The complexity of social/cultural dimension in communication disorders.

There has been growing recognition in the field of communication disorders concerning the importance of multicultural and diversity issues. This discussion needs to move beyond the theoretical and descriptive stage to the clinical use of this knowledge to improve the communicative functioning of diverse populations. This paper argues that the tenets of evidence-based practice and the International Classification of Functioning, Disability and Health (ICF) by the World Health Organization can be used to advance the scholarship and service concerning diversity issues. Both evidence-based practice and the ICF are client-based approaches that can facilitate the achievement of culturally relevant rehabilitation outcomes. This article discusses the use of evidence-based practice and the ICF for providing assessment and intervention that address the social and cultural complexities of the persons we serve. In addition, the author states that work on diversity issues can also be used to discover crucial underlying knowledge regarding communication and communication disorders.

Towards an international framework for communication disorders: use of the ICF.

UNLABELLED: There has been an interest in the World Health Organization's framework of functioning and disability by those in communication disorders since the original 1980 International Classification of Impairments, Disabilities, and Handicaps (ICIDH). In 2001, WHO published the substantially revised International Classification of Functioning, Disability, and Health (ICF). This framework is gaining in acceptance as a system that would be beneficial for the field and for our clients. This article describes the basics of the ICF and how it differs from the ICIDH; the possible applications of the ICF to communication disorders; some of the work done with the ICF in communication disorders internationally; and the benefits to the field from increased interdisciplinary and international collaboration using the ICF as a common framework. LEARNING OUTCOMES: As a result of this activity the reader will be able to: (1) describe the basics of the ICF, (2) describe the applications of the ICF to communication disorders, and (3) describe the possible impact upon the field internationally.

Outcome assessment in aphasia: a survey.

UNLABELLED: There has been a marked increase in attention to the measurement of "outcomes" after speech-language intervention for adult aphasia. Consumers, speech-language pathologists (SLPs), and funding sources desire evidence of therapy outcomes that improve communication and enhance the quality of life for people with aphasia. While many assessment tools are available to measure outcomes after aphasia therapy, there is little information regarding the use of these tools in everyday practice by SLPs. Therefore, the current investigation was undertaken to identify and describe the practices of SLPs relative to outcome assessment in aphasia. An online survey of outcome assessment practices was distributed. Results revealed that 85% of the 94 respondents reportedly perform outcome assessment. A majority of respondents reported barriers to assessment such as time and funding limitations. Considerable variability existed in the types of assessments and the actual tools reported. The impact of the results on clinical practice is discussed. LEARNING OUTCOMES: As a result of this activity the reader will be able to (1) define outcome assessment in aphasia, (2) describe patterns of outcome assessment in aphasia as reported by survey respondents, and (3) describe a conceptual framework for situating outcome assessment in aphasia.

Influences on perceived function of a nursing home resident.

UNLABELLED: This article describes a typical, yet fictionalized woman with Alzheimer's disease during her first week at a nursing home. Readers are challenged to ask themselves in what areas of difficulty a speech-language pathologist may or may not be able to contribute to the success of this resident. The authors use the World Health Organization's International Classification of Functioning, Disability, and Health [International Classification of Functioning, Disability, and Health, 2001, Geneva, Switzerland] as the framework for assessments and the resident-centered interventions for this case study. LEARNING OUTCOMES: 1. The reader will be able to identify the four main constructs of the ICF classification system. 2. The reader will be able to identify three environmental factors that may influence the functioning of a person with Alzheimer's disease. 3. The reader will be able to discuss at least four interventions that can be implemented by a speech-language pathologist to improve a nursing home resident's participation in daily activities.

The ICF and speech-language pathology: aspiring to a fuller realization of ethical and moral issues.

The World Health Organization's (WHO) International Classification of Functioning, Disability, and Health (ICF) is a tool that was developed to improve the functional health of the world's people. The ICF is meant to be more than simply a better way to classify functional limitations. WHO seeks to change the way people view disability. This article discusses the ethical guidelines listed in the ICF and how they can be used by speech-language pathologists to aspire to a fuller realization of the ethical and moral aspects of their vocation. This realization includes an argument that the disability rights struggle is part of an overall quest for the basic human rights of all people.

Use of the ICF in dysphagia management.

The evaluation and intervention of persons with dysphagia represents a significant percentage of speech-language pathologists' caseloads in medical settings. Because of its overtly medical nature, there has been considerable focus dealing with the direct physical health aspects of dysphagia management. This article argues that the use of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) by clinicians can expand and greatly enhance the outcomes for persons with dysphagia. The different components of the ICF are discussed in relation to dysphagia assessment and management. The article concludes by noting that speech-language pathologists can use the ICF framework beneficially to justify and strengthen their role in the management of dysphagia.

Multiinfarct dementia and communication.

Traditionally, speech-language pathologists have treated patients who have suffered from strokes that resulted in aphasia, but have not always worked with patients labelled as having multiinfarct dementia (MID). Patients with MID also have difficulties with communication in which the speech-language pathologist's input would be beneficial. This article examines the clinical characteristics and neurology of MiD along with the assessment and clinical issues that need to be examined if speech-language pathologists are to evaluate and treat these patients more effectively.