Bijoyaa Mohapatra

Purpose: Stroke is the leading cause of aphasia, disproportionately impacting racially and ethnically diverse populations. With the aging and diversification of the U.S. population, stroke-related aphasia prevalence is expected to rise significantly. This article estimates projected prevalence trends of poststroke aphasia through 2050, focusing explicitly on racial/ethnic differences and contributing social determinants of health (SDOH). Method: This article synthesizes national epidemiological data on stroke prevalence, integrating population projections from the U.S. Census Bureau and public health sources to assess the expected rise in aphasia across racial and ethnic groups. A brief review of literature on SDOH, including socioeconomic status, health care access, and neighborhood factors, is included to contextualize disparities observed in projected aphasia prevalence. Results: The findings demonstrate significant disparities in stroke and aphasia prevalence across different racial and ethnic groups. Specifically, by 2050, poststroke aphasia cases are projected to nearly double, with the Black population expected to have the highest prevalence rate among all racial and ethnic groups. These trends are driven by demographic shifts, including the aging population and racial/ethnic diversification. Discussion: The findings highlight the need for targeted health care interventions that address disparities rooted in SDOH affecting stroke and aphasia care. Key priorities include expanding culturally responsive speech-language services, improving access to preventive care and poststroke rehabilitation, and supporting high-risk regions like the Stroke Belt. Integrating demographic and SDOH factors into public health planning and workforce development is essential to reduce the growing burden of stroke-related aphasia and prevent deepening health disparities. Supplemental Material: https://doi.org/10.23641/asha.31141657

Dementia is a progressive condition that affects cognition, communication, mobility, and independence, posing growing challenges for individuals, caregivers, and healthcare systems. While traditional care models often focus on symptom management in later stages, emerging artificial intelligence (AI) technologies offer new opportunities for proactive and personalized support across the dementia trajectory. This concept paper presents the Assistive Intelligence framework, which aligns AI-powered interventions with each stage of dementia: preclinical, mild, moderate, and severe. These are mapped across four core domains: cognition, mental health, physical health and independence, and caregiver support. We illustrate how AI applications, including generative AI, natural language processing, and sensor-based monitoring, can enable early detection, cognitive stimulation, emotional support, safe daily functioning, and reduced caregiver burden. The paper also addresses critical implementation considerations such as interoperability, usability, and scalability, and examines ethical challenges related to privacy, fairness, and explainability. We propose a research and innovation roadmap to guide the responsible development, validation, and dissemination of AI technologies that are adaptive, inclusive, and centered on individual well-being. By advancing this framework, we aim to promote equitable and person-centered dementia care that evolves with individuals’ changing needs.

Purpose: Although there are several reports of attention deficits in aphasia, studies are typically limited to a single component within this complex domain. Furthermore, interpretation of results is affected by small sample size, intraindividual variability, task complexity, or nonparametric statistical models of performance comparison. The purpose of this study is to explore multiple subcomponents of attention in persons with aphasia (PWA) and compare findings and implications from various statistical methods—nonparametric, mixed analysis of variance (ANOVA), and linear mixed-effects model (LMEM)—when applied to a small sample size. Method: Eleven PWA and nine age- and education-matched healthy controls (HCs) completed the computer-based Attention Network Test (ANT). ANT examines the effects of four types of warning cues (no, double, central, spatial) and two flanker conditions (congruent, incongruent) to provide an efficient way to assess the three subcomponents of attention (alerting, orienting, and executive control). Individual response time and accuracy data from each participant are considered for data analysis. Results: Nonparametric analyses showed no significant differences between the groups on the three subcomponents of attention. Both mixed ANOVA and LMEM showed statistical significance on alerting effect in HCs, orienting effect in PWA, and executive control effect in both PWA and HCs. However, LMEM analyses additionally highlighted significant differences between the groups (PWA vs. HCs) for executive control effect, which were not evident on either ANOVA or nonparametric tests. Conclusions: By considering the random effect of participant ID, LMEM was able to show deficits in alerting and executive control ability in PWA when compared to HCs. LMEM accounts for the intraindividual variability based on individual response time performances instead of relying on measures of central tendencies.

The purpose of this study is to evaluate the outcomes of a remotely delivered collaborative storytelling program based on the TimeslipsTM approach in persons with aphasia (PWA). The program aims to...

Review question / Objective: Review Questions: 1. What are the publicly available databases that can identified in Complementary and Integrative Medicine (CIM) studies? 2. What are the main characteristics of these studies? 3. Which of the CIM studies identified are associated with rehabilitation? Objectives 1. To create a tool for future research approaches based on lessons from the studies identified - hence promoting robust scientific protocols in its pursuit – for better acceptance by scientists, practitioners, and end-users. 2. To map and review open access databases that include CIM related data as defined by the National Institute of Health in 2012. 3. To highlight a subset of CIM studies that are associated with rehabilitation; to be identified as CIRM and promote it as an inclusive rehabilitative modality. 4. To guide future research on Complementary and Integrative Medicine. 5. To stimulate future research in Complementary and Integrative Medicine. 6. To promote evidence-based practice in Complementary and Integrative Medicine.

