A - 25 Without Words: Relational Neuropsychology and Creative Arts Therapies with People Managing Aphasia

Abstract Objective Common approaches to functional rehabilitation with persons managing aphasia after stroke highlight conversation and semantic retrieval, with a lack of evidence considering the diversity of physiological, social–emotional, and psychiatric symptoms and responses. Further, evidence shows high dropout rates and limited engagement for post-stroke therapies. This research considered: How does participating in a neuropsychologically-informed creative arts therapy program influence cognitive and clinical therapeutic outcomes for a person with aphasia? Method A 64-year-old White man presented mixed conduction aphasia following left middle cerebral artery stroke in the temporal parietal region. Burden of Stroke Scales, Western Aphasia Battery, Montreal Cognitive Assessment, and Rey Complex Figure Tasks indicated moderate aphasia, diffuse cognitive impairment with severe memory impairment, and functional difficulties with communication, social relationships, and mood. The patient participated in six 1-¼ hour creative arts therapies with a clinical neuropsychology doctoral candidate co-located in a speech-language-hearing clinic. Results The patient actively participated in all individualized arts-based directives with complete adherence to specific session goals. Outcomes evidenced clinically significant improvements in tasks evaluating perceptual-motor, executive function, and memory domains of function. Linguistic inquiry and analysis software indicated reduction in nonfluencies and increased use of affective language. Clinical therapeutic outcomes included improved mood, engagement, and relational experiences assessed at session- and program- levels. Conclusions Multi-modal, low-verbal approaches for assessment and rehabilitation after stroke improve individualized approaches to treatment beyond semantic retrieval. Clinical neuropsychologists are well-placed to inform psychotherapies for this unique symptom-clustered condition, and creative arts therapies show promise in improvements in cognitive and social–emotional domains of function.