The Accessibility of Community Environments

1
The Accessibility of Community Environments for
Adults with Aphasia
Tami Howe, Linda Worrall, Louise
Hickson Communication Disability in Ageing
Research Centre, School of Health
Rehabilitation Sciences

• Introduction
• The United Nations (UN) states
• In all societies of the world
  there are still obstacles preventing persons
  with disabilities from exercising their
  rights and freedoms and making it difficult
  for them to participate fully in the
  activities of their societies. It is the
  responsibility of States to take
  appropriate action to remove such
  obstacles.1
• ASHA Scope of Practice in Speech Pathology
  
• states
• Speech-language pathologists work to
  improve quality of life by reducingenvir
  onmental barriers of the individuals they
  serve.2
• Many aphasiologists recommend identifying
  
• and reducing barriers for clients with
  aphasia.3,4
• However, what are these barriers and what
• facilitators are needed to overcome these
  barriers?
• To date, most research in this area has been on
  
• physical disorders.

• Results
• Examples of Barriers Related to Other People
• Lack of familiarity with other person If it was
  a new doctor,Id have to explainjust too hard
• Other peoples attitudes about them Stupid,
  Mentally deranged, Like
  a child, Drunk
• Examples of Physical Barriers
• Objects Every one of them (automated teller
  machines) are differentTheyre really there just
  to struffle (stifle).
• Visual aspects In the coffee shopif theres a
  lot of movement on the street more difficult to
  concentrate on the conversationI could cope with
  anything like that (before the stroke).
• Examples of Societal Barriers
• Procedures Use of recorded telephone messages in
  businesses Phoning, number 1, number 2, number
  3. Hope someone says (hope an operator comes
  on) If they dont comeput the phone down
  and thatsnothing.

• Results (continued)
• Some factors were identified
• as both a facilitator AND a
• barrier (e.g. support of other
• people)
• Some participants reported
• factors related to their physical
• AND communicative difficulties
• Stairs without handrails (is a barrier)-
• Balance is a problem with
• aphasia too, isnt it?

• Method
• Participants
• 25 adults with aphasia caused
  
• by CVA living in community
• sampled by maximum
  
• variation sampling

What environmental factors hinder community
participation?

• Societal Barriers

Barriers Related to Other People

• Physical Barriers

• Conclusions
• Wide range of barriers and
• facilitators identified that
• policy makers and clinicians
• may need to consider
• Different from some World
• Health Organization
• International Classification
• of Functioning, Disability,
• and Health6 (ICF) Environmental
• Factor codes Future versions of
• ICF may need to incorporate
• these factors
• Data along with findings from a
• participant observation study
• will contribute to development

• Research Questions
• What environmental factors are perceived by
  adults with aphasia to hinder participation of
  people with the communication disorder in the
  community?
• What environmental factors are perceived by
  adults with aphasia to support participation of
  people with the communication disorder in the
  community?

References 1United Nations (1993). Standard
rules on the equalization of opportunities for
persons with disabilities. Retrieved December
12/2003 from http//www.un.org/documents/ga/res/48
/a48r096.htm 2American Speech-Language-Hearing
Association. (2001). Scope of practice in
speech-language pathology. Rockville, MD
American-Speech-Language-Hearing Association
3Byng, S., Pound,C., Parr, S. (2000). Living
with aphasia A framework for therapy
interventions. In I. Papathanasiou (Ed.),
Acquired neurogenic communication disorders A
clinical perspective (pp.49-75). London Whurr
Publishers 4Chapey, R., Duchan, J.F., Elman,
R.J., Garcia, L.J., Kagan, A., Lyon, J.G.,
Simmons-Mackie, N. (2001). Life participation
approach to aphasia A statement of values for
the future. In R. Chapey (Ed.), Language
intervention strategies in aphasia and related
neurogenic communication disorders (4th ed., pp.
235-245). New York Lippincott Williams
Wilkins 5Sandelowski, M. (2000). Whatever
happened to qualitative description? Research in
Nursing and Health,23,334-340 6World Health
Organization. (2001). International
classification of functioning, disability, and
health ICF. Geneva World Health Organization.
Acknowledgement Queensland Governments Growing
the Smart State A Ph.D. Research Funding Program