Tracking social connection versus isolation in aphasia

The World Health Organization’s assertion that “health is more than the absence of disease” (WHO, 2001) is relevant to clinicians serving persons with aphasia (PWA). In the framework proposed by the WHO’S International Classification of Functioning, Health and Disability (ICF) (WHO, 2001) contextual and personal factors are presented as key parts of a model that describes functioning in the context of life with some type of disability. For PWA, life with reduced access to spontaneous and effortless use of language skills represents a daily challenge, but the impact is more far reaching than reductions in language use. Social networks reduce after aphasia, thus narrowing the field of communication opportunities and possibly leading to social isolation (Hilari & Northcott, 2006; Vickers, 2010). This reduction may be a critical clinical factor because social networks are tied to health, well-being and longevity. Further, post stroke depression is a compounding factor, especially when aphasia is present(Thomas & Lincoln, 2008). A variety of national and international policies support the clinical investigation of social networks. First, evidence based practice calls for clinicians to consider client perspectives and values (ASHA, 2005) . Also, the international Commission on Accreditation of Rehabilitation Facilities (CARF, 2012) sets standards for a variety of program areas, including medical rehabilitation. CARF mandates that qualifying rehabilitation programs offer services uniquely designed for stroke survivors that result in the improvement of the quality of life, increase of life participation, and reduction of activity limitations. Therefore, having a brief and easily accessible instrument to investigate the PWA’s sense of social connection versus social isolation could encourage more frequent attention to this aspect of functioning during the rehabilitation process. Such a tool may also provide aphasia group leaders and program directors or specialists with a valuable and quick way to track outcomes related to PWA’s participation in programming designed to meet their needs, thus providing support for ongoing programming and development of programs