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Strategies Used by Communication Partners of Aphasic Speakers
Abstract
This article explores the experiences of communication partners of individuals with aphasia. The social model of aphasia intervention provided a useful framework when addressing the impact of the aphasic person's environment on the success of communication attempts. The communication partners perceived strategies such as maintaining a routine, using multiple communication modalities, and using targeted questions as helpful. Behaviors of the communication partners were considered just as important to establishing effective communication, including active listening, patience, and a genuine desire to perceive the message of the aphasic individual. Implications for practical applications and future research are outlined.
... Significant others are often directly affected by aphasia, 5,6,8,10,11 and they play an important role in rehabilitation. 12,13 Their needs and priorities for rehabilitation should therefore be considered in order to ascertain buy-in and appropriateness of therapeutic intervention to everyday contexts. At the same time, the perspectives of family members/friends and those of the person with aphasia do not always coincide when it comes to aspects concerning the life of the adult with aphasia. ...
Objectives:
Client-centred rehabilitation implies that persons with aphasia and their significant others are actively involved in all decisions regarding rehabilitation, including the setting of rehabilitation priorities and goals. This study aimed to describe and compare the perspectives of adults with aphasia, their significant others and their speech-language pathologists (SLPs) regarding the importance of nine life areas for the rehabilitation of adults with aphasia.
Method:
A total of 15 adults with expressive aphasia rated the importance of nine life areas using the Talking Mats™ framework. A questionnaire was used to obtain the ratings of 15 of their significant others and the 15 SLPs treating them.
Results:
Most life areas were rated as important to work on in rehabilitation by most participants. The adults with aphasia rated the areas as important more frequently than their significant others and SLPs. All participants rated Communication as important. Statistically significant differences were noted for three of the nine life areas.
Discussion:
The life areas which the participants were questioned about seem to provide a good starting point for rehabilitation teams to find common ground for collaborative goal setting. The Talking Mats™ approach allowed adults with aphasia to participate in the process. It can be a useful tool to promote client-centred rehabilitation for adults with expressive communication difficulties.
... So far, though, little is known about who would benefit from this type of training, as Turner and Whitworth (2006a, b) point out when advocating for increased general knowledge about CPs taking part in communication training. It has been shown that CPs of persons with aphasia adopt various communicative strategies that they consider helpful, also without specific training (Paul & Sanders, 2009). Carlsson, Hartelius, and Saldert (2014) described how spontaneous communicative strategies used by CPs of persons with PD are often similar to the ones used by CPs of persons with aphasia. ...
Purpose:
Communication partner training is an increasingly common approach to improve the possibilities for people with communication disorders to participate in everyday interaction. So far, though, little is known about what conversation partner characteristics might influence the ability to be a supportive partner in conversation. The current study explored possible associations between the observed skill to support a person with communication difficulties in conversation and the following characteristics of the conversation partner; executive function, inference ability, age, education level and relationship to the person with communication disorder. The impact of the aetiology of the communication difficulties was also explored.
Method:
Thirty-five dyads participated: 23 people with aphasia along with 18 significant others and five enrolled nurses and 12 people with Parkinson's disease along with 10 significant others and two enrolled nurses.
Result:
Only tendencies of associations were found between observed skill to support conversation and executive function for the significant others and inference ability for the enrolled nurses.
Conclusion:
Although type of activity involved in the conversation may be a key factor, the results indicate that executive function and ability to make mental inferences may matter for the ability to support a person with communication disorder in conversation.
... However, when considered in the context of the broader literature, there are several implications for preparing students for interacting with PWA. Previous research has indicated that the way a communication partner interacts with a PWA is as important as the communication abilities of the PWA (Paul and Sanders, 2009;Ross et al., 2006;Simmons-Mackie et al., 2010). Positive attributes of communication partners include active listening, patience, perseverance, and a genuine desire to perceive the intended message; in addition to an appropriate surrounding environment. ...
This study investigated occupational therapy and physiotherapy students' level of confidence and knowledge of strategies for communicating with people with aphasia (PWA) before and after a communication partner-training (CPT) program. Twenty-eight physiotherapy and occupational therapy students participated in a pre–post CPT program. Students completed a customized mixed-methods questionnaire before and after the intervention. The CPT program involved a lecture about effective communication strategies followed by a conversation with PWA to practice strategies learnt. Before CPT, students were not confident with the possibility of communicating with PWA. Students demonstrated rudimentary knowledge of supported conversation, identifying a maximum of five strategies for communicating effectively with PWA. Following intervention, students demonstrated increased confidence. Students' knowledge of effective communication strategies improved, with students identifying a maximum of 16 suitable strategies post-training. The results suggest that occupational therapy and physiotherapy students have potential to benefit from practical training in supported communication with PWA, which may assist them during placements in clinical settings with neurological patients or subsequent employment.
