Navigating the italian landscape of post-stroke aphasia treatment: Insights from the clinical practice of speech and language therapists

Abstract

Background

In Italy, stroke represents a significant healthcare burden, with many people experiencing aphasia (PwA) necessitating effective speech and language therapy (SLT). Despite the crucial role of speech-language therapists (SLTs) in supporting PwA, knowledge about the clinical decision-making processes used by SLTs is unclear.

Purpose

To investigate the current state of SLT practices in Italy, prevalent assessment tools, intervention approaches, education provided to PwA and their families, and factors guiding goal-setting and discharge decisions.

Method

An online survey was developed and distributed to Italian SLTs. The survey was available for 8 weeks. The questionnaire examined demographic characteristics, assessment and intervention approaches, and familiarity with therapeutic approaches.

Results

In total, the survey yielded responses from 114 participants and revealed that most work with PwA in sub-acute and chronic phases. Formal assessments, particularly the Aachen Aphasia Test and the Esame Neuropsicologico per l’Afasia, were predominantly employed, while informal methods like spontaneous speech sampling were also common. Intervention approaches largely focused on language impairment, with over 50% of clinicians reporting familiarity with impairment-based therapies. However, advanced approaches such as Constraint-Induced Aphasia Therapy and newer technologies were underutilized, reflecting a knowledge gap. Respondents identified functional communication and quality of life enhancement as primary criteria for evaluating therapeutic success.

Conclusions

The findings underscore the necessity of advocating for enhanced training on innovative therapeutic approaches and systematic assessments that encompass cognitive and functional communication aspects. Given SLTs' reliance on personal expertise, establishing comprehensive frameworks for aphasia management can better support individualized care.