Functional Independence Measure (SFA)

Goals and Treatment

Treatment plans and functional goals are developed based on the assessment. Although these initial goals were developed based on the information available regarding D.L.s current abilities and personal interests, as information gaps resolve (e.g., if he can type, the level of text complexity he comprehends, if there are important needs such as communicating about a medical condition), his goals may require some adjustments accordingly. Also, these goals reference terms which are based on the Functional Independence Measure (FIM; Uniform Data Set for Medical Rehabilitation, 1996). Minimal assistance means the person can perform 75% or more of task, moderate assistance means the person can perform 50% to 74% of task, and maximal

In an even slightly less-contextualized situation (e.g., if the clinician was not familiar with the movies and actors he was talking about), D.L.’s intended message may not be understood at all. Yet, if D.L. could contribute even a little more context to the exchange there would be a better chance of the message being received. Thus, Semantic Feature Analysis (SFA) offers a promising avenue to expand D.L.’s use of related words which might provide that context, more communication independence, and eventually reactivate related words in the semantic network (Chapey, 2008, p. 520) to improve word-finding overall. Indeed, SFA has been demonstrated to serve as both a functional communication facilitator and a longer-term impairment-targeted therapy for the word-finding process (Wambaugh & Ferguson, 2007, Davis & Stanton,

reported living fully independently prior to his stroke. His mother is now his primary caregiver, but he reported difficulty depending on his parents. Further, he has children who presumably do not live with him, and he indicated a desire to communicate via Facebook. Together, this information suggests that increasing social connections is likely important to him. So, in addition to improving word-finding abilities via SFA, a goal targeting activity and social participation levels seems appropriate. Moreover, given D.L. has a functional level of reading comprehension, improving his written expression would enable two-way written exchanges, thus, likely increasing his sense of independence and overall communication effectiveness with others. The full assessment would confirm his candidacy (i.e., written confrontation naming, graphomotor skills, single-word reading, and willingness to do homework), but the initial interview revealed that he printed his name, copied his address from a notebook, and was able to decode directions. Together this implies D.L. may have the prerequisite skills for