Aphasia therapy involves improving receptive and expressive language through traditional language approaches. Over the past few years, some research has started to indicate that non-linguistic factors may also affect auditory comprehension: Distractions that interfere with attention may negatively affect auditory comprehension in people with aphasia.
While most treatment approaches focus solely on linguistic deficits, I believe it is helpful to consider how other areas of cognition impact a person’s ability to interpret and produce language. I look to techniques from other disciplines for solutions when working on attention issues in clients with aphasia.
One such approach includes Mindfulness-Based Stress Reduction (MBSR). This evidence-based practice—developed by Jon Kabat-Zinn at the University of Massachusetts Medical School—helps reduce various psychological symptoms for people with chronic illness. MBSR uses western medicine and psychology along with Buddhist principles to alleviate anxiety, depression and stress.
To achieve stress-reducing mindfulness, a person must pay attention to the present moment while ignoring competing thoughts. Attaining a state of “mindfulness” involves internalizing seven attitude traits: non-judging, patience, beginners’ mind, trust, non-striving, acceptance and letting go. To reach this state, a person must sustain their focus and attention on all seven attributes. Therefore, a positive tertiary effect of mindfulness can include improved attention.
MBSR might relate particularly to speech-language treatment because participation does not simultaneously strain attention and language. If we believe impaired attention negatively affects auditory comprehension, then MBSR principles can potentially help bridge the gap between attention and language. I suggest SLPs find a professional specializing in MBSR to recommend for their clients. Our focus is language, but ideally the two professionals will collaborate with their treatment approaches.
I know a strong base of evidence is lacking to specifically apply MBSR principles to people with communication difficulties, but when I think about past patients who have experienced strokes—especially younger clients with mild aphasia—I wish I’d had MBSR resources to offer. According to the American Heart Association, 33 to 66 percent of people who have a stroke later suffer from depression. I can’t help but wonder whether or not I could have reduced my patients’ risk for depression and improved their language by putting them in contact with someone trained in this practice.
Many questions remain about using MBSR for patients with aphasia, such as: Who are the appropriate candidates for MBSR? How might a speech-language pathologist measure the benefit of MBSR on language goals? Perhaps with the help of functional MRI scans and collaboration with other professionals trained in MBSR techniques, we can begin to make deeper connections and continue to serve our patients.
Annie Gatziolis, MS, CCC-SLP, works in private practice focused on pediatric and health care settings. She is an affiliate of ASHA Special Interest Group 1, Language Learning and Education.