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Aphasia United Best Practice Recommendations for Aphasia

18 Nov 2014 2:00 PM | Ann Ninness (Administrator)

Dear Indiana Colleagues:

We would like your help in improving services for people with aphasia!  Please take a few minutes of your time to let us know if you agree with our Best Practices Recommendations for aphasia.

Here is a little background on the project: Aphasia United is an international organization designed to unite the global aphasia community including people affected by aphasia, researchers, clinicians and policy makers for the advancement of aphasia science and services. Our goal is to further a shared vision and advocate for aphasia internationally.

One aim of Aphasia United has been to create a set of international Best Practices Recommendations for aphasia to help advocate for appropriate aphasia services. To that end, the Aphasia United Best Practices Working Group has crafted a list of 10 aphasia ‘best practice recommendations’ (BPRs). These BPRs were synthesized from a variety of published recommendations and guidelines from around the world .  Our Aphasia United BPRs represent many cycles of editing and revising by our working group. Please note that we have attempted to retain wording or meanings that are not too far from the original sources in order to reasonably represent the evidence base, while at the same time create a relatively short list of internationally relevant recommendations.  At the end of this email is a “preamble” that will be published with the BPRs to create a context along with the sources cited in each recommendation statement. The current version of the BPRs has been accepted by the Aphasia United Advisory Group


We are now beginning a process to obtain wider international consensus on the BPRs. We are inviting people associated with various professional organizations or databases that relate to aphasia or speech-language pathology to complete a short survey. We would very much  appreciate your feedback.  Below is a link to a SurveyMonkey site that will allow you to give your input on the Aphasia United Best Practices Recommendations.

Please take a few minutes to complete the survey (only 10 questions) by rating your level of support for each recommendation. Our hope is to gain agreement on aphasia best practices from interested parties around the world. Please help us with this important consensus process.

Best wishes,

Laura Murray

Professor, Indiana University

On behalf of:

Aphasia United Best Practices Working Group: Nina Simmons-Mackie, Pam Enderby, Tami Howe, Anu Klippi, Julie Morris, Laura Murray, Ilias Papathanasiou, Stacie Raymer, Miranda Rose & Gloriajean Wallace

For background details on this project please go to the Aphasia United Summit 2014 Best Practices powerpoint presentation link at (please note that the BPRs on the ppt do not reflect the most recent, updated version that you will see in the survey). 



Aphasia United Best Practice Recommendations for Aphasia



Aphasia is an acquired communication disability resulting from damage to the language areas of the brain, most often due to stroke, although other etiologies such as brain trauma or tumor can also cause aphasia. Aphasia is characterized by impairments in language modalities including speaking, understanding, reading and writing. Because of the pervasive importance of communication in daily life, aphasia typically has a negative impact on social relationships, participation and wellbeing. People with aphasia have preserved pre-onset intelligence, but intelligence can be masked by difficulty communicating. It should never be assumed that a person with aphasia is mentally incompetent. People with aphasia are typically able to make decisions and participate in activities if information or activities are made communicatively accessible.


People with aphasia have the right to be treated with dignity and respect and to participate in the same level of health care as people without aphasia (including  participating in personally relevant decision making). People with aphasia and their family members have the right to relevant services designed for the individual to enhance communication and participation in life activities of choice. Health care services for people with aphasia should be person-centered and collaborative.


 “Best practice recommendations” for health care or community services involving people with aphasia are provided below. These have been compiled from a variety of sources around the world. Sources are cited along with the level of recommendations/evidence cited in the source.  Sources have not been directly quoted; rather, themes across cited sources have been worded to be representative. For more details on the levels of evidence please refer to the original source documents. It should be noted that most recommendations have been drawn from general stroke guidelines, rather than other etiologies or aphasia specific guidelines.


Sources for Aphasia United Best Practice Recommendations for Aphasia


  • 1.      National Health and Medical Research Council Clinical Centre for Research Excellence in Aphasia Rehabilitation (CCRE) (2014). Australian Aphasia Rehabilitation Pathway.

  • 2.      Intercollegiate Stroke Working Party. National clinical guideline for stroke, 4th edition. London: Royal College of Physicians, 2012.

  • 3.      Lindsay MP, Gubitz G, Bayley M, Hill MD, Davies-Schinkel C, Singh S, and Phillips S. Canadian Best Practice Recommendations for Stroke Care (Update 2012). On behalf of the Canadian Stroke Strategy Best Practices and Standards Writing Group. Ottawa, Ontario Canada: Canadian Stroke Network

  • 4.      Miller, E., Murray, L., Richards, L., Zorowitz, R., Bakas, T., Clark, P. Billinger, S. (2010). Comprehensive Overview of Nursing and Interdisciplinary Rehabilitation Care of the Stroke Patient: A Scientific Statement from the American Heart Association. Stroke. 2010;41:2402-2448. Downloaded from

  • 5.      National Stroke Foundation Australia (2010) Clinical guidelines for stroke prevention and management. Melbourne Australia.

  • 6.      Royal College of Speech & Language Therapists (2005).RCSLT Clinical Guidelines

  • 7.      Scottish Intercollegiate Guidelines Network (2010) Management of patients with stroke: Rehabilitation, prevention and management of complications, and discharge planning A national clinical guideline. Edinburgh, Scotland.

  • 8.      Stroke Foundation of New Zealand and New Zealand Guidelines Group. Clinical Guidelines for Stroke Management 2010. Wellington: Stroke Foundation of New Zealand; 2010.

  • 9.      US Veteran’s Administration / Department of Defense (2010). Management of Stroke: VA/DoD Clinical Practice Guideline.

Levels of Recommendation / Evidence


Level A:          Body of research evidence can be trusted to guide practice

Level B:          Body of research evidence can be trusted to guide practice in most situations

Level C:          Body of research evidence provides some support for recommendation

Level D:          Body of research evidence is weak

Good Practice Point:  Recommendation is based on expert opinion or consensus



To support and empower members to provide the highest quality, life changing communication, swallowing and hearing services to the people of the State of Indiana.

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