The rehabilitation of numerical processing and calculation in aphasia: An international survey of speech-language pathologists

Background: A high proportion of people with aphasia may have substantial difficulties with numerical processing and calculation. Such difficulties are likely to have a significant emotional and practical effect on individuals. However, numeracy difficulties are rarely assessed or managed clinically. This study aims to provide insight into speech-language pathologists’ (SLPs’) experiences of and attitudes towards supporting individuals with numeracy difficulties.Methodology: We disseminated an online survey to reach a representative sample of SLPs in the United States and United Kingdom. Sixty three respondents completed the survey comprising 22 items, collecting information about: difficulties observed in numerical processing and calculation; work carried out to address these; possible facilitators and barriers for work on numeracy.Results: SLPs reported observing a range of difficulties in numerical processing (e.g. counting, transcoding) and calculation (e.g. addition, multiplication), as well as in functional numeracy skills (e.g. paying bills, calculating a tip), but low levels of confidence regarding their assessment and treatment. Where difficulties were addressed in intervention, this most often targeted functional skills. Barriers to working on numeracy included a lack of standards relating to management of difficulties as well as appropriate assessments and intervention approaches.Discussion: Respondents felt that numeracy was relevant in their work but that additional training would be beneficial. Future work could explore the effects of incorporating numeracy into clinical training on outcomes for aphasic individuals. The development of more assessments and evidence-based interventions for numeracy difficulties in aphasia could help to improve the management of this largely unmet clinical need.