A Survey on the Speech Therapy Rehabilitation Landscape for Aphasia in Brazil

Purpose: to evaluate characteristics of aphasia rehabilitation, its barriers, and differences according to educational level (undergraduate level in speech-language pathology (SLP) or otherwise, professional qualification, Master's or Doctoral/Post-doctoral degree) and region of Brazil. Methods: A cross-sectional, quantitative, exploratory, analytical survey study was conducted. Speech therapists who work with people with aphasia (PwA) were invited to answer the online survey. Participants were recruited through the Brazilian Society of Speech-Language Pathology and Audiology and by snowball sampling. Results: Of the 103 participants, 55 (53%) were from the Southeast region, 55 (53.4%) held an SLP undergraduate or professional specialization degree only, 21 (20.4%) a Master's, and 27 (26.2%) a Doctoral or Post-doctoral degrees. Standardized instruments for assessing aphasia were used by 51 (49.5%) respondents. Functional therapy was used in 99% of cases. Professionals holding Doctoral or Post-doctoral degrees had a greater level of engagement in conferences (p=0.014) and in professional associations/societies than therapists qualified with lower education degrees (p<0.001). The high-educated group worked more with PWA during the year (p=0.002) and with more public health system users (p=0.002). These professionals also made greater use of telerehabilitation (p<0.001), group therapy approaches (p=0.015), and Transcranial Direct Current Stimulation (p=0.009). Additionally, they charged higher private consultation fees (p<0.001) and were predominantly from the Southeast region (p=0.047). Professionals from the South region delivered more outpatient care to PwA (p=0.007). All participants from the Southeast region used a multimodal therapy approach (p=0.021). For chronic PwA, professionals holding a Doctoral or Postdoctoral degree (p=0.035), and those from the Southeast region (p=0.049) provided therapy for longer. Conclusion: Results revealed differences in type of therapeutic approach, assessment instruments and duration of aphasia treatment, according to region and postgraduate level of education. Future studies should investigate the causes of these disparities, along with barriers or approach preferences that may stem from undergraduate training and impact aphasia treatment approaches in Brazil.