get better outcomes when clients are invested and able to participate actively in their own treatment. Part of this includes defining priorities and strategies clients should use when they practice and when they communicate in their daily lives. Speech-language pathologists’ plans to work collaboratively often on these priorities and strategies fall apart when clients do not know what to suggest. Haley explained that this happens most often because of the effects of aphasia or how to navigate therapy.
Ten years ago, Haley and her colleagues developed Life Interest and Values (LIV) Cards to help people with aphasia communicate about life activities they care about without needing their loved ones to speak for them. Her next therapy-planning project was to team up with clinicians and patients in outpatient rehabilitation settings to develop a method for demystifying holistic aphasia treatment and for putting the client in the drivers’ seat. The name of the method, FOURC (pronounced fork), is a word play: the model has four treatment prongs and four steps, each of which begins with the letter C. When using the FOURC model, speech-language pathologists guide their clients to suggest ideas and then help them modify those ideas into effective intervention strategies. The American Journal of Speech Language Pathology published a tutorial earlier this year that explains how to use the model in an outpatient setting. Haley explained that she is working on a FOURC adaptation to be used in inpatient rehabilitation.
ActionSC is the newest treatment method developed in the Center for Aphasia and Related Disorders (CARD) lab. This program has two steps: People with apraxia of speech learn to say words and phrases and then they learn to use them effectively in conversational exchanges. ActionSC was developed based on evidence-based principles of motivation. Using the ActionSC model, the role of the clinician is that of a knowledgeable coach and counselor; the role of the client is that of an active learner and self-advocate.
The Aphasia Goal Pool
Haley started the Aphasia Goal Pool as a community resource for speech-language pathologists who work with people with aphasia. She said the purpose is to help clinicians learn from each other about the many kinds of goals that are appropriate in different work settings. Any speech-language pathologist or speech-language pathology student can participate as long as they are working with aphasia. SLPs send in three goals used in practice, and in return, SLPs receive examples of 30-100 goals other SLPs have used. Often, there is a specific theme to the call and feedback. For example, a current themes is about goals that have to do with conversation. So far, hundreds of speech-language pathologists, and almost as many students, have contributed from all corners of the world. Haley said she is so grateful and hopes her colleagues will continue to participate and spread the word so they can make the feedback even more relevant to busy clinicians.
Diagnosing Acquired Apraxia of Speech
Haley continues her work on assessing and diagnosing adult onset apraxia of speech. She said she works closely on this project with Adam Jacks, her co-director at the Center for Aphasia and Related Disorders. In collaboration with doctoral students and other colleagues, the two have collected data from nearly 200 people with speech difficulties after stroke and have begun data collection for progressive disorders. With this large sample, Haley and Jacks are able to evaluate diagnostic criteria for apraxia of speech critically. They are working to develop objective and precise metrics that hopefully soon can replace subjective reference to mental check lists. Many of their recent research articles are about sound distortions and error consistency and their current focus in on the type of sound and prosody errors that are supposed to define the disorder.