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Abstract

Background : Focusing treatment for aphasia requires systematic collection and analysis of an individual's biographical, medical, and behavioural data including, ideally, appraisal of his or her health, functioning, and quality of life. Determining treatment outcomes requires methodical indexing of therapeutic effect(s), ranging from a decrease in one or more specific communication impairments to an increase in overall quality of life. Despite the abundance of available measures, current appraisal of aphasia may be insufficient for focusing socially valid treatment and evaluating its outcomes, because most tests were developed without the advantage of a widely accepted, programmatic framework for evaluating the interaction between an individual's health condition and personal factors, and the external factors that represent the circumstances in which he or she lives. Aims : This paper urges incorporation of the World Health Organisation's (WHO) international classifications of functioning, disability, and quality of life into the appraisal of aphasia to facilitate both more meaningful treatment planning, designed to address the entire consequences of aphasia for each individual, and more meaningful comparison of treatment outcomes, within and among healthcare disciplines and providers. Main Contribution : Limitations of the current appraisal of aphasia are listed, and suggestions for using the WHO framework to evaluate existing instruments and develop new measures are provided. Conclusions : If proven applicable, incorporation of the WHO international classifications of functioning, disability, and quality of life into the appraisal of aphasia should facilitate: development of meaningful and practical health policy; methods to assess quality assurance; improved outcome evaluation; and, most importantly, development of socially relevant treatment for people with aphasia.

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