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APPEAR - Praxis Aphasia. Pilotstudy for evaluation as an associative recherche

Background and aims

In 2001 the Conference of Swiss Health Ministers recommended adoption of the International Classification of Functioning, Disability and Health (ICF), which likewise applies to speech therapy. Practising speech therapists are familiar with and advocate this standard classification. The initiators of the pilot study APPEAR suspect, however, that implementation is not yet sufficiently underway as a result of conceptual, organisational and professional barriers. It would be valuable to ascertain what barriers exist in Switzerland, Germany and Austria in order to derive successful visions.


The key questions for APPEAR are:

  • Does practice in relation to ICF and aphasia in a rehabilitation context reveal a difference between status and target (measured against standards, Aphasia Guidelines and ICF as required by the Conference of Health Ministers)?
  • What needs to happen to move forward conceptually and practically towards implementing ICF in actual practice?
  • Are there any country-specific concepts and premises relating to ICF that should be taken into account?


For the purposes of the study, a survey is being conducted of heads of speech therapy units in rehabilitation clinics in Switzerland, Germany and Austria. The researchers have focused on clinics where aphasia plays a major part in rehabilitation, on patients in a stable, post-acute condition, and on return to work and a continued ability to live independently as rehabilitation aims. Clinics with a focus on dysphagia, acute patients and geriatric rehabilitation have been excluded.


The study found that the idea of ICF had become established in speech therapy practice in all three countries (Germany, Austria and Switzerland). For a focus on the context, however, further developments are needed:

  • Inter-professional identification of objectives and documentation is being implemented in rehabilitation institutions in all countries; however, further discussion on specific framework conditions of cooperation and the importance of a focus on the context is needed.
  • In the narrower speech therapy field of work, there is a lack of concepts for context-oriented diagnostics and context-oriented therapy. This conceptual gap needs to be remedied.
  • To assess the success of speech rehabilitation, referrers (physicians) refer to test results. But test results are of limited usefulness in measuring the fit for the context; what is needed here is communication for a commitment and for an expanded perspective.
  • Committed work in inpatient settings is undermined, if transfer of the patient to outpatient care does not succeed or not with the necessary number of therapy hours. Stagnation at this intersection is unsatisfactory for all involved and calls for revision of the process.
  • Future research in aphasia should be more participatory in orientation, with inclusion of persons affected.



Project Management

Prof. Dr. habil.   Steiner



Forschung und Entwicklung
Tel: +41 44 317 11 81

zfe[at] zfe