EVERYDAY READING AND WRITING IN APHASIA - ROLE CHANGE AND THE INFLUENCE OF PREMORBID LITERACY PRACTICE

This qualitative study details the findings resulting from semi-struct ured interviews undertaken with 20 aphasic people and, in some cases, their partners. The aim of the study was to establish factors which mi ght affect the focus of functional reading and writing therapy. This w as done by investigating the aphasic respondents' level of pre-morbid and current involvement with a range of roles in a variety of contexts . The literacy practices associated with the roles and the perceived r easons for changes in the roles were delineated. Aspects of pre-morbid literacy practice were described, including the use of social network s, procedures such as drafting and editing in the composition of text, and technical aids. Current use of these practices was also delineate d. Pre-morbid and current roles were found to be variable, and gains a s well as losses in roles were reported subsequent to the onset of aph asia. Many perceived reasons for change were given, aphasia not always being seen as the predominant factor causing change. Idiosyncratic pa tterns of pre-morbid and current literacy practice suggest that functi onal assessment and therapy should not be prescriptive, and that indep endence may not always be an appropriate gear for rehabilitation. Thre e levels of functional therapy are suggested: activities, strategies a nd adjustment. Assessment and therapy of this kind may be more sensiti ve to the patterns of written language use delineated by contemporary research into literacy.