by Kelsey Herbers
For Dominique Herrington, MS, assistant manager of Rehab Services for the Department of Hearing and Speech Sciences’ Pi Beta Phi Rehabilitation Institute, Thursdays are the best days to come to work.
Each week, Herrington hosts the Aphasia Group of Middle Tennessee — an all-day support group designed to help patients with aphasia understand and cope with the condition through the building of communication skills and greater independence.
A language disorder that is often acquired through a stroke in the left hemisphere of the brain, aphasia leaves a patient unable to communicate effectively with others. The condition can also be caused by tumors, a progressive disorder or trauma to the head, affecting at least 2 million people across the country with an estimated 180,000 new cases each year.
“It’s a loss of language rather than a loss of intelligence, and that’s what people oftentimes mistake,” said Herrington. “The person has difficulty communicating, but that doesn’t mean they’re incompetent. They have a language barrier.”
Herrington began her work at Vanderbilt 15 years ago, recruited from another local hospital to help establish a more comprehensive care approach for patients with aphasia, filling a large need in Middle Tennessee.
“At the time, I was taking my outpatients to a monthly meeting that was a community-based aphasia group, but it wasn’t meeting their needs. Each time I went, there was always one or two different people there — there wasn’t any consistency. That’s when I started saying, ‘We really need a group that’s about communication and helping the patient understand what aphasia is,’” said Herrington.
In 15 years, the group has tripled in attendance. The program currently serves patients ranging from age 19 to their mid-70s — some of whom have been attending since the group’s formation.
“Dominique has done a wonderful job with the Aphasia Group,” said Anne Marie Tharpe, PhD, chair of the Department of Hearing and Speech Sciences and associate director of the Vanderbilt Bill Wilkerson Center.
“Part of the group’s success comes from her idea to include so many different stakeholders — the patients, their loved ones, professionals and students. The fact that some of these patients and their families have faithfully attended these weekly group meetings for years is testament to Dominique’s approach.”
The program has a daily schedule of activities targeted at building communication and social interaction skills, such as a book club, current events discussion group, computer lab and one-on-one sessions with a patient’s dedicated partner in communication (PIC), who is typically a graduate student clinician who provides support tailored to the patient’s specific needs.
Each Thursday begins with a one-hour session between the patient and his or her PIC to review communication goals and prepare for the day’s discussions by creating scripts ahead of larger group interactions.
“With aphasia, the No. 1 side effect is that these people were a part of society and now they can’t communicate, so they end up staying home,” said Herrington. “They become depressed and lose their confidence to interact. Couples will drop out of social gatherings because people don’t know how to communicate with the individual who has aphasia. Their whole social well-being changes.”
Activities such as the current events discussion group and the program’s executive groups, which consist of more fluent patients who make decisions about the program’s direction, help re-establish a sense of community belonging by giving patients the opportunity to offer their opinions, ask each other questions and foster lasting relationships.
The program’s model also offers an educational experience for graduate students studying speech-language pathology in Vanderbilt’s Department of Hearing and Speech Sciences.
“Very rarely does a graduate student have the opportunity to sit in a room with 20 other people who all have aphasia, and everyone has a different severity of aphasia and different coping strategies. The students get to observe that. You can go through the entirety of graduate school and maybe only interact with one person with aphasia,” said Herrington.
But the skills students gain translate beyond assisting patients with language disorders.
“When students leave at the end of the semester, they should be able to use supported conversation techniques with any patients who have language barriers, including those who do not understand English,” said Herrington. “And I think getting the message across, especially in medicine, is very important. We are a medical society that relies on good communication between the patient and the provider.
“The patient needs to comprehend what is required to heal. When patients don’t understand, we have the obligation to assist them with their comprehension skills, thus leading to healthier lives. It’s amazing how everything comes back to communication,” Herrington said.
The Aphasia Group is available to individuals with aphasia who reside in Middle Tennessee. Patients can be referred by area speech-language pathologists or can be self-referred.
