Communication focused approach in aphasia

Question 1

What is the focus of communication focused approach?

Answer 1

the transfer of info

Question 2

What led to communication focused approach being implemented?

Answer 2

• recognition that PWA communicate better than they talk (Holland, 1977)
• compensate for language problems to some extent

Question 3

Define compensatory strategies

Answer 3

• a new or expanded communicative behaviour
• often spontaneously acquired and systematically employed
• to overcome a communication barrier
• in effort to meet both transactional and interactional communicative goals (Simmons-Mackie & Damico, 1997)

Question 4

How can compensations be categorised?

Answer 4

• verbal
• non-verbal

Question 5

What are the main non-verbal compensatory strategies?

Answer 5

• drawing
• writing
• gesture

Question 6

What has been found about drawing as a compensatory strategy?

Answer 6

• esp useful for more severe PWA
• improvements acheived after intervention in accuracy and recognisability
• SOs report greater use of drawing by PWA after intervention
• imp for non-aphasic communication partner to also use drawing

Question 7

What has been found about writing as a compensatory strategy?

Answer 7

• e.g. writing words or parts of words
• writing involves lots of interactional functions (eye gaze, facial expression, prosody)

Question 8

What has been found about gesture as a compensatory strategy?

Answer 8

Lots of interest in terms of spontaneous use and how can be used in therapy. Clear that:
- PWA use gesture more than typical speakers
- different types of aphasia show different gesture use (Broca’s more meaning, Wernickes more metaphoric and beats)
- Brocas rely more on gesture

Question 9

Describe communication focused approach intervention

Answer 9

• typically encourage multimodal/total communication by setting up task where PWA has to convey message to listener who doesn’t know message
• involves SLT encouraging use of all modes of communication

Question 10

What are the main communication focused approach interventions?

Answer 10

• PACE (Davis, 2005)
• conversational coaching (hopper et al, 2002)
• APPUTE (Nykanen et al, 2013)
• Communication partner training (CPT)

Question 11

Describe PACE (Davis, 2005)

Answer 11

• popular 80s and 90s
  PWA picks up picture and doesnt show therapist
• must describe to therapist
• PWA encouraged to use all modalities to convey message

Question 12

Describe conversational coaching (hopper et al, 2002)

Answer 12

• similar to PACE
• PWA has to convey stories to SO who is part of session
• SLT acts as coach for them both

Question 13

Describe APPUTE (Nykanen et al, 2013)

Answer 13

• similar to conversational coaching but more formalised
• SLT takes more active role and more involvement of SO

Question 14

Describe conversation partner training

Answer 14

• attempts to improve how communication partner communicates with PWA
• can focus on inteactional and psychosocial issues

Question 15

What are the ways of viewing CPT?

Answer 15

• work with CP to be good CP for PWA
• work for benefit of CP