Aphasia Training

Let's learn about Aphasia! [[Let's start!->Q1]] <img src="http://imageshack.com/a/img633/7579/DIfLUY.jpg" alt="Smiley face" height="420" width="420">

Once upon a time an older man sat in a dark doctor's office deep in the Lakeridge Health Center. He had recently suffered a stroke. His doctor now explained that he has aphasia. [[Let's get a general definition of "aphasia". ->Q2]] <img src="http://imageshack.com/a/img903/4909/iIUYfN.jpg" alt="Man at Doctor's"> image credit: FreeStockPhotos.biz

The doctor explained all about aphasia and what the man would need to know about it. He learned that this is a disability that can get better, but from which he would likely never fully recover. He showed the man a <a href="https://www.nlm.nih.gov/medlineplus/aphasia.html" target="_blank">summary definition of aphasia from MedLine Plus.</a> Follow that link to learn a general summary definition of aphasia. The doctor hands the man a stack of cards that can be used to help others understand that he has aphasia. [[Let's see what that card can look like.->Q3]] <img src="http://imageshack.com/a/img907/9089/WhOuFc.png" alt="Smiley face"> image credit: FreeStockPhotos.biz

This is an example of what an Aphasia ID Card could look like. <img src="http://imageshack.com/a/img911/1821/y8HBv7.jpg" alt="Aphasia ID Card"> Note that there is often information about how this person would like to communicate with you. There is also his/her name on the card. This can be especially helpful so that you can address your client personally and access his/her account information if needed. So, let's role play. A client comes into the library. He approaches you without saying anything and struggles to hand you a card from his wallet. When he hands it to you, you can see that it's an aphasia ID card. What should you do next? You rip the card from his hand and openly mock him for having such a lame ID card. [[Rip card->Q4]] OR You wait patiently for him to give you the ID card and read it carefully, making sure to note any special communication barriers he might have. You greet him warmly by name and ask him, "how can I help you today?" [[Patience->Q5]]

So, you chose to rip the card out of this older gentleman's hand, huh? Well, that's some pretty terrible customer service. You should hang your head in shame. Let's try this again. <img src="http://imageshack.com/a/img908/9962/XL3TKw.jpg" alt="Smiley face"> [[Try again.->Q3]] image credit: Wikipedia: Face palm

That is some considerate customer service you just provided. Remember that people with aphasia are just going to take additional time to be able to communicate with you. Patience is going to be your best friend when dealing with people with this disability. Let's learn a few more helpful hints about how best to communicate with people with aphasia. The American Speech-Language-Hearing Association has a <a href="http://www.asha.org/public/speech/disorders/Aphasia/#communicate" target="_blank">list of 14 things to remember when communicating with people with aphasia.</a> Follow that link to read about the ASLHA's tips. Now that we understand how to communicate with people with aphasia, let’s better understand what library resources are available for this demographic. [[Resources->Q6]]

Mr. Doe, a regular at your library and an avid reader, has just explained that he has aphasia. He still wants to be able to read his stories, but he needs some accommodation. What should you do? <img src="http://imageshack.com/a/img907/6715/Ln4psg.jpg" alt="Avid Reader"> In a very loud voice, you tell him that the large print books are in the back and generally point the way. Without seeing whether he has headed in that direction, you walk away and start gossiping with your co-worker about your boss' new toupee. [[Loud voice->Q7]] OR You ask him what genre of book he likes to read. Using questions that only require short answers, you find out that he likes westerns. You then ask him if he has access to a tablet. [[Tablet->Q8]] image credit: WikiCommons: Avid Reader

Remember that people with aphasia are not deaf and yelling at them does not help them to understand more clearly what you are saying. Also, you boss is very sensitive about his toupee and you should not be gossipping about it with your co-worker. You need to try selecting a better response. [[Try again.->Q6]] <img src="http://imageshack.com/a/img907/2228/DxG3mM.jpg" alt="Toupee"> image credit: Pixabay

Wait, why did we just ask him if he has access to a tablet? Well, people who have aphasia often find interacting with a tablet to be easier than a traditional book. When using a tablet, the ability to have a word read out to them or to get a definition for a word is just a finger touch away. Also, people who have had brain injury or stroke may also have some fine motor skill difficulties. Tablets are often easier to hold and they are definitely easier to use when it comes to turning pages! Mr. Doe explains that he does not have a tablet of his own. You walk him to the IT desk and show him the variety of tablets that he can borrow from your library. You lead him to a quiet table with the tablets and you offer to help him navigate their interfaces. [[He does not have a tablet->Q9]] OR Mr. Doe tells you that he does have his own tablet, but he is unfamiliar with reading apps on it. He happens to have it on him, and you offer to help him use it. You lead him to a quiet table and you show him how to load OverDrive onto his tablet and get him logged into his account. [[He does have his own tablet->Q10]]

Trick question! There is no wrong answer to his question. Whether Mr. Doe has his own tablet or not, helping him to navigate through the interface is just good customer service! <img src="http://imageshack.com/a/img910/111/pVM5Qs.jpg" alt="Tablet"> [[Let's learn about how OverDrive can help.->Q11]] image credit: Pixabay

