APSU combines speech therapy with photography to treat aphasia through free community program

By: Ethan Steinquest February 19, 2024

Jim Dunn and his wife, Pat, share an embrace during the CCC-ICAP’s closing photo exhibition. Dunn, a retired businessman, incorporated several family photos into his display. | Photo by Jaylon Gonzales, APSU student

CLARKSVILLE, Tenn. - Austin Peay State University’s Speech-Language & Swallowing Community Clinic recently wrapped up a free two-week program aimed at treating individuals with aphasia, a language disorder that disrupts the ability to understand or express speech, and the experience proved life-changing for clients like Kim Dettwiller Burton.

Burton, the president and owner of the public relations company Team Strategies, LLC, was diagnosed with aphasia following a stroke two years ago, and it directly impacted the communication skills she uses to succeed in her career.

However, the Clarksville Conversation Care – Intensive Comprehensive Aphasia Program (CCC-ICAP) offered intensive treatment that helped Burton regain her self-assurance as a speaker, and she publicly introduced a photography exhibit that capped off the program on Feb. 2.

“The program has given me my confidence back when it comes to speaking and writing the words I need to use to communicate,” she said. “When you have a stroke, you become more guarded about being public because you feel challenged with your ability to speak. It also wears you out, you’re tired. This program gives you the tools to help and challenges you to get better in the process.”

Kim Dettwiller Burton’s photography exhibit includes a picture of a finished crossword puzzle, a hobby she was able to reengage with through treatment for aphasia. | Photo by Jaylon Gonzales, APSU student

An opportunity for expression

Three clients and their loved ones took part in the CCC-ICAP, which was funded through a Clarksville-Montgomery County Community Health Foundation grant. The program’s structure was based on emerging studies that suggest short-term intensive treatment can provide lasting benefits for aphasia patients, and provided 31 hours of treatment over two weeks as compared to the traditional one hour per week.

“The comprehensive aspect of the program is designed to maximize functional communication by encouraging persons with chronic aphasia to use all communication means they have at their disposal,” said Dr. Kelly Kleinhans, associate professor and program director for Austin Peay’s Master of Speech-Language-Pathology (MSLP) program. “It is comprised of individualized treatment plans to focus on language interventions and quality of life for all those affected by aphasia. ICAPs are important because typically rehabilitation for persons with aphasia is exclusively in the acute stage post-stroke.”

Austin Peay’s clinic provided a combination of individualized and group therapy sessions, family support groups and hands-on experience with assistive technologies. Along the way, clients learned photography skills and created a public exhibition hosted on Feb. 2 in the Trahern Building that allowed them to share their stories with the community.

“The big missing piece with persons with chronic aphasia is that they often don’t get the full range of participation in their social roles that they did before the onset of the aphasia,” Kleinhans said. “The photo exhibit was an opportunity for them to talk about authentic things and meaningful experiences, how aphasia has affected their lives and how they manage.”

According to Kleinhans, the idea came from a participatory research methodology that has allowed other marginalized groups to document their lived experiences through photographs and interviews in group settings.

“It seemed like a logical extension to apply the concept to persons living with aphasia,” she said. “There is a small body of literature on using this approach with individuals who have had a stroke, so we adapted it for the CCC-ICAP … [and] it enabled participants to share their trials and victories. We even had a photographer come in and teach them a little bit about taking pictures to ease any concerns about taking photographs.”

Dr. Becky Glass discusses the meaning behind her photography with community members at the Trahern Building during an exhibition hosted on Feb. 2. | Photo by Jaylon Gonzales, APSU student

Dr. Becky Glass, a retired professor of exercise physiology who taught at Austin Peay for 32 years, used her exhibit to showcase her outdoor lifestyle and help people understand how primary progressive aphasia impacts her speech. While she can understand what others are saying as well as she did before her diagnosis, she has difficulty expressing her own thoughts.

“[In one of my photos], there’s a bucket,” she said. “When you see the bucket, when I talk to someone, I want to get it out. I used to be a teacher – when I start talking, I want to say the words right. With the bucket, it was raining outside, and water was coming down. That bucket holds the words I want to say, but it’s hard to get it out.”

Graduate students from Austin Peay’s Master of Speech-Language Pathology (MSLP) program welcome community members to the CCC-ICAP’s closing photo exhibition. | Photo by Jaylon Gonzales, APSU student

Shaping future speech therapists

Emili Dyce, a graduate student in the MSLP program, worked closely with Dr. Glass during the CCC-ICAP, providing one-on-one therapy sessions with supervision from credentialed faculty.

“I saw tremendous improvement, and I’m so proud of her,” she said. “It’s amazing to be able to look at her now and watch her fluently explain all the photographs she has taken throughout the course to these people who are coming in to visit.”

Dyce said the program also gave her and her classmates valuable clinical experience and helped them to better understand aphasia.

“This definitely helped me learn a lot, and I feel like it gave me a more hands-on experience than reading a book and having to figure it out,” she said. “We also learned about the statistics of people who know what aphasia is, and it’s around 8.8%. I think this was a great opportunity to bring awareness to the condition, and I would like for the public to learn more and educate themselves on what it is.”

Shelby Koonce, another graduate student in the MSLP program, organized the photo exhibit to spread awareness of aphasia within the community while leading group therapy sessions and family support groups throughout the CCC-ICAP.

“Aphasia is an experience that a lot of people don’t understand, so for the caregivers to be able to come together and relate to each other was really beneficial,” she said. “In the group for the clients, we were also able to help them communicate with each other in really unique ways. We used whiteboards, gestures and slowed speech to help get the message to people because input and output can be challenging.”

From left: Kim Dettwiller Burton, Jim Dunn and Dr. Becky Glass celebrate the progress they made through the CCC-ICAP. | Photo by Jaylon Gonzales, APSU student

Finding renewed confidence

The clients’ efforts paid off, and by the time the program wrapped up, they were eager to use the techniques they had learned to meet new people and talk about their photographs.

“It was amazing to see how much more confidence they had when communicating with others and how they learned skills with their individual therapists that have translated into group settings,” Koonce said. “I’ve seen them using those skills today in the gallery as well … the turnout has been great to see, and I think the clients are really enjoying getting to tell people about things that are meaningful to them.”

Jim Dunn, a retired businessman who founded Dunn Insurance, Inc., filled his exhibition space with photos of his wife Pat and children Jim, David and Dana. The images captured everything from board games and family get-togethers to a night out at the Nashville Symphony Orchestra.

Dunn, whose aphasia affects his ability to understand language and form sentences, said he appreciated the chance to meet others who have been diagnosed with the condition and work on his communication skills.

“I’m not [totally] there, but I’m better, yes, from the school,” he said. “The fact is we can know that people are like me. Speech is straight, and through the brain is a little spot that’s bad … but a lot in my brain is still there. And we’re going to the future.”

Austin Peay’s Speech-Language & Swallowing Community Clinic is planning another ICAP this summer and hopes to offer them once a year moving forward, based on the inaugural program’s success.

“Anecdotally, you can see that the clients’ confidence in their own ability to communicate increased tremendously,” said Jennifer Brandon, clinical education coordinator and clinical assistant professor for the MSLP program. “It exceeded my expectations for what we were able to do. The students learned so much, the clients benefited tremendously and everyone had a wonderful time.”

For more information on the Speech-Language & Swallowing Community Clinic or to sign up for a future program, call Brandon at 931-221-1623.