Welcome to the 25th annual meeting of the Clinical Aphasiology Conference.

In 1971 in Albuquerque, Dr. Bruce Porch, convened the first Clinical Aphasiology Conference. Since that first meeting, many people have contributed to C.A.C., through their leadership and through their contribution to papers and discussion. This, our Silver Anniversary, is dedicated to all of you.

My opening remarks were inspired by a story in a New York Times editorial about a French woman who turned 120 years old this past February. At the age of 13 (106 years ago), she met Vincent van Gogh. Sadly, she did not speak with him, leaving the sound of his voice lost for all time.

So, inspired by this story, I sent audiotapes to all past conference chairs, asking them to reflect upon C.A.C.’s past accomplishments and its future challenges -- or -- to say whatever they might like: Today, you will hear 17 of these voices. This joint venture, a tribute to our Silver Anniversary, is entitled:

The Sound of Their Voices

In these necessarily brief excerpts, you will hear the voice of reminiscence, the voice of gratitude, the voice of concern, the voice of optimism, and the voice of humor. The central theme of all of the voices, explicit or implicit, is how the C.A.C. has helped, and how we can and will continue to help individuals with neurologic communication disorders.

 First, Dr. Bruce Porch describes the early motivations for C.A.C. and then reads the written PREAMBLE to the early conferences.

 Bruce Porch, Conference Chair 1971-1973:

We had many problems and few solutions and the questions began to arise as to whether we were accomplishing anything with the treatment of aphasia. All of these developments made it clear that we needed to do and discuss better research. Unfortunately, there were few forums in which to exchange information.

. . . And so CAC was born.

{PREAMBLE}

IT SAID THIS: ‘As is implied by its title, this conference is dedicated to the exchange of current information dealing with the clinical course of aphasia. All issues, both theoretical and applied, which bear on the diagnosis, prognosis, and treatment of aphasia and related disorders will come under consideration and are acceptable for presentation. Because the conference is designed to stimulate the exchange of information and thought, all participants will be encouraged to take part in the discussions. In this spirit, the number of participants will be limited, there will be no restriction as to how long or short the presentations may be, and liberal allowances will be made for discussions. It is in the contrast in views from which we all hope to learn.’

Robert T. Wertz, Conference Chair 1974:

Certainly, the most significant contribution of the Clinical Aphasiology Conference over the past 25 years has been its male members’ taste and style in cross-dressing. Not only has this contributed to differentiating transvestite aphasia from dressing apraxia, it has also given a definite style to C.A.C.’s science and service.

Dr. Porch, dear Bruce E., hosted the first C.A.C. in a stunning cobalt-blue wool trapeze with open-backed heels and a false chignon. That very day, if memory serves, Dr. Porch had done ten PICAs and his nails, and not a hair out of place.

...

Present-day C.A.C., with its dreary denim, has no concept of our kind of style. And, that, of course, is the most significant challenge facing the Clinical Aphasiology Conference in the future.

Bill Berry, Conference chair 1975-1977:

C.A.C. has definitely had an impact, and it did it without a pompous society that meets annually to puff up the egos of all who attend. It did it with dedicated professionals who merely desire to serve the patients who sought their help. Yes, I'm proud of C.A.C. and it will live on as long as dedicated folks like you are motivated to do so. But I personally hope we never see C.A.C. bylaws published. If that ever happens, C.A.C. will no longer be what it was designed to be. That I see as the primary challenge to the conference in the future. To resist the temptation to become something important, rather than just creating ideas that become important.

E. Gene Ritter, Conference Chair, 1978:

 The C.A.C. in the past has weathered severe criticism from that of being an exclusive V.A. instrument, to being clique-ish, to being top-heavy with doctoral participants. But, the C.A.C. has survived by responding to these criticisms and revising the program participant composition in the mid-’80’s.

To continue serving aphasic patients and the clinicians who they provide direct service to them, the C.A.C. must avoid two challenges, in my opinion. First, is an economic challenge. We must not outprice the C.A.C. to average clinicians by raising registration fees and local arrangement costs unduly.

Bob Marshall, Conference Chair, 1984:

What is the most significant challenge facing Clinical Aphasiology Conference in the future?

Probably I think it’s going to be keeping participation ‘UP’ in the conference. As managed care comes into existence I think more and more people are going to be strapped to travel, asked to produce more with less, and be confined, and perhaps restricted in their ability to do clinical - based research. So I think we’re going to have to think long and hard about how we’re going to keep this good thing going until we can see the pendulum swing the other way.

G. Albyn Davis, Conference Chair, 1981:

There are many challenges, I think, for C.A.C. One, of course, is informing the rest of the clinical world of the results of our special process here. Another, I think, is to be sure that our deliberations balance the demands of the health care system with meeting the needs of aphasic people. Finally, I’d like to take a little liberty and ask that those of us at C.A.C. not forget to keep the windows open and let in some fresh air, and that we don’t forget to maintain an assured clear distance between ideas and egos, and that we remember that ideas are a whole lot easier to fix.

Tom Prescott, Conference Chair, 1985:

In the early days we used to have exchanges of clinical ideas, around a table, and people just expressed what was on their mind. Today, in a much more formal environment, people submit, have reviewed, have accepted, and present work that is well thought out, and their hope is that this work can be published and shared with others even beyond the conference. This I would consider to be growth. . .

