A Set of Observational Measures for Rating Support and Participation in Conversation Between Adults with Aphasia and Their Conversation Partners

Kagan, Aura; Winckel, Joanne; Black