About the Aphasia CRE
The Centre for Research Excellence in Aphasia Rehabilitation and Recovery (Aphasia CRE) aims to transform the health and wellbeing of people with aphasia and their families through research that leads to enhanced, cost-effective and sustainable interdisciplinary aphasia rehabilitation and community services.
We are a national research centre based at La Trobe University led by Professor Miranda Rose, with Chief Investigators (CI) based at numerous universities and institutes Australia-wide.
The $2.5 million centre is funded by the National Health Medical Research Council (NHMRC) [external link].
What is aphasia?
Aphasia is a common language-based communication disability after brain injury. It can disrupt the ability to:
- understand speech
It impacts 30% of the stroke population representing over 140,000 Australians. People can also experience aphasia after:
- head injury
- brain tumour
- other diseases that impact the brain.
Communication is vital to our everyday activities, independence, social relationships, and identity – so it is not surprising that aphasia radically impacts quality of life.
Medical, nursing, rehabilitation and welfare professionals strive to reduce the impacts of aphasia. However, our current research evidence base, and our health and wellbeing care practices do not meet the needs of many people with aphasia.
We aim to tackle the many of the main issues in aphasia research and care.
Including aphasia in stroke research
General stroke research has systematically excluded people with aphasia despite the fact that people with aphasia can provide informed consent and adapted outcome measures exist that enable full participation for people with aphasia.
Excluding people with aphasia from research limits the applicability of research findings to the general stroke population and slows the pace of improvements in medical and rehabilitation care for people with aphasia.
Prognosis and tailoring services
Aphasia is a complex condition arising from damage to many areas of the brain. The impact of aphasia varies considerably for people. For some it severely impacts all language functions (e.g. speaking, listening, reading and writing), while for others it impacts only one function (e.g. reading) or may be mild or moderate in severity. This complexity makes it difficult to accurately predict recovery from aphasia.
Predicting recovery accurately would help practitioners to provide appropriate advice about rehabilitation and prognosis to people with aphasia and their families, as well as helping to better manage our limited health care resources through prescribing treatments appropriately.
The hospital and rehabilitation workforce struggles to cope with the communication challenges associated with aphasia and this can limit quality of care. People with aphasia struggle to engage in health care and personal communication while in hospital and this seriously impacts their wellbeing.
Evidence-based solutions to improving healthcare communication with people with aphasia exist but have not been implemented in practice.
Improving the evidence for aphasia treatments
Recent research evidence confirms that speech therapy treatments for aphasia are effective. However, we have very limited evidence on patient-related and therapy dose factors that contribute to best immediate outcomes, as well as maintenance of treatment effects.
Existing stroke clinical guidelines provide limited information for aphasia across the continuum of care. Aphasia care in acute stroke is particularly lacking, with speech therapy time dominated by swallowing care. A pathway for acute stroke aphasia care is needed to maximise patient recovery and improve patient experience at a time of great vulnerability and need.
Mental health and wellbeing
People with aphasia are highly susceptible to mental health problems. For example, up to 44% experience anxiety and up to 56% depression at any one time after stroke. Failure to provide appropriate psychological management of these mental health problems not only causes avoidable suffering and poorer rehabilitation outcomes, it also impacts the Australian healthcare system and economy due to associated increased length of hospital stays and greater use of community-based healthcare.
Stroke Foundation audits of rehabilitation services since 2008 show that the mental health needs of Australian stroke survivors with aphasia are consistently neglected.
Long-term community support and care
Aphasia is a chronic disability with support and rehabilitation needs long after hospital discharge. However, once discharged from rehabilitation care, people with aphasia find it difficult to access community services that meet their needs. This lack of engagement contributes to further social isolation and carer burden. Offering aphasia-specific supports in various community settings is another key priority for improving long-term health outcomes.
Reaching people in rural and remote locations
The majority of aphasia care is one-to-one and face-to-face with a healthcare practitioner. This model is unsustainable, expensive and inaccessible to people living outside metropolitan or larger regional centres. Services must change to address the current underservicing of rehabilitation in Australia.
Consumers with aphasia want:
- evidence-based therapy in greater doses
- more support after leaving hospital
- more assistance with maintaining or transforming life roles after their stroke.
Technology is revolutionising healthcare, but aphasia poses barriers to uptake. We need innovative technology-solutions that are tailored to the challenges of aphasia.