OverDrive has a variety of features that can work for people with aphasia. Let's examine the three main features that can be helpful. OverDrive has e-books, e-audiobooks, and read-alongs. [[Learn about OverDrive E-Books->Q12]] OR [[Learn about OverDrive E-Audiobooks->Q13]] OR [[Learn about OverDrive Read-Alongs->Q14]]

OverDrive E-Books - These can be helpful in a variety of ways. First, they are easy to access for those with fine-motor skill issues. They are able to have the font enlarged in a straight forward manner. They can offer dictionary definition for highlighted words. They can have multiple bookmarks added to the text with ease. And the collection size for e-books is extensive in our library. You know all you need to know. Aren't you clever? [[Clever->Q15]] OR You want to learn about OverDrive E-Audiobooks. [[E-Audiobooks->Q13]] OR You want to learn about OverDrive Read-Alongs. [[Read-Alongs->Q14]]

OverDrive E-Audiobooks - Sometimes, no matter how you configure an e-book, a person with aphasia may not be able to use it with ease. This is where e-audiobooks can be a real salvation. This gives people and opportunity to hear their stories. You may still have to do some configuring within the settings for OverDrive to give your client the best experience possible, but this is a simple adjustment. The speed of the voice reading the content can also be sped up or slowed down to suit your client. Remember that most tablets give the user the opportunity to increase the font size for the entire tablet in general. This may be necessary for some older clients who may also have some sight issues. Encourage clients to browse the extensive collection available to them. Help them to create a wish list of titles they would like to listen to in the future. Your brain is as full as it ever could be about OverDrive and its features. [[Brain Full->Q15]] OR You want to learn about OverDrive E-Books. [[E-Books->Q12]] OR You want to learn about OverDrive Read-Alongs. [[Read-Alongs->Q14]]

OverDrive Read-Alongs - This is a very new format that could possibly give your client the best of both worlds. Please note that because this is a very new format, there are not as many titles available yet compared to e-books and e-audiobooks. This format allows a client to have the text before them and hear the audio for it simultaneously. The sentence that is being read is highlighted while being read for ease of following. Like e-audiobooks, the speed of the voice reading the text can be sped up or slowed down. Because of the limited number of titles available right now, this might be a format that is best to test with your client so that as titles are added, you can inform your client and continue a positive dialogue. You are an OverDrive expert and no one can teach you any more about the subject. [[Expert Knowledge->Q15]] OR You want to learn about OverDrive E-Books. [[E-Books->Q12]] OR You want to learn about OverDrive E-Audiobooks. [[Audiobooks->Q13]]

You are an OverDrive Wizard! You know all there is to know about the features of this app and how to use them to help people with aphasia. So, you're clearly done learning about this disability, right? Yuppers. I feel like I could teach a university level course about aphasia now. [[Yuppers->Q16]] OR I can always learn more. What other sources of information are available? [[Learn More->Q17]] <img src="http://imageshack.com/a/img905/5453/LV0rZY.png" alt="Wizard"> image credit: Pixabay

Well, aren't you full of yourself? Unless you are an actual medical professional whose specialty is aphasia, you could probably always learn more. Why not expand your mind a tiny bit and head back? [[Try again.->Q15]] <img src="http://imageshack.com/a/img905/6026/ZFssls.jpg" alt="Shame"> image credit: Pixabay

There are many ways to have both positive and negative interactions with people with aphasia. Let's look at those now. Positive interactions are the best kind and the ones we are trying to encourage. [[Positive->Q18]] OR Negative interactions can happen and they can really damage your relationship with your client. Let's look at one and see if we can't get negotiate it a bit better. [[Negative->Q19]]

An older gentleman enters the library. You recognize him as a regular and know him to be an avid reader. You have not seen him in a while, but you still smile warmly when he enters. Being the helpful library technician that you are, you approach the man. He says something that doesn’t sound like a real word and he recognizes that you look a little confused. He hands you a card that states that he has aphasia. What do you do next? Ask him if he would like to an alternate form of communication such as any additional conversation cards that he may already have, or pen and paper. [[Alternate communication->Q20]] OR Blink and slowly creep away. [[Creep away->Q21]]

An older gentleman enters the library. You recognize him as a regular and know him to be an avid reader. You have not seen him in a while, but you still smile warmly when he enters. Being the helpful library technician that you are, approach the man. He says something that doesn’t sound like a real word and he recognizes that you look a little confused. He hands you a card that states that he has aphasia. What do you do next? You look at the card, then at him, and then back at the card. You shrug, hand the card back and say, "how can I help you?" [[Pretend the card is irrelevant->Q24]] OR You mispronounce the word "aphasia", look confused, and then lean over to your co-worker and say in a loud voice, "have you ever heard of this phalasia thing before?" [[Mispronounce a pretty easily spoken word->Q25]]

