ADAPTING APHASIA REHABILITATION: A CULTURALLY SENSITIVE AND COMPREHENSIVE APPROACH FOR URDU-SPEAKING PATIENTS AND THEIR COMMUNICATION PARTNERS

Authors

DOI:

https://doi.org/10.18623/rvd.v23.n3.4661

Keywords:

Chronic Aphasia, Quality of Life, Speech Language Pathology, Melodic Intonation Therapy

Abstract

Background: Chronic aphasia is a neurological disorder that affects language comprehension, expression, reading and writing, with significant consequences for daily functioning, social participation, and quality of life. Rehabilitation approaches aim to maximise functional communication; however, culturally responsive strategies remain underexplored for Urdu-speaking populations. Objective: To develop a culturally sensitive and comprehensive approach for Urdu-speaking patients with chronic aphasia and their communication partners. Methodology: An exploratory qualitative design was employed to identify communication needs. Data were collected from focused structured groups of four speech-language pathologists and three caregivers recruited through convenience sampling. Interviews were culturally adapted and analysed using thematic analysis following Braun and Clarke’s framework. Results: Findings highlighted substantial psychosocial impacts of chronic aphasia and emphasised the need for functional, goal-oriented intervention. Key barriers included limited availability of Urdu-language resources and cultural misunderstandings affecting rehabilitation practices. Conclusion: Effective management of chronic aphasia requires culturally competent, integrated approaches that address psychosocial needs and systemic barriers to improve communication outcomes and quality of life.

References

Armstrong, E., & Ferguson, A. (2010). Language, meaning, context, and functional communication. Aphasiology, 24(4), 480–496. https://doi.org/10.1080/02687030902775157

Ayerbe, L., Ayis, S., Crichton, S., Wolfe, C. D., & Rudd, A. G. (2013). The natural history of depression up to 15 years after stroke: The South London Stroke Register. Stroke, 44(4), 1105–1110. https://doi.org/10.1161/STROKEAHA.111.679340

Beukelman, D. R., & Light, J. C. (2020). Augmentative and alternative communication: Supporting children and adults with complex communication needs (5th ed.). Paul H. Brookes.

Boyle, M. (2010). Semantic feature analysis treatment for aphasic word retrieval impairments: What’s in a name? Topics in Stroke Rehabilitation, 17(6), 411–422. https://doi.org/10.1310/tsr1706-411

Brady, M. C., Kelly, H., Godwin, J., Enderby, P., & Campbell, P. (2016). Speech and language therapy for aphasia following stroke. Cochrane Database of Systematic Reviews, 6, CD000425. https://doi.org/10.1002/14651858.CD000425.pub4

Chapey, R., Duchan, J. F., Elman, R. J., Garcia, L. J., Kagan, A., Lyon, J. G., & Simmons Mackie, N. (2000). Life participation approach to aphasia: A statement of values for the future. The ASHA Leader, 5(3), 4–6. https://doi.org/10.1044/leader.FTR.05032000.4

Cruice, M., Worrall, L., Hickson, L., & Murison, R. (2003). Finding a focus for quality of life with aphasia: Social and emotional health, and psychological well being. Aphasiology, 17(4), 333–353. https://doi.org/10.1080/02687030244000707

Cumming, T. B., Marshall, R. S., & Lazar, R. M. (2016). Stroke, cognitive deficits, and rehabilitation: Still an incomplete picture. International Journal of Stroke, 8(1), 38–45. https://doi.org/10.1111/j.1747-4949.2012.00972.x

Dalemans, R. J., de Witte, L. P., Wade, D. T., & van den Heuvel, W. J. (2010). Social participation through the eyes of people with aphasia. International Journal of Language & Communication Disorders, 45(5), 537–550. https://doi.org/10.3109/13682820903223633

Denman, A. (1998). Determining the needs of spouses caring for aphasic partners. Disability and Rehabilitation, 20(11), 411–423. https://doi.org/10.3109/09638289809166103

