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About PIRATE

VA Pittsburgh’s Program for Intensive Residential Aphasia Treatment and Education (PIRATE) provides treatment to Veterans and active duty service members with aphasia. Aphasia is a language disorder that limits a person’s ability to understand language, speak, read, and write.

Treatment through PIRATE can help patients improve their listening, speaking, reading, or writing abilities, and may include the use of communication technology.

PIRATE is offered throughout the year with a maximum of six sessions per year. Each session is four weeks long, and therapy takes place on weekdays during business hours. Patients’ family members can participate in select educational and therapy sessions.

PIRATE philosophy of care

Our integrated team of clinical providers, educators, and scientist-practitioners is dedicated to improving the functioning and well being of people with aphasia.

We believe that:

• Aphasia recovery continues for many years beyond the time of stroke or brain injury.
• Aphasia therapy should focus on improving impaired language functions, training the use of compensatory strategies, or both.
• Aphasia therapy is effective whether provided one-on-one or in a group setting.
• Intensive aphasia therapy can help bring about the most treatment-related gains in the shortest amount of time.
• Each person with aphasia, along with their significant others and their providers, should determine their own treatment goals.
• Creating a supportive environment and community for people with aphasia enhances the recovery process.
• When people with aphasia are able to use newly acquired skills and strategies outside of the therapy room, their confidence and ability to communicate effectively improve.
• Assistive technologies— for example, social media and apps for tablet computers and smartphones — can provide opportunities for communication support and continued practice of treatment activities.

We strive to:

• Increase access to evidence-based, individualized intensive aphasia treatment, counseling, and education.
• Help people with aphasia improve their ability to communicate both with people at home and in the community.
• Empower people with aphasia to become strong self-advocates so they can clearly communicate their needs, act to help others with aphasia, and raise public aphasia awareness.
• Provide social and emotional support to people with aphasia and their significant others.
• Improve clinical care and contribute to the existing evidence base by conducting controlled clinical trials and fostering a collaborative clinician/researcher environment.
• Engage with and educate community members and other healthcare professionals through the use of sponsored summits and conferences.

Apply for PIRATE

If you or a family member is interested in participating in the PIRATE program, please complete an application and return it to Mary Sullivan. You may fax or mail your completed application.

Fax: 412-360-6426
Mail:
VA Pittsburgh Healthcare System
PIRATE, ATTN Mary Sullivan
University Drive, 112 SP-U
Pittsburgh, PA 15240

Your VA primary care physician must also submit a consult request to PIRATE.

• Outside of VISN 4, the physician should use an e-consultation request form.
• Within VISN 4, the physician should send an electronic speech pathology consult through VISTA/CPRS for “Residential Aphasia Treatment and Education.”

PIRATE staff will review your application materials and VA medical records to determine whether you’re eligible for an application; participation in an evaluation doesn’t guarantee acceptance into PIRATE.

PIRATE speech-language pathologists, medical staff, and occupational therapists will also evaluate you before you’re allowed to participate in the program.

What our clients are saying

We gauge our success based on our clients’ progress and their satisfaction with the treatment they receive. Here’s what some of our former participants have said about the PIRATE program:

"I am sure that this program did make me better to use writing and reading. I will have it for forever and ever." — A former participant 

"For us, PIRATE is much more than speech pathology. So far you and the others have performed a minor miracle in Dan's personal life. We hope to continue the gains." — Father of a former participant

"It was great. I'll recommend it to everyone. Thank you so much for sending me there." — A former participant

"Thanks for giving me my life back." — A former participant

Program outcomes

One of the ways we measure the success of the PIRATE program is using outcome tools. We collect two kinds of data. First, we ask participants to rate their own effectiveness in communicating using the Aphasia Communication Outcome Measure (ACOM; Hula et al., 2015).

Second, we collect a performance-based measure of participants’ communication ability using the  Comprehensive Aphasia Test (CAT; Swinburn et al., 2004). This test asks participants to perform specific communication tasks, such as naming objects, pointing to pictures named by the examiner, or reading aloud.

We collect data on both types of outcome measures before they begin PIRATE (baseline measurement), at PIRATE Entry, PIRATE Exit, and again 3-4 weeks after PIRATE completion for PIRATE Follow-up (ACOM only at Follow-up).

In response to the COVID-19 pandemic, we began offering virtual PIRATE sessions. The outcomes from these sessions are not included in those reported in Figures 1 and 2.  However, we are also collecting ACOM and CAT data on these virtual sessions, with preliminary results also showing improvements in participants who have completed the PIRATE program virtually.

Figure 1. Percentage of PIRATE patients demonstrating positive outcomes on each of three kinds of measures.

Figure 2 shows the average score on each measure at each time point. The scores in Figure 2 are given on a percentile scale, meaning that the observed score is equal to or higher than the corresponding percentage of patients from a large reference sample.

For example, the surrogate-reported scores on the SUR-ACOM were at the 28th percentile at PIRATE entry and were at the 49th percentile at follow-up. This means that, on average, Veterans participating in PIRATE scored higher than 28% of patients in a large reference sample before PIRATE and higher than 49% of patients after PIRATE.

Figure 2. Average percentile scores on PIRATE outcome measures by measurement point.

References

1. Doyle PJ, Hula WD, Austermann Hula SN, Stone CA, Wambaugh JL, Ross KB, Schumacher JG. Self- and surrogate-reported communication functioning in aphasia. Quality of Life Research 2012.

2. Porch B. Porch index of communicative ability. Albuquerque, NM: PICA Programs; 2001.

3. Swinburn, K, Porter, G, Howard, D. Comprehensive Aphasia Test. New York, NY: Psychology Press: 2004.

Contact us

If you have questions about the PIRATE program, please contact Mary Sullivan, the program Intake Coordinator and Caseworker.

Phone: 412-360-6472
Email: mary.sullivan@va.gov
Mail:
VA Pittsburgh Healthcare System
PIRATE, ATTN Mary Sullivan
University Drive, 112 SP-U
Pittsburgh, PA  15240

Frequently asked questions

Aphasia-friendly documents