A. M. O'Callaghan

Insight vs readiness: Factors affecting engagement in therapy from the perspectives of adults with TBI and their significant others

Introduction: Adults sustain significant, often irreversible impairments following brain injury. The process they go through coming to terms with these impairments can seriously interfere with their readiness to engage in rehabilitation. Aim: This study aimed to look beyond the development of self-awareness and insight in order to explore the concept of readiness as it relates to clients’ experiences of engaging with therapy. Method: Sixteen in-depth interviews were conducted with 14 adults with a moderate–severe traumatic brain injury (TBI) and nine of their significant others. These participants were asked to speak about the continuum of care they experienced and the factors that effected their engagement with care. Results: The results of this study indicated that participants believed their ability to engage in therapy was related to the degree to which they were aware of and accepted their impairments and motivated to engage in rehabilitation. Participants reported that the rate and degree to which they developed awareness varied according to the type of impairments they experienced (i.e. physical vs cognitive). Participants also stated that one way to augment their awareness was to compare their new vs old selves and to compare their recovery to those of others with a similar impairment. Finally, participants reported that it was important to be able to access services when they had accepted their impairment and were ready to engage in therapy. Conclusion: The clinical implications for considering the degree of awareness of impairments and readiness for engagement in care of an adult with a moderate–severe TBI are discussed in relation to future services planning.

The World Report on Disability as a blueprint for international, national, and local aphasia services.

Abstract This commentary aims to extend the debate of the lead article authors (60) by translating the nine recommendations of the World Report on Disability into a plan of action for the aphasia community. Solutions for the advancement of aphasia science and services are presented at international (macro), national (meso), and local (micro) levels. Implications for speech-language pathologists and aphasia service delivery are discussed. An overarching call to action is the need for speech-language pathologists to support a strong and vibrant aphasia community at all levels, so that the voices of people with aphasia can be heard.

Diversity and development: Selected papers from the Speech Pathology Australia National Conference (2011)

ã o (2012) tested the phonological representations of children with specifi c language impairment. Their study provided support for a model of separate input and output representations, and so demonstrated the importance of considering both when undertaking assessments with this population. McKean et al. (2012) also refl ected on changes needed in the area of paediatric practice, specifi cally they aimed to explore whether parent/carer satisfaction was greater with family-centred practice (FCP) or usual practice paediatric models of care. Their study did not demonstrate a signifi cant benefi t for a FCP model in terms of client outcomes and parent satisfaction; however, they did identify that by utilizing a FCP approach the treatment goals implemented were more likely to target the children ’ s activities and participation as defi ned by the World Health Organization ’ s (2007) International Classifi cation of Functioning, Disability and Health – Children and Youth . Williams and McLeod (2012) explored an issue of increasing signifi cance to the Australian, and international contexts: the practices of SLPs with children who speak languages other than English. The Australian context is somewhat unique among Englishspeaking countries since there is no dominant minority language; thus, SLPs come into contact with people speaking a wide variety of languages. This paper provides an important starting point for considering Australian SLPs ’ experiences of multilingualism, and their needs for improving the delivery of assessment and intervention services to this growing and diverse population. The paper by Teoh et al. (2012) also examined SLPs ’ practices with multilingual clients, specifi cally children who speak Singaporean Mandarin English. In this paper, Teoh et al. demonstrated how the results of a standardized language assessment with bilingual children may not refl ect true language abilities. They raised a number of important considerations for SLPs working with multilingual clients, such as the need for standardized tools to be examined for potential This issue of the International Journal of SpeechLanguage Pathology showcases papers from the 2011 Speech Pathology Australia National Conference held in Darwin. All who attended will recall the energy and spirit of the conference, and it has been a privilege to edit the papers included in these proceedings, which exemplify some of the innovative work that was presented. The conference theme, Diversity and Development, brought together Australian and international speech-language pathologists (SLPs) who work with diverse client groups, in a variety of environments, within a number of different service delivery models. The conference provided a platform for delegates to share their stories of the development of our profession and scope of practice, as well as developments in technology, our knowledge, and our research base. In the Elizabeth Usher Memorial Lecture of the conference, given by Theodoros (2012), we were challenged to embrace innovations in technology and new evidence-based treatment protocols to improve the delivery of speech-language pathology services and facilitate better outcomes for our clients. Theodoros ’ thought-provoking presentation has been adapted in an invited paper within this issue. Her paper reminds us of the emergence of a new era in speech-language pathology practice which will require ongoing innovation and diversifi cation as the 21 st century progresses. Kenny and Lincoln (2012) demonstrated the valuable insights that may be gained through an innovative approach to research. They examined SLPs ’ experience of caseload management through analysing the metaphors used by SLPs when discussing this issue. Do we, for instance, regard caseload management as a “ ball game ” , a “ balancing act ” , or a “ battle ” ? The authors described how our choice of metaphors provides insight into our lived experiences, and may provide a window into professional culture. Consequently, the authors ask us to consider the messages we portray to clients and others by our word choice and metaphor use.