Aims: The purpose of this study is to evaluate the outcomes of a remotely delivered collaborative storytelling program based on the TimeslipsTM approach in persons with aphasia (PWA). The program aims to improve social interaction, communication, and participation through a guided experience. Methods: Six PWA of mild-moderate severity and of fluent and nonfluent types participated in the program twice a week for seven weeks. They collaboratively created 28 free-form stories from staged pictures. PWA were tested pre- and post-treatment on several validated outcome measures representing each of the Living with Aphasia: Framework for Outcome Measurement (A-FROM) domains. PWA self-rated on group therapeutic factors and program satisfaction scales. To assess the benefits of the program, the results were analysed for clinical significance (reliable change index) and meaningfulness for each of the outcome measures.Results: Comparison between pre- and post-test scores yielded clinical significance among all participants on at least one A-FROM domain and most participants improved on communication confidence, functional communication, and overall language abilities. All participants’ ratings of perceived group therapeutic factors and satisfaction with the program were high. Conclusions: The findings provide preliminary evidence for the effectiveness of a collaborative storytelling program for PWA. Such a program may have an important place in aphasia rehabilitation in improving psychosocial and communication deficits through engagement in creative arts. Large-scale studies with rigorous mixed-methods designs are needed to build on the present findings.Key words: group therapy, reliable change index, TimeSlips, functional communication, life participation

Purpose: Despite the growing clinical and research advances in communication sciences and disorders (CSD), health disparities persist by race/ethnicity and socioeconomic status among patients. A diverse CSD workforce can improve access to services and reduce health care disparities for diverse populations. Increasing diversity of the workforce begins with recruiting and training a diverse student body in CSD academic programs. In the absence of relevant literature in CSD, the primary objective of this tutorial is to introduce readers to successful diversity and inclusion programs in health-related disciplines such as nursing, medicine, rehabilitation sciences, public health, and clinical psychology, as well as provide recommendations for developing a racially and ethnically diverse and inclusive CSD academic program. Conclusions: We group the evidence from other health-related academic programs for increasing diversity and inclusion under three headings—(a) recruitment, (b) inclusion, and (c) retention of underrepresented racial and ethnic minority (UREM) students. Based on this information, we have designed the Recruit–Equip–Access–Progress model to illustrate the strategies for a diverse and inclusive CSD training program. We recommend the following for UREM students in this model—(a) developing pipeline programs, institutional partnerships, and holistic admissions reviews; (b) equipping students with academic and financial supports; (c) providing students access to faculty and peer mentors; and (d) evaluating outcomes and processes associated with student and program success. Given the limited literature concerning successful diversity initiatives in our field, we encourage administrators and educators to implement these strategies, systematically evaluate the outcomes, and publish the results for other programs to adopt.

Purpose: This article presents a viewpoint highlighting concerns regarding currently available assessments of working memory in adults with neurogenic communication disorders. Additionally, we provide recommendations for improving working memory assessment in this population.Method: This viewpoint includes a critique of clinical and experimental working memory tests relevant to speech-language pathologists. We consider the terminology used to describe memory, as well as discuss language demands and test construction.Results: Clinical and experimental testing of working memory in adults with neurogenic communication disorders is challenged due to theoretical, methodological, and practical limitations. The major limitations are characterized as linguistic and task demands, presentation and response modality effects, test administration, and scoring parameters. Taking these limitations into consideration, several modifications to working memory testing and their relevance to neurogenic populations are discussed.Conclusions: The recommendations provided in this article can better guide clinicians and researchers to advocate for improved tests of working memory in adults with neurogenic communication disorders. Future research should continue to address these concerns and consider our recommendations.

Background/Aims There is growing evidence to suggest that cognitive processes, in particular working memory and executive functions, are related to language functions such as syntactic processing, reading comprehension, narration and conversational discourse. This article offers rehabilitation considerations for speech-language pathologists to include cognitive assessment and treatment in their clinical practice. The information presented will also be useful in promoting multidisciplinary rehabilitation. Methods A critical review of the literature on the interaction between cognitive processes and linguistic functions in communication disorders was undertaken. Specific key terms including but not limited to executive functioning, working memory, language, assessment, intervention and communication disorders were searched on the Google Scholar database. Relevant literature from the last three decades pertaining to cognitive behavior, assessment and intervention in communication disorders of all age groups and severities is included in the review. Results The review presents analyses of the multidimensional and dynamic interaction of language and cognition in children (specific language impairment, attention deficit hyperactivity disorder, stuttering) and adults (traumatic brain injury, stroke, dementia) with communication disorders. The article elaborates on the speech-language pathologist's scope of practice in cognitive assessment and intervention that are consistent with the World Health Organization's International Classification of Functioning, Disability and Health framework. Conclusions By documenting cognitive-communication behaviour, speech-language pathologists are able to effectively contribute to the clinical assessment and management of cognitive deficits. However, future research efforts are required to develop clinically reliable tests of cognitive functioning in communication disorders and promote evidence-based cognitive treatment practices.