Beginning With the End

Outcome-Driven Assessment and Intervention With Life Participation in Mind

Abstract

This article suggests outcome measurement practices in aphasia in line with the World Health Organization's definition of health, as well as with current legislation. That is, the choice of aphasia assessment and intervention strategies should be directly influenced by outcome goals related to life participation in its broadest sense. This requires that speech–language pathologists broaden conceptions about how to measure successful outcomes. Currently, however, there is no simple, overarching aphasia framework for having this discussion. The authors describe a recently developed conceptual guide—Living With Aphasia: Framework for Outcome Measurement—that is compatible with the World Health Organization's International Classification of Functioning, Disability and Health (WHO ICF, 2001) and that has direct application to aphasia. In a simple schematic, Living With Aphasia: Framework for Outcome Measurement clearly shows the overlap between 4 domains (impairment, participation, environment, and personal factors) and quality of life. Using these domains, the article provides selected examples of using life participation goals to influence how and where intervention is needed along the healthcare pathway.