Jay Rosenbek, Conference Chair, 1979:

I think, to pick up on the theme, that C.A.C. perhaps has given clinical aphasiology a voice. Not that there’s not other research going on. . . . (T)hat by reading papers and discussing those papers and publishing those papers, systematically for 25 years, we have let a variety of professional communities know about the issues, about some responses to those issues, and in general I think have helped to guarantee that clinical aphasiology, if there’s ever a history written of the behavioral sciences, will get more than a single page.

Chick LaPointe, Conference Chair, 1981:

My guess is that you’ll get alot of redundancy in the responses from all of the folks. . .

I think some of the redundancy you get will be relative to the friendships, to the sense family, to the camaraderie among the participants over the years. Personally I've had no fun at these meetings, and I find the people quite distasteful. I imagine as well you'll get some sense of the archival database that has been generated over the past 25 years, and the information that has emerged about "people" with aphasia, truly clinical aspects of aphasiology as opposed to fascination simply with the disorder of aphasia. In my view, the most significant contribution, really, has been a revival and nurturing of the ideas surrounding phrenology. I think this group has done more for that than any other group and I'm grateful for it. Regarding our most significant challenge, I think that the continuing struggle that we face to deal with the death of Paul Broca is really our biggest challenge. Thanks.

Joe Duffy, Conference Chair, 1986:

I can think of a few things that the conference will probably face. One will be to maintain its simplicity, and by simplicity I mean to remain a small group; to remain a conference that is dedicated to us all attending all papers, and all having a willingness to participate in discussion and feedback following those papers; simplicity relative to us not succumbing to being driven by a publication but still maintaining a mechanism for sharing what goes on in the conference with our colleagues who do not attend and with the professional community at large. A challenge to become better without becoming so different that we destroy what has made the conference so good in the past.

Mick McNeil, Conference Chair, 1987:

. . . it seems to me that the most important challenge facing clinical aphasiology, in the near future, is one of improving the requirements for publishing, and that includes the quality of the written material as well as the scientific rigor -- at the same time shedding the rigor mortis that we have with the current publishing practices. I believe that increasing the distribution of the material will have profound impact on the quality of material that eventually gets presented and then published, and will only increase the excitement about clinical aphasiology . . .

Craig Linebaugh, Conference Chair, 1990:

But C.A.C. has not only been about therapy for those whom we serve. . . . It has been about therapy for our minds and for our spirits. Each year we gather to hear about and to discuss the newest ideas our colleagues have tested. Many times we have watched as our discussions have added a pinch of this or a dash of that to a half-baked idea until after a series of C.A.C.’s, we each get a lick from the frosting spoon. As to therapy for our spirits, we need look no further than the eagerness with which we anticipate each gathering and the mixed feelings with which we depart.

Rich Katz, Conference Chair 1991:

But it is the expectation of the safe exchange of research and ideas that to me remains the distinctive characteristic of C.A.C. today. Emerson said: "It is one of the blessings of old friends that you can afford to be stupid with them." At C.A.C., we for the most part, are not stupid, or are we afraid to take risks, as we are among friends.

Penny Myers, Conference Chair, 1988:

I think if I came up with one single contribution it would have to be right there in the title, the juxtaposition of the word clinical and the word aphasiology in the conference title gives a good indication of what this conference is all about, what makes it unique, and what its major contribution has been. . . . For people involved in the Clinical Aphasiology Conference the focus is always ultimately on rehabilitation, on the patients we see, who are not just subjects in a study but actually are looked at as individuals with unique and individual characteristics. This is very, this is very unique and has made a tremendous impact I think on the rehabilitation research.

Kevin Kearns, Conference Chair, 1989:

Changes in the healthcare environment have also made it more difficult to conduct research in hospitals and rehab settings, and it’s not going to get any better. Despite these challenges I think that C.A.C. will continue to survive and thrive, mostly because of the spirit of the people involved and I think that what we do is important and that should be enough to sustain us.

Linda Nicholas, Conference Chair, 1992

I think the most significant future challenges facing Clinical Aphasiology Conference and clinical aphasiology in general will stem from the changing shape of health care. . . . However, these challenges I think can be viewed as opportunities. Opportunities to create more efficient, effective and relevant diagnostic and treatment methods for our patients to meet the changing timeframe for our interventions.

Marilyn Selinger, Conference Chair, 1994:

I think that clinical aphasiology’s most significant contribution has been the clinical aphasiologist’s steadfast belief that we would learn about aphasia and how to treat aphasia from the behavior of our patients rather than from a model or a theory that we thought about from a book. I think that there is a difference between what we have done over the years and what other groups and other researchers have done . . . We over the years have treated our patients, we observed our patients, we tested our patients, we talked to our patients, and from our patients, and not necessarily what they said to us, maybe it’s what they didn’t say to us -- but from those individuals who exhibited aphasia, we built our theories and our treatment . . .

In closing, let’s thank all of our past Conference Chairs, and especially Dr. Bruce Porch, who had both the enthusiasm, the concern, the vision -- and THE VOICE -- to inspire the foundation of Clinical Aphasiology Conference 25 years ago.

Thank you.

Permission for e-publication granted to the CAC website 20 January 2000.

(WINWORD\1995\CAC95\VOICETK2.DOC 6/2/95)

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