Initial prognosis

2.3 Individual language recovery cannot be accurately predicted immediately post stroke, therefore all individuals with post-stroke aphasia should be offered aphasia rehabilitation services.

Reference: ASC Rehabilitation Working Group, 2012: Pathway & decision-making tool
NHMRC level of Evidence: GPP

Rationale:  The Australian Stroke Coalition (ASC) report that the current literature fails to identify any clear indicators (clinical or otherwise) that could be used to definitively confirm someone as ineligible for or unlikely to benefit from rehabilitation. Based on this, the ASC Assessment for Rehabilitation: Pathway and Decision-Making Tool (ASC Working Group, 2012) recommends that all patients (including people with aphasia) be considered for rehabilitation unless they meet one of four exceptions: (i) return to pre-morbid function, (ii) palliation, (iii) coma and/or unresponsive, not simply drowsy and (iv) declined rehabilitation.

 Resource:

1. Assessment for Rehabilitation Pathway and Decision-Making Tool. The tool was developed by the Australian Stroke Coalition Rehabilitation Working Group with input from the South Australian (SA) Stroke Network Rehabilitation Working Group. The tool was designed to be used in stroke units and ideally within the first week of admission, but it can be used in other settings. Multi Disciplinary Team members complete the sections relevant to their practice; this can then be used as a basis for team communications as well as communication with the family.  The website has lots of training materials and videos to get your started. 

References:

1. Australian Stroke Coalition Rehabilitation Working Group. (2012). Assessment for Rehabilitation: Pathway and Decision-Making Tool. Melbourne, Australia: Australian Stroke Coalition