Challenges amid the pandemic (Current limitations)

Opportunities to improve care of aphasia (Future directions)

1. Overall emotional distress in PWA

・ PWA have experienced various levels of emotional distress about COVID-19 and its impact on them, their loved ones, and their communities

・ To conduct more research investigations to examine the short- and long-term effects of COVID-19 on PWA’s psychosocial well-being (Kong, 2021)

・ To review and expand existing phone or online outreach programs or “check-in” services (e.g., Ryan, 2020) to supplement regular aphasia therapy

2. Telepractice for PWA

・ Telehealth for PWA has been around for years but has not been the most popular option (Kurland, Liu, & Stokes, 2018)

・ Some PWA might not be able to transition to teletherapy amid COVID due to digital inequality (Menger, Morris, & Salis, 2016)

・ To continue to advocate and promote the application of telepractice, with reference to the COVID-related public health guidance and telehealth policy changes

・ To explore application of online programs that treat and prevent stress-related disorders in PWA (e.g., Weiner et al., 2020)

・ To monitor the sudden and unexpected growth of telepractice during COVID, which may evolve and prompt a new trend of remote or virtual PWA care in the future

3. Use of technology

・ COVID-19 prompted more PWA to turn to mobile applications and online resources for conducting home-based practice

・ Available “Aphasia apps” are still limited (Vaezipour, Campbell, Theodoros, & Russell, 2020) and predominantly available in English (National Aphasia Association, 2015)

・ To explore the use and effectiveness of digital tools (e.g., evidence-based websites, smartphone applications, or conversational agents) by PWA to ameliorate psychological symptoms (Zhang & Smith, 2020)

・ To develop more aphasia-specific applications in the future (Vaezipour, Campbell, Theodoros, & Russell, 2020)

・ To develop new and to further refine existing mobile health applications

・ To monitor the clinical use of some new initiatives on family-mediated digital aphasia training

4. Accessible information about COVID-19

・ On average, most current government/official materials with information about COVID-19 are too complex for many readers (Hirsch, 2020)

・ PWA had limited access to comprehensible and reliable health information about COVID-19

・ PWA need communicatively accessible (i.e., aphasia friendly; Rose, Worrall, Hickson, & Hoffmann, 2011) written health information about COVID-19

・ To improve and empower PWA to obtain, read, understand, and use information to make appropriate health decisions (i.e., health literacy; National Institutes of Health, 2021)

5. Family support

・ Caregivers of PWA assumed multiple important roles in the rehabilitative process and were overwhelmed (Shafer, Shafer, & Haley, 2019)

・ To examine and gain a better understanding of psychological trauma caused by COVID-19 among caregivers of PWA (Sun et al., 2020; Xiang et al., 2020)

6. PWA receiving training at home

・ Home-based intervention was relatively less common (or unavailable) in the pre-COVID era

・ To increase use of virtual clinical visits conducted from PWA’s home, given the convenience to receive therapy (which is also an incentive that PWA continue with teletherapy; Chiu, 2020)

・ To examine if and how PWA respond differently to home-based therapy, as PWA feel less intimidated in a familiar environment