Keywords: Aphasia, Physiotherapy, Occupational therapy, Allied health students, Supported conversation, Training needs, Healthcare communication, Healthcare access
Purpose:
The aim of the study was to explore the communication experiences of key communications partners (CPs) of individuals receiving home mechanical ventilation (HMV), with particular emphasis on the possibilities, difficulties and limitations CPs experienced in communication, possible support given to facilitate communication and exploring what made a skilled communicator.
Method:
A qualitative research design using interviews was used. The participants included 19 key CPs of individuals receiving HMV.
Results:
The analysis resulted in five themes: Encountering communication limitations, Functional communication strategies, Being a communication facilitator, Role insecurity and Emotional reactions and coping. The findings revealed that CPs needed to develop partly new reference frames for communication. In particular, participants emphasised the need to understand and interpret subtle details in the communicative interaction.
Conclusions:
The findings are discussed in the light of previous research, in particular an earlier study exploring another perspective; the ventilator-supported individuals' experiences of communication. Issues relating to the educational needs of CPs of individuals receiving HMV are discussed. The results are intended to enhance understanding of the challenges that individuals receiving HMV and their CPs face with communication, which should be of relevance not only to speech therapists, but for all healthcare practitioners in the field of HMV.
Background: Because communication deficits caused by aphasia affect both persons with aphasia and their communication partners, most speech-language pathologists are aware of the importance of client and caregiver education. To maximise the effectiveness of their communicative interactions, training should be conducted for both the aphasic clients and their caregivers. Training conducted in group environments offers peer support through shared learning experiences and joint problem solving.Aims: The purpose of this study was to explore the benefits of a caregiver education and training programme in improving communication between caregivers and their aphasic partners using didactic and experiential approaches in a group setting.Methods & Procedures: Ten caregivers and their aphasic partners, ranging from 4 to130 months post-stroke, participated in a 12-week group training and education programme. Information about stroke and aphasia was provided in a didactic format, and facilitative communication strategies were discussed and practised using Kolb's (1984) experiential learning cycle model. The experiential learning cycle involved drawing on concrete experiences, engaging in reflective observation and abstract conceptualisation, and practising what was learned through active experimentation.Outcomes & Results: Analysis of communicative performance on transactional and interactional tasks demonstrated increased communicative success. Responses on a questionnaire indicated that participants had a better understanding of aphasia and were more confident using facilitating strategies.Conclusions: Group education and training for caregivers and their aphasic partners can be beneficial, even after the couple has been living with aphasia for a number of years. Having an opportunity to practise, observe, and reflect on their performances facilitated participants' learning, and there were observed and reported positive alterations in interactions.
This thoroughly revised and updated Fifth Edition is the most comprehensive resource on aphasia and related neurogenic communication disorders from the most distinguished authorities of our time. This classic text has been used by graduate speech language pathology students for over 25 years, and continues to be the definitive resource across the speech sciences for aphasia. The book describes a wide range of intervention strategies including team treatment, group therapy, approaches for bilingual and culturally diverse clients, augmentative and alternative communication, and computer-assisted interventions. An important section addresses psychosocial/functional approaches to intervention. New to this edition are Activities for Discussion that encourage students to reflect on what they just read.
This qualitative research aimed to identify and describe the needs perceived by spouses of persons with severe aphasia. The analyses revealed different categories of needs: (1) information, (2) need to acquire an effective mode of communication with the aphasic partner, (3) better interpersonal relationships, (4) need to be considered as a partner in the caring process, (5) support, (6) respite. These needs were not static but in interaction with one another. Moreover, they varied within a temporal axis and appeared at different time periods: within the acute hospitalisation phase, rehabilitation phase, and after the aphasic person returned home. Taking into consideration the needs of spouses of persons with severe aphasia requires an eco-systemic and interdisciplinary approach aiming for the social reintegration of the person with aphasia. Services should be developed in order to respond to the unique and individual experiences and needs of people affected by aphasia. Speech language pathologists play a pivotal role within this approach because communication problems are central to the consequences of severe aphasia.
Background: Little is known about what happens to people with severe aphasia in the years after stroke when rehabilitation comes to an end, or about day‐to‐day life for this group.Aims: This study aimed to track the day‐to‐day life and experiences of people with severe aphasia, and to document levels of social inclusion and exclusion as they occurred in mundane settings.Methods and Procedures: Ethnography was chosen as the qualitative methodology most suitable for studying the experience of people with profoundly compromised language. 20 people who were judged to have severe aphasia following stroke agreed to be visited and observed three times in different domestic and care settings. The observer documented environments, protagonists, events, and interactions. Field notes were elaborated with personal, methodological, and interpretative notes. Written material (for example information leaflets) was also documented and described. Data were subject to thematic analysis.Outcomes and Results: The study revealed how social exclusion is a common experience for this group, played out in a variety of ways in a range of domestic and care settings. Social exclusion occurs at infrastructural, interpersonal, and personal levels.Conclusions: The study suggests that the social exclusion of people who struggle to communicate could be addressed through training, for professional and lay carers, that promotes support for communication; opportunity and access; respect and acknowledgment; and attention to the environment.