Interactions between the environment, physical demands, and social engagement at an Aphasia Camp

Authors

  • Jerry K. Hoepner University of Wisconsin – Eau Claire
  • Heather Buhr ChildServe, Des Moines
  • Marquell Johnson University of Wisconsin – Eau Claire
  • Thomas Sather University of Wisconsin – Eau Claire
  • Mary Beth Clark Mayo Clinic Health Systems, Eau Claire

DOI:

https://doi.org/10.1558/jircd.34497

Keywords:

aphasia camp, environment, social engagement, physical factors, ICF

Abstract

Individuals with aphasia experience impairments in communication that can be exacerbated by environmental and task demands. This investigation examined the interaction between physical-demands, social-engagement, and environment. An interdisciplinary team, including speech language pathologists and a kinesiologist measured the activities of individuals with aphasia at the Chippewa Valley Aphasia Camp. Accelerometers were used to measure degree of physical exertion as an indication of physical demands. The Clinical Discourse Assessment (Damico, 1991), Measure of Participation in Conversation and Measure of Skill in Supported Conversation (Kagan et al., 2004), qualitative analyses, and investigator field notes served as indicators of social engagement. The International Classification of Disease Functioning (ICF) was used to code environmental factors, which either served as a facilitator or barrier to participation. Qualitative analyses indicate that the presence of physical environmental barriers and more strenuous physical exertion sometimes serve to decrease social engagement and exchange. However, partners who served as facilitators enabled participants to overcome high environmental and/or physical task demands to support successful social engagement and exchange. These analyses suggest that participants with aphasia can overcome physical environmental barriers and/or high physical task demands, given effective partner supports. This investigation contributes to a small body of research regarding the interaction between environmental demands and social communication among individuals with aphasia. Further, the investigation contributes empirical information about the environment and social communication context of a rustic Aphasia Camp.

Author Biographies

  • Jerry K. Hoepner, University of Wisconsin – Eau Claire

    Dr. Jerry Hoepner is an associate professor in the department of Communication Sciences and Disorders at the University of Wisconsin - Eau Claire. He teaches undergraduate foundational coursework, including anatomy and physiology, neuroanatomy and physiology, and undergraduate research. His graduate courses include aphasia and related disorders, acquired cognitive disorders, dysphagia, and counseling. He continues to work clinically with persons with acquired neurological disorders. He is a co-facilitator of the Chippewa Valley Aphasia Camp (staff since its inception in 2004), Chippewa Valley Aphasia Group (staff since its inception in 1998) and founder of the Blugold Brain Injury Group. His research addresses student learning outcomes, as well as outcomes at aphasia camp, video self-modeling, partner training, and related topics. He is a founding editor of the Teaching and Learning in Communication Sciences and Disorders journal.

  • Heather Buhr, ChildServe, Des Moines

    Heather Buhr is a speech language pathologist at a pediatric rehabilitation facility in Des Moines, IA. She received her BS from the University of Wisconsin - Eau Claire and MS from the University of Nebraska - Lincoln. Since graduation, she has worked in outpatient and inpatient settings, serving both pediatric and geriatric populations. Starting from research while in school, Ms. Buhr continues to be interested in the relationship between neurocognitive disorders and communication. Her research has examined the development and implementation of social networking applications with individuals with aphasia.

  • Marquell Johnson, University of Wisconsin – Eau Claire

    Dr. Marquell Johnson is an associate professor in the Department of Kinesiology at the University of Wisconsin - Eau Claire. He is also the director of the Physical activity and Recreation for Individuals with Disabilities in Eau Claire area (P.R.I.D.E.) and P.R.I.D.E.4Adults programs. He is a National Strength and Conditioning Association Certified Strength and Conditioning Coach and an American College of Sports Medicine/National Center on Health, Physical Activity and Disability Certified Inclusive Fitness Trainer. His research interests include physical activity and health behaviors of individuals with disabilities across the lifespan; Health promotion for individuals with disabilities across the lifespan.

  • Thomas Sather, University of Wisconsin – Eau Claire

    Dr. Tom Sather is an assistant professor in the Communication Sciences and Disorders department at the University of Wisconsin - Eau Claire, and a speechlanguage pathologist on staff at Mayo Clinic Health System - Eau Claire. He teaches and works clinically in the areas of adult neurogenics, acute care speechlanguage pathology service delivery, aphasia, motor speech and dysphagia. He received his PhD at Western Michigan University in the Interdisciplinary Health Sciences program, and studied flow experiences among individuals with aphasia for his dissertation. He is currently serving as chair of the Wisconsin Hearing and Speech Board. Tom has been a staff member of the Chippewa Valley Aphasia Group since 1998, and currently serves on their board of directors. He has been a staff member of the Chippewa Valley Aphasia Camp since its inception in 2004. Tom also serves on the Aphasia Access board of directors.

