Department of Rehabilitation Medicine, University of Washington, Seattle.
Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson.
Am J Speech Lang Pathol. 2020 Aug 4;29(3):1335-1360. doi: 10.1044/2020_AJSLP-19-00043. Epub 2020 May 28.
Introduction The World Health Organization's International Classification of Functioning, Disability and Health calls on speech-language pathologists (SLPs) to provide care that impacts all aspects of an individual's experience with a communication disorder, including their participation in valued life situations. However, SLPs often report feeling unprepared to implement and document interventions that target life participation. The purpose of this article is to propose a framework to guide participation-focused intervention practices. This age- and disorder-generic framework is designed to be applicable with clients across the variety of settings in which SLPs work. Method In this clinical focus article, we draw on past research and clinical experience to propose a restructuring of World Health Organization's International Classification of Functioning, Disability and Health components such that participation is the primary focus and outcomes indicator for intervention. In this framework, a specific communicative participation situation is identified and assessed quantitatively, and a corresponding participation-focused goal is established through shared decision making. Following that, assessments are conducted and goals are established in the areas of communication skills, physical and social environments, and personal perspectives. Results The proposed framework provides a concrete organizational structure as well as assessment, goal-writing, and intervention examples to assist SLPs in translating theoretical biopsychosocial frameworks into clinical practices. Conclusions SLPs can and do provide holistic communication services to clients to help them achieve their life participation goals. This article provides an example as to how we can document the need for, as well as the value and impact of our important work, meeting the diverse life participation needs of clients. Supplemental Material https://doi.org/10.23641/asha.12360758.
简介 世界卫生组织的《国际功能、残疾和健康分类》呼吁言语-语言病理学家（SLP）提供影响个体交流障碍体验各个方面的护理，包括他们参与有价值的生活情境。然而，SLP 经常报告感到准备不足，无法实施和记录针对生活参与的干预措施。本文的目的是提出一个框架，以指导以参与为重点的干预实践。这个针对年龄和障碍的通用框架旨在适用于 SLP 工作的各种环境中的所有客户。 方法 在这篇临床重点文章中，我们借鉴了过去的研究和临床经验，提出了对世界卫生组织《国际功能、残疾和健康分类》组成部分的重新构建，以便将参与作为干预的主要焦点和结果指标。在这个框架中，确定并定量评估特定的交流参与情况，并通过共同决策建立相应的以参与为重点的目标。之后，在沟通技巧、身体和社会环境以及个人观点领域进行评估并制定目标。 结果 所提出的框架提供了一个具体的组织结构，以及评估、目标编写和干预示例，以帮助 SLP 将理论的生物心理社会框架转化为临床实践。 结论 SLP 可以为客户提供全面的沟通服务，以帮助他们实现其生活参与目标。本文提供了一个示例，说明我们如何记录我们重要工作的需求、价值和影响，以满足客户多样化的生活参与需求。 补充材料 https://doi.org/10.23641/asha.12360758.