Faria, A. L., Cameirão, M. S., Couras, J. F., Aguiar, J. R., Costa, G. M., & Bermúdez i Badia, S. (2020). Combined cognitive–motor rehabilitation in virtual reality improves motor outcomes in chronic stroke: A randomized controlled pilot study. Frontiers in Psychology, 11, 964. https://doi.org/10.3389/fpsyg.2020.00964

Flowers, H. L., Skoretz, S. A., Silver, F. L., Rochon, E., Fang, J., Flamand-Roze, C., & Martino, R. (2016). Poststroke aphasia frequency, recovery, and outcomes: A systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation, 97(12), 2188–2201. https://doi.org/10.1016/j.apmr.2016.03.006

Fonseca, J., Raposo, A., Martins, I. P., & Barata, J. (2019). Cognitive deficits in aphasia: A review. Frontiers in Neurology, 10, 887. https://doi.org/10.3389/fneur.2019.00887

Goodglass, H., & Kaplan, E. (2001). The assessment of aphasia and related disorders (3rd ed.). Lippincott Williams & Wilkins.

Grohn, B., Worrall, L., Simmons-Mackie, N., & Hudson, K. (2014). Living successfully with aphasia: A qualitative meta-analysis of the perspectives of individuals with aphasia, family members, and speech-language pathologists. International Journal of Speech-Language Pathology, 16(3), 267–281. https://doi.org/10.3109/17549507.2013.855885

Hersh, D., Worrall, L., Howe, T., Sherratt, S., & Davidson, B. (2012). SMARTER goal setting in aphasia rehabilitation. Aphasiology, 26(2), 220–233. https://doi.org/10.1080/02687038.2011.640392

Hilari, K., & Byng, S. (2009). Health-related quality of life in people with severe aphasia. International Journal of Language & Communication Disorders, 44(2), 193–205. https://doi.org/10.1080/13682820802008820

Hilari, K., Northcott, S., Roy, P., Marshall, J., Wiggins, R. D., & Chataway, J. (2010). Psychological distress after stroke and aphasia: The first six months. Clinical Rehabilitation, 24(2), 181–190. https://doi.org/10.1177/0269215509346090

Kagan, A., Simmons-Mackie, N., Rowland, A., Huijbregts, M., Shumway, E., McEwen, S., & Sharp, S. (2008). Counting what counts: A framework for capturing real-life outcomes of aphasia intervention. Aphasiology, 22(3), 258–280. https://doi.org/10.1080/02687030701282595

Khan, A., Ahmad, F., & Qureshi, I. A. (2022). Challenges in speech-language pathology practice in Pakistan: A focus on aphasia rehabilitation. Pakistan Journal of Neurological Sciences, 17(2), 45–53.

Kiran, S., & Gray, T. (2018). Neuroplasticity and aphasia treatments: New directions for research and clinical practice. Journal of Speech, Language, and Hearing Research, 61(12), 2743–2754. https://doi.org/10.1044/2018_JSLHR-L-17-0377

Kiran, S., & Thompson, C. K. (2019). Neuroplasticity of language networks in aphasia: Advances, updates, and future challenges. Frontiers in Neurology, 10, 295. https://doi.org/10.3389/fneur.2019.00295

Le Dorze, G., & Brassard, C. (1995). A description of the consequences of aphasia on aphasic persons and their relatives. Aphasiology, 9(3), 239–255. https://doi.org/10.1080/02687039508248198

Marangolo, P., Fiori, V., Calpagnano, M. A., Campana, S., Razzano, C., Caltagirone, C., & Marini, A. (2013). tDCS over the left inferior frontal cortex improves speech production in aphasia. Frontiers in Human Neuroscience, 7, 539. https://doi.org/10.3389/fnhum.2013.00539

Mumby, K., & Whitworth, A. (2012). Evaluating the effectiveness of intervention in chronic aphasia: Defining criteria and determining outcomes. Aphasiology, 26(7), 889–903. https://doi.org/10.1080/02687038.2012.676852

Northcott, S., Moss, B., Harrison, K., & Hilari, K. (2016). A systematic review of the impact of stroke and aphasia on quality of life. Aphasiology, 30(11), 1139–1165. https://doi.org/10.1080/02687038.2016.1184251

Papathanasiou, I., Coppens, P., & Potagas, C. (2020). Aphasia and related neurogenic communication disorders (3rd ed.). Jones & Bartlett Learning.