  • Mary Beth Clark, Mayo Clinic Health Systems, Eau Claire

    Mary Beth Clark is a speech-language pathologist at Mayo Clinic Health Systems Eau Claire in the Neurosciences unit, where she is the Clinical Manager of Rehabilitation Services. She is a co-founder of the Chippewa Valley Aphasia Group and the Chippewa Valley Aphasia Camp. Further, she is the camp director and creator. She works clinically in the areas of adult neurogenics and acute care speech-language pathology. Her research has examined outcomes of individuals with aphasia at the Chippewa Valley Aphasia Group and the Chippewa Valley Aphasia Camp, along with measuring student and volunteer outcomes in those contexts.

References

American Speech-Language-Hearing Association. (2013). National Outcomes Measurement System (NOMS): Adult speech-language pathology user’s guide. Rockville, MD: ASHA. https://doi.org/10.1044/gero16.2.32

Brush, J., Sanford, J., Fleder, H., Bruce, C., and Calkins, M. (2011). Evaluating and modifying the communication environment for people with Dementia. Perspectives on Gerontology 16 (2), 32–40. https://doi.org/10.1177/000841740907600204

Carin-Levy, G., Kendall, M., Young, A., and Mead, G. (2009). The psychosocial effects of exercises and relaxation classes for persons surviving a stroke. Canadian Journal of Occupational Therapy 76 (2). 73–80. https://doi.org/10.1177/000841740907600204

Chapey, R., Duchan, J. F., Elman, R. J., Garcia, L. J., Kagan, A., Lyons, J., and Simmons-Mackie, N. (2001). Life participation approach to aphasia. In R. Chapey (Ed.), Language Intervention Strategies in Aphasia and Related Neurogenic Communication Disorders (4th ed.), 235–245. Baltimore: Lippincott, Williams & Wilkins.

Clark, M. B., Hintgen, T. L., Sather, T., and Hoepner, J. K. (2009). Environmental strategies that improve social participation at aphasia camp. Unpublished manuscript, Department of Communication Sciences and Disorders, University of Wisconsin – Eau Claire, Eau Claire, WI.

Cruice, M., Worrall, L., and Hickson, L. (2006). Quantifying aphasic people’s social lives in the context of non-aphasic peers. Aphasiology 20 (12), 1210–1225. https://doi.org/10.1080/02687030600790136

Damico, J. (1991). Clinical discourse analysis: A functional approach to language assessment. In C. Simon (Ed.), Communication Skills and Classroom Success: Assessment and Therapy Methodologies for Language and Learning Disabled Students, 125–148. Eau Claire: Thinking Publications.

Damush, T. M., Plue, L., Bakas, T., Schmid, A., and Williams, L. S. (2007). Barriers and facilitators to exercise among stroke survivors. Rehabilitation Nursing 32 (6), 253–262. https://doi.org/10.1002/j.2048-7940.2007.tb00183.x

Esliger, D. W., Probert, A., Connor, G. S., Bryan, S., Laviolette, M., and Tremblay, M. S. (2007). Validity of the Actical accelerometer step-count function. Medicine and Science in Sports and Exercise 39 (7), 1200–1204. https://doi.org/10.1249/mss.0b013e3804ec4e9

Fong, T. G., Gleason, L. J., Wong, B., Habtemariam, D., Jones, R. N., Schmitt, E. M., de Rooij, S. E., Saczynski, J. S., Gross, A. L., Bean, J. F., and Brown, C. J. (2015). Cognitive and physical demands of activities of daily living in older adults: Validation of expert panel ratings. PM&R 7 (7), 727–735. https://doi.org/10.1016/j.pmrj.2015.01.018

Fox, L. E., Poulsen, S. B., Bawden, K. C., and Packard, D. (2004). Critical elements and outcomes of a residential family-based intervention for aphasia caregivers. Aphasiology 18 (12), 1177–1199. https://doi.org/10.1080/02687030444000525

Gesler, W. M. (1992). Therapeutic landscapes: Medical issues in light of the new cultural geography. Social Science & Medicine 34 (7), 735–746. https://doi.org/10.1016/0277-9536(92)90360-3

Goodwin, D. L., and Staples, K. (2005). The meaning of summer camp experiences to youths with disabilities. Adapted Physical Activity Quarterly 22 (2), 160–178. https://doi.org/10.1123/apaq.22.2.160

Heil, D. P. (2006). Predicting activity energy expenditure using the Actical® activity monitor. Research Quarterly for Exercise and Sport, 77 (1), 64–80. https://doi.org/10.1080/02701367.2006.10599333

Hoepner, J. K., Clark, M. B., Sather, T. S., and Knutson, M. (2012). Immersion learning at Aphasia Camp. EBE Briefs: Evidence-Based Education, September, 1–10.

Howe, T. J., Worrall, L. E., and Hickson, L. M. H. (2008). Observing people with aphasia: Environmental factors that influence their community participation. Aphasiology 22 (6), 618–643. https://doi.org/10.1080/02687038.2013.869305

Howe, T. J., Worrall, L. E., and Hickson, L. M. H. (2007). Interviews with people with aphasia: Environmental factors that influence their community participation. Aphasiology 22 (10), 1–29. https://doi.org/10.1080/02687030701640941

Kagan, A. (1998). Supported conversation for adults with aphasia: Methods and resources for training conversation partners. Aphasiology 12 (9), 813–830. https://doi.org/10.1080/02687039808249575

Kagan, A., and Kimelman, M. (1995). Informed consent in aphasia research: Myth or reality. Clinical Aphasiology 23, 65–75.

