Examining aphasia rehabilitation in Colombia from the perspective of speech-language pathologists and neuropsychologists: a pilot study

Background
Clinicians such as speech-language pathologists (SLPs) and neuropsychologists play a central role in the rehabilitation process of people with aphasia (PWA). Some studies, mostly from the Global North, have reported training, assessment, and treatment practices, as well as facilitators and barriers faced by clinicians working with PWA. However, less is known about these topics from the perspectives of clinicians working with PWA in the Global South. Understanding clinical practices in these countries can help to identify gaps in aphasia rehabilitation services and guide tailored implementation strategies to improve aphasia care in the Global South. This pilot study aims to contribute to this broader understanding by focusing on the experiences and perspectives of clinicians working with PWA in Colombia.

Aims
The current pilot study had three aims, to: 1) describe the aphasia training received and the training needs perceived by SLPs and neuropsychologists working with PWA in Colombia; 2) report the assessment and treatment practices used when working with PWA in Colombia; and 3) outline the main facilitators and barriers to providing rehabilitation services to PWA in Colombia

Methods and Procedures
Five SLPs and five neuropsychologists working with PWA in Colombia participated in this study. In-depth interviews were conducted to explore participants’ training, assessment, treatment practices, and perceived facilitators and barriers to aphasia care. A thematic analysis was employed to identify key themes emerging from the interviews

Outcomes and Results
Eleven key themes emerged from the thematic analysis. These themes were organized into four groups: training characteristics and resources, usual clinical practice characteristics in aphasia, facilitators of clinical practice, and barriers to clinical practice. Overall, clinicians perceived aphasia training to be insufficient. Perceived barriers included a lack of assessments and treatments adapted to the Colombian context, and Spanish-speaking patients. There were also barriers associated with the Colombian healthcare system, where some administrative processes hindered access and continuous rehabilitation services for PWA. Facilitators included some features of the universal healthcare system in Colombia and the ample number of qualified clinicians who could potentially work with aphasia.

Conclusions
Our findings underscore the need to expand aphasia research in the Global South. Describing the training, assessment, and treatment practices, as well as systemic facilitators and barriers perceived by clinicians working with PWA in Colombia, is the first step toward understanding what implementation targets and strategies could meaningfully improve aphasia care in the country.