British Aphasiology Society Symposium 2019

I have to say, the 2019 BAS Symposium was one of the most enjoyable and constructive conferences I have ever been to (and not just because I received best lightening talk on the first day!).

If I were to review in depth all my highliScreen Shot 2019-09-17 at 21.17.15ghts I would be here until Christmas, no one has time for that. So here are my themed highlights. For me there were two key themes to this conference. One gave me hope and excitement about the future of aphasia therapy, and the other practical reassurance about how to get there.
The first theme was creative wellbeing. Ian Duffy a survivor of two brain haemorrhages powerfully illustrated the importance of creativity at the conference opening with his beautifully shot video ‘The Fence Painter’ (https://youtu.be/Jfv3BT6mBR0). From pebble collecting, to lawn mowing with a difference Ian revealed how creativity can be motivational and a deeply personal companion when defining your post stroke self. This creative wellbeing continued in Ciara Shiggin’s talk. Ciara argued the case for moving away from the classic pathogenesis cure to salutogenesis i.e. identifying goals and outcomes to support a person’s mental health and wellbeing. A simple flip and therapy becomes a positive activity, pursuing wellness rather than chasing ‘cure’. She demonstrated how salutogenesis partnered with an asset based approach changed the nature of living well with aphasia in Norwich, including the opening of the Community Aphasia Café and UEA’s Conversation Partner Training Scheme. The creativity these two changes created in Norwich were tangible in the glowing, and emotional in the introduction Linda Watson from the UEA Aphasia Research Collaboration gave to Prof Simon Horton. Her testimony about the impact Simon and UEA’s Conversation Partner training scheme had on her self belief and confidence was inspiring. Sarah Northcott (City University) used her 5 minute Soapbox slot to describe the power Solution Focused Brief Therapy (SFBT) can have for a person with aphasia’s mood. Her case study brought the power of SFBT to life, as she explained how it can be used to acknowledge the darkness aphasia can create aphasia, whilst looking for the light. Other creative presentations included Prof Jane Marshall’s EVA Park, a virtual world including two new updates: a talking penguin, and Ruby Robot, an avatar you can practice your narrative with. One criticism of EVA Park from the audience (you know who you are) was that EVA Park is too nice. Watch this space for ‘DARK Park’ an altogether grittier experience…

The second exciting theme of the conference for me was the speech and language therapist’s role in facilitating living well with aphasia. Prof. Linda Worrall championed this with her opening talk about the 7 habits of effective aphasia therapists. A great talk and now published paper (Worrall, L. (2019). The seven habits of highly effective aphasia therapists. Aphasiology. https://doi.org/10.1080/02687038.2018.1487022). Prof. Linda Worrall gave seven key habits clinicians can use to reflect on their own practice. These highlighted the importance of building rapport, and our role in ensuring the end goal of therapy is living well with aphasia and being able to self-advocate. Indeed, Sarah Scott on day two of the conference highlighted her biggest challenge to living well with aphasia being the public not understanding what aphasia is. The invisibility of aphasia is a big problem. Prof Nina Simmons-Mackie highlighted the abysmal rates of understanding of aphasia in the US and UK in her closing keynote of the Symposium. However she offered a simple change we could all make as a positive start towards improving public awareness. Next time we are asked what we do, rather than saying “an SLT” (and then having defend the profession as not being all about elocution), describe what it waking up with aphasia is like: “imagine waking up in a hospital, you have no idea what has happened and when you try to find out, you find you cannot talk, the right words do not come out of your mouth, and no-one understands you. That is aphasia and I work with people who experience this”. Prof Nina Simmons-Mackie explained how making the impact of aphasia real alters people’s responses, leading to probing questions about the nature of aphasia and whether it could happen to them. One small step for we can all take to, raise UK awareness of aphasia above 5%.

Finally, my key learning points from the Symposium where:

  1. There are many creative technologies out there to support your clinical work from the comprehension aphasia therapy app Cue Speak by Jon Hunt, to app supporting creative writing (MakeWrite from City University).
  2. Technology cannot replace a good therapeutic relationship, which is at the heart of all good interventions.
  3. People with aphasia report using their phones more than other devices on a daily basis to compensate for their aphasic difficulties.
  4. There is a good therapeutic rationale for working with people with Primary Progressive Aphasia. Living well with PPA is about developing good conversation flow (Better Conversations with PPA) rather than re-learning words that will be lost again further down the road (see Anna Volkmer, UCL for details)
  5. Improving discourse and conversation skills for the person with aphasia and conversation partners is key to improving participation in wider society.
  6. SLTs need to unite globally to raise awareness of aphasia within the public domain. Prof Nina Simmons-Mackie’s quote of a 5% understanding by the UK public as to what aphasia is (someone thinking it was half a facial) is not good enough. Living well with aphasia is a community, not individual responsibility!