Kagan, A., Simmons-Mackie, N., Victor, J. C., Carling-Rowland, A., Hoch, J., Huijbregts, M., et al. (2011). Assessment for Living with Aphasia. (ALA). Toronto, ON: Aphasia Institute.

Kagan, A., Winckel, J., Black, S., Felson Duchan, J., Simmons-Mackie, N., and Square, P. (2004). A set of observational measures for rating support and participation in conversation between adults with aphasia and their conversation partners. Topics in Stroke Rehabilitation 11 (1), 67–83. https://doi.org/10.1310/CL3V-A94A-DE5C-CVBE

Kim, E. S., Ruelling, A., Garcia, J. R., and Kajner, R. (2017). A pilot study examining the impact of aphasia camp participation on quality of life for people with aphasia. Topics in Stroke Rehabilitation 24 (2), 107–113. https://doi.org/10.1080/10749357.2016.1196907

Lawton, M.P. and Nahemow, L. (1973). Ecology and the aging process. In C. Eisdorf and M. P. Lawton (Eds), The Psychology of Adult Development and Aging, 619–670. Washington, DC: American Psychological Association.

Matthews, C. E. (2005). Calibration of accelerometer output from adults. Medicine and Science in Sports and Exercise 37 (11 supplement), 512–522.

McKenzie, M. (2003). Beyond ‘the Outward Bound process’: Rethinking student learning. Journal of Experiential Education 26 (1), 8–23.

Mishna, F. (2005). The application of self psychology to therapeutic camps. Psychoanalytic Social Work 12 (1), 51–71.

Morris, J., Oliver, T., Kroll, T., and MacGillivray, S. (2011). The importance of psychological and social factors in influencing the uptake and maintenance of physical activity after stroke: A structured review of the empirical literature. Stroke Research and Treatment, 2012. https://doi.org/10.1155/2012/195249

Murphy, S. L. (2009). Review of physical activity measurement using accelerometers in older adults: Considerations for research design and conduct. Preventive Medicine 48 (2), 108–114. https://doi.org/10.1016/j.ypmed.2008.12.001

Palmer, R., and Patterson, G. (2011). One size does not fit all: Obtaining informed consent from people with aphasia. Advances in Clinical Neuroscience and Rehabilitation 11, 30–31.

Parr, S. (2007). Living with severe aphasia: Tracking social exclusion. Aphasiology 21 (1), 98–123. https://doi.org/10.1080/02687030600798337

Pretty, J., Peacock, J., Sellens, M., and Griffin, M. (2005). The mental and physical health outcomes of green exercise. International Journal of Environmental Health Research 15 (5), 319–337. https://doi.org/10.1080/09603120500155963

Rand, D., Eng, J., Tang, P. Jeng, J., and Hung, C., (2009). How active are people with stroke? Use of accelerometers to assess physical activity. Stroke 40:163–168.

Rose, T. A., Worrall, L. E., Hickson, L. M., and Hoffmann, T. C. (2011). Aphasia friendly written health information: Content and design characteristics. International Journal of Speech-Language Pathology 13 (4), 335–347.

https://doi.org/10.3109/17549507.2011.560396

Simmons-Mackie, N. (2000). Social approaches to management of aphasia. In L. Worrall and C. Frattali (Eds), Neurogenic Communication Disorders: A Functional Approach, 162–189). New York: Thieme.

Simmons-Mackie, N., and Kagan, A. (2007). Application of the ICF in aphasia. Seminars in Speech and Language 28 (4), 244–253. https://doi.org/10.1055/s-2007-986521

Welk, G. J. (2002). Use of accelerometry-based activity monitors to assess physical activity. In G. J. Welk (Ed.), Physical Activity Measurement for Health Related Research, 125–141. Champaign, IL: Human Kinetics.

Westerterp, K. R., (2008). Physical activity as determinant of daily energy expenditure. Physiology and Behavior 93, 1039–1043. https://doi.org/10.1016/j.physbeh.2008.01.021

World Health Organization. International Classification of Functioning, Disability and Health [Final Draft]. Geneva: World Health Organization; 2001, Available online at: http://www.who.int/icidh, accessed 1 September 2008.

Worrall, L., Rose, T., Howe, T., McKenna, K., and Hickson, L. (2007). Developing an evidence-base for accessibility for people with aphasia. Aphasiology 21 (1), 124–136. https://doi.org/10.1080/02687030600798352

Published

2019-01-17

Issue

Section

Articles

How to Cite

Hoepner, J., Buhr, H., Johnson, M., Sather, T., & Clark, M. (2019). Interactions between the environment, physical demands, and social engagement at an Aphasia Camp. Journal of Interactional Research in Communication Disorders, 9(1), 44-75. https://doi.org/10.1558/jircd.34497