Background: Spouses play a major role in adaptation following the onset of their partner's aphasia. Sometimes, overprotection can occur in the relationship and this may be a disadvantage in adapting to aphasia. Overprotection from spouses can manifest itself in conversation when the spouse “speaks for” the person with aphasia and this could affect his or her participation in conversation. Aim: The aim of the present research was to study the phenomenon of overprotection, “speaking for” behaviours in conversation as well as the person with aphasia's participation in conversation. Methods & Procedures: A total of 18 couples, each including one person with aphasia, participated in this study. The perceptions of overprotection by persons with aphasia and their spouses were measured with the Overprotection Scale for Adults (Thompson & Sobolew‐Shubin, 1993 Thompson, S. C. and Sobolew‐Shubin, A. 1993. Overprotective relationships: A nonsupportive side of social networks.. Basic and Applied Social Psychology, 14: 363–383. [Taylor & Francis Online], [Web of Science ®] [Google Scholar] ) and the Questionnaire on Resources and Stress for Families with Chronically Ill or Handicapped Members (Holroyd, 1987 Holroyd, J. 1987. Questionnaire on resources and stress for families with chronically ill or handicapped members, Brandon, VT: Clinical Psychology Publishing Co. [Google Scholar] ). The participants were also videotaped in an interview situation where they answered questions on a systematic turn‐by‐turn basis. “Speaking for” behaviours, defined as the conversational turns in which the non‐aphasic spouse expressed an opinion or added information when the person with aphasia was clearly talking with the interviewer, were measured. Participation was measured by tabulating the number of contributive turns produced by the person with aphasia and the spouse in the nine turns following the “speaking for” behaviour. Participation of the aphasic person was considered “minor” if the number of those turns was fewer than those produced by the spouse. Outcomes & Results: Results showed that overprotection reported by spouses was positively associated with “speaking for” behaviours produced by spouses. “Speaking for” behaviours were positively related to minor participation in conversation. Aphasia severity and motor disability were also associated to minor participation of persons with aphasia in conversation. Conclusions: More research on overprotection and its effects on conversation is needed to further our understanding about the links between communication and psychosocial aspects of aphasia. In rehabilitation, attention should be given to overprotection and “speaking for” behaviours on the part of the spouse. In fact, the person with aphasia and the rehabilitation team's efforts to improve language and communication could be labour in vain if overprotection and “speaking for” behaviours on the part of the spouse develop and persist.

Aphasia is a communication disorder affecting participation. Although there are evidence-based practice recommendations about participation and aphasia rehabilitation, it may be challenging for speech-language pathologists to ensure that rehabilitation activities have an impact on the person’s participation, in part due to time limitations. Participation remains limited after rehabilitation for persons who have aphasia. Communities of practice (CoPs) are a collaborative knowledge transfer strategy that can be used for evidence-based practice implementation. The aim of this study was to describe the components and evaluate a CoP for speech-language pathologists about participation and aphasia rehabilitation. Logic analysis was used to determine the adequacy between resources, implemented activities, outputs and short-term outcomes of the CoP. Qualitative and quantitative descriptive data were collected through observation and participants’ logbooks. Outputs and outcomes of the CoP were revealed through thematic analysis and interpretation of descriptive statistics. Resources including CoP design and educational aims, human and material resources were combined to create various web-based, online and offline activities. Participants invested more time per week than expected in the CoP, shared and created clinical tools and appreciated the array of suggested activities. Participant engagement allowed them to reflect, interact and collaborate with each other. All 13 participants reported they acquired knowledge about clinical tools and 12 mentioned they reflected on their practice. While the CoP was ongoing, six participants noticed evidence-practice gaps, seven prepared to change their practice, and three changed their practice towards including more participation-based considerations. This study showed that speech-language pathologists can include more participation-based approaches in aphasia rehabilitation as a result of participating in a time-bound, web-based CoP.

Background: Social participation is the stated ideal end purpose of rehabilitation, however people with aphasia often have limited social participation following rehabilitation. Despite growing evidence regarding the importance of addressing social participation issues in aphasia rehabilitation, it is unknown how much these issues are considered by speech-language pathologists. More importantly, it is unclear what aphasia rehabilitation practice includes. Aim: The aim of this study was to understand speech-language pathology practice in aphasia rehabilitation by means of a theoretical model. Methods & Procedures: Grounded theory was used to structure this research study. Seventeen speech-language pathologists working in different settings of the care continuum of aphasia rehabilitation in Quebec (Canada) were recruited to participate in individual, semi-structured interviews. They were questioned about the ideal end purpose of aphasia rehabilitation and the clinical activities performed in practice. Recorded interviews were transcribed and analysed following an inductive, constructivist-based approach. Categories were identified and a theoretical model was developed. Outcomes & Results: The main characteristic of the participants’ practice was that it included underlying questions. These questions were either related to the purpose of aphasia rehabilitation or to the clinical activities performed to achieve that purpose. Four central clinical activities were described: counselling; assessing needs and abilities; setting therapy goals; and conducting therapy. Two clinical activities were not systematically performed; thus, they were considered peripheral within practice: including relatives in therapy and considering other parties. The focus of practice was either on language impairment or on social participation of the person with aphasia. Participants expressed different perceptions about the ideal end purpose of aphasia rehabilitation and considered their workplace environment as constraining or encouraging professional autonomy, which had an impact on the focus of practice. Underlying questions led participants to express a need for guidance to orient their practice. Conclusions: Results contribute to a better understanding of aphasia rehabilitation practice. When deeply motivated by helping the person resume significant life habits, speech-language pathologists’ practice was more likely to be focused on social participation, but questions regarding clinical activities persisted. A future knowledge transfer strategy could help guide and orient speech-language pathologists.