Parr, S., Byng, S., & Gilpin, S. (1997). Talking about aphasia: Living with loss of language. Open University Press.

Pulvermüller, F., & Berthier, M. L. (2008). Aphasia therapy on a neuroscience basis. Aphasiology, 22(6), 563–599. https://doi.org/10.1080/02687030701612213

Qureshi, I. A., Shamim, M. S., & Ahmed, R. (2016). Stroke rehabilitation in Pakistan: Challenges and prospects. Journal of the Pakistan Medical Association, 66(9), 1110–1114.

Rangarathnam, B., Bonilha, H. S., & Krishnamurthy, A. (2016). Telepractice in the assessment and treatment of aphasia: A systematic review. Aphasiology, 30(4), 473–495. https://doi.org/10.1080/02687038.2015.1100701

Shadden, B. B., & Agan, J. (2004). Renegotiation of identity in chronic aphasia: Impact on caregivers. Aphasiology, 18(3), 291–304. https://doi.org/10.1080/02687030344000567

Shao, Z., Janse, E., Visser, K., & Meyer, A. S. (2019). What do verbal fluency tasks measure? Predictors of verbal fluency performance in older adults. Frontiers in Psychology, 10, 259. https://doi.org/10.3389/fpsyg.2019.02559

Simmons-Mackie, N., & Damico, J. S. (2008). Engagement in group therapy for aphasia. Topics in Stroke Rehabilitation, 15(6), 452–470. https://doi.org/10.1310/tsr1506-452

Simmons-Mackie, N., Worrall, L., Murray, L. L., Enderby, P., & Cruice, M. (2017). The life participation approach to aphasia: A consumer-driven service delivery approach. Plural Publishing.

Stahl, B., Mohr, B., Dreyer, F. R., Lucchese, G., & Pulvermüller, F. (2011). Singing in the brain: Inducing a cortical plasticity by melodic intonation therapy. Frontiers in Human Neuroscience, 6, 197. https://doi.org/10.3389/fnhum.2012.00197

Torres, J., Drebing, D., Hamilton, R., & Fregni, F. (2013). Noninvasive brain stimulation for treatment of post-stroke aphasia: Systematic review and meta-analysis. Neurorehabilitation and Neural Repair, 27(9), 765–775. https://doi.org/10.1177/1545968313494119

Wilkinson, R., Beeke, S., & Maxim, J. (2010). Adapting to conversation: Strategies for conversation training in aphasia. International Journal of Speech-Language Pathology, 12(2), 125–138. https://doi.org/10.3109/17549500903373967

Williams, J. (2013). Speech and language therapy in practice: Cross-cultural perspectives. Routledge.

Zumbansen, A., Peretz, I., & Hébert, S. (2014). Melodic intonation therapy: Back to basics for future research. Frontiers in Neurology, 5, 7. https://doi.org/10.3389/fneur.2014.00007

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Published

2026-02-02

How to Cite

Ahmed, M., Fall, A. A., & Khan, S. G. (2026). ADAPTING APHASIA REHABILITATION: A CULTURALLY SENSITIVE AND COMPREHENSIVE APPROACH FOR URDU-SPEAKING PATIENTS AND THEIR COMMUNICATION PARTNERS. Veredas Do Direito, 23, e234661. https://doi.org/10.18623/rvd.v23.n3.4661

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Vol. 23 (2026): Veredas do Direito, v. 23, 2026

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