Social participation in working-age adults with aphasia: an updated systematic review

Background: A previous systematic review found limited data regarding social participation in working-age people with aphasia (PWA). A review of recent studies may reveal more information on challenges in reestablishing social roles. Method: The aim was to provide an updated systematic review on social participation in PWA under 65years of age. Studies from 2005 to 2017 were searched from Scopus, Pubmed, and Psychinfo. Search terms were derived from the International Classification of Functioning, Disability and Health (ICF) and the Aphasia- Framework for Outcomes Measures (A-FROM). Aspects of domestic life, interpersonal relations and interactions, education and employment, and community, civic, and social life were investigated. Results: From 2864 initial hits, 11 studies were identified, all of which were on the American Speech-Language-Hearing Association (ASHA) Level III of evidence. The studies indicated that participation in domestic life is reduced and PWA showed reduced social networks, loss of friendships and changes in the quality of marital relations. Few PWA returned to work or spent time on education. Limitations in community, civic, and social life were noted and there were contradictory findings on the impact of contextual factors on social participation. There was an increase in research into contextual factors impacting on social participation in PWA and in the use of conceptual frameworks in the last decade. Conclusions: While the ICF conceptual framework is increasingly used, no studies used the A-FROM. There is greater use of standardized assessments and larger sample sizes.