Persons with communication disorders in Montana represent a unique population. Montana is a large, rural state with few resources and/or speech and language services. Barriers that may prevent access to outpatient services may include: (1) geographic obstacles including distance, difficulty of travel on rural roads, and severe winter weather, (2) financial obstacles including lack of insurance or out-of-pocket funds for services and transportation costs, (3) physical limitations including reduced mobility, and comorbid health conditions. As a result of these obstacles, individuals in Montana do not always receive the services they need to improve and maintain their communication skills and their participation in social, vocation, and/or recreational roles.
The Big Sky Aphasia Program offers high-quality, individualized speech-language and cognitive-communication therapy through the use of HIPAA-compliant web-based telecommunication. We require an initial in-person, on-campus assessment before beginning telepractice treatment services.
We offer two weekly group sessions for individuals with aphasia during the fall, spring, and summer academic semesters. Group treatment includes small and large conversation groups and support for the person with aphasia. The Aphasia Community Group occasionally hosts guest speakers or therapists from other disciplines. Periodically, we offer a caregiver support group that occurs at the same time as the Aphasia Community Group. We expect to offer an ongoing, regularly scheduled caregiver support, training, and education group in the near future. We also offer weekly Aphasia Clubs. The Aphasia Clubs allow our participants to engage socially with other individuals with aphasia, with the support of our graduate student clinicians while engaging in activities such as card and board games, cooking, gardening, and other hobbies. Please note that we follow the University of Montana Academic Calendar for all of our group sessions.
Intensive Comprehensive Aphasia Programs (ICAPs) are a relatively new service delivery model for stroke rehabilitation. The number of ICAPs across the country is increasing as a result of a desire to approach aphasia rehabilitation from a holistic and bio-psychosocial background, while also implementing intensive treatment. Currently, the evidence suggests that intensive treatment yields the most effective treatment outcomes. The overarching goal of an ICAP is to maximize communication potential and improve the life participation. In short, ICAPs are multi-faceted and take into consideration the many aspects of communication needs faced by those affected by aphasia.
ICAPs provide a minimum of three hours of treatment per day for at least two weeks, with some programs providing as many as four to six hours per day over a period of four to five weeks. Daily treatment should include individual sessions, group sessions, and computer-based or technology-based treatment. Patient and family education should also be provided. Persons with aphasia and their carers who are enrolled in an ICAP may receive as many as 120 hours of focused language treatment over the span of one month, whereas a person who is enrolled in a standard treatment model will receive approximately 8 to 12 hours of treatment in the same time frame. While research of the ICAP model is in its infancy, initial efficacy studies indicate positive patient outcomes across a variety of impairment-based and psychosocial domains.