He indicates that he would like paper communication by nodding when you suggest it. To try and help, you take a pad of paper and pen and write single words: books, music, movies, computer. “What are you looking for?” you ask as you point to the first word. “Book? Music? Movies? Computer?” Some people affected by aphasia need to hear the entire list first. When you go through the list again, he nods and points when you say books. “Hi dee.” “You’re looking for books?” The man nods. “Hi dee ee.” You smile at him. “Great! I know you know who you’re looking for, but it might take me a couple of minutes to figure it out. Think you can bear with me?” “Hi dee. Hi dee ee. Ohh!” the man laughs and you laugh too because you can tell his expressions that he was making a joke. You can see that while things are progressing slowly, you are indeed making progress. What do you do next? You try and put words in his mouth by playing an elaborate game of charades and jumping in with a suggestion each time he makes a sound. [[Charades->Q22]] OR You continue to smile and start to write down book genres in which he may be interested. [[Keep going, you're doing great->Q23]]

Creeping away is never an effective way to retain clients at your library. I would suggest skulking rather than creeping because it sounds cooler… er, NO! I'm not suggesting skulking. You need to choose again. [[Try again.->Q18]] <img src="http://imageshack.com/a/img908/928/ioZ3wC.jpg" alt="Sneaking Out"> image credit: Flickr: Marcel Oosterwijk

“Hi dee!” the man says. You just look at him blankly. "I said, can I help you? Do you speak English?" “Hi dee ee!” he taps on the desk. You look over at him. “What?” “Oh Jesus,” he says, very clearly and very angrily and leaves the library. Congratulations, you just lost a patron. Now don't you just feel bad about yourself? You really should be more sensitive to people's disabilities. Perhaps consider a job that is not in the public service sector? Maybe you could kick over sand castles for a living? <img src="http://imageshack.com/a/img633/2229/cfbTxv.png" alt="Sand Castle Destroyed"> [[To experience a positive interaction->Q18]] OR [[Let's summarize what we've learned->Q26]] image credit: DeviantArt: Steph O'Dell

“Hi dee!” the man says. You just look at him blankly. You make a face and lean back in to your co-worker. "Get a load of this guy. He doesn't even know how to talk!" “Hi dee ee!” he taps on the desk. You look over at him. “What?” “Oh Jesus,” he says, very clearly and very angrily and leaves the library. Congratulations, you just lost a patron. You really are terrible at this whole "treating others the way you would want to be treated thing", aren't you? Perhaps you should consider a different line of work. Maybe you could be a person who tells young children that Santa isn't real? <img src="http://imageshack.com/a/img911/9053/jrtqIJ.jpg" alt="Santa Dead"> [[To experience a positive interaction->Q18]] OR [[Let's summarize what we've learned->Q26]] image credit: Flickr: Steve Jurvetson

While charades might be an enjoyable way to pass an afternoon, this is not how you should interact with someone with Aphasia. I mean, are you even trying? [[Try again.->Q20]] <img src="http://imageshack.com/a/img903/908/ANGk7o.jpg" alt="Charades"> image credit: Flickr: NealeA

“What kind of book are you looking for?” As you ask this, you write down “Western, Biography, Sports, Fiction, Science Fiction & Fantasy”. When you read the last option, he shakes his head with a disgusted look on his face and waves the air as if brushing it away. You go over the list again, this time as soon as you get to sports, he nods. “Yep! Hi dee!” Knowing that tablets make books more accessible, you then ask him if he has access to a tablet. Again, he nods. “Hi dee ee. Hi dee ohh!” “Have you used reading apps on it?” He looks confused so you try again. “Have you read a book on your tablet?” He shakes his head no. You smile and show him to a quiet table and show him how to use it so he can read the new Bobby Orr book. Every time you show him how to do something, he gets excited and makes funny faces to make you laugh. Once he understands how to use it, he rummages through his bag to find the other cards the doctor had given him and hands you the “thank you” card. You tell him he’s welcome and you hope to see him soon. [[To experience a negative interaction->Q19]] OR [[Let's summarize what we've learned->Q26]]

Let's summarize what we have learned today: There are clients that you will have who have something called "aphasia". It is a language and communication barrier that can be a result of brain injury or stroke. It mostly manifests itself with trouble either vocalizing the right word, vocalizing any words, or understanding the meaning of words. It can be very frustrating for those suffering with this disability to navigate through their day. It is YOUR job to make the library a safe, welcoming place for them to turn. If someone comes in to the library with aphasia, you are going to be PATIENT. You are going to make your questions as simple as possible. You are going to offer alternate forms of communication. You are going to inform these clients about alternate technologies that might be available to them. YOU ARE GOING TO BE SENSITIVE. If in doubt, or if you are struggling, do not hesitate to call for your supervisor. It is more important that our clients have a positive experience in the library than being able to accomodate them entirely on your own. You should be proud of yourself. You have learned something new! And now you are better equipped to meet the needs of our clientele! <a href="http://cdn.meme.am/instances/500x/62371882.jpg" target="_blank">Click here to get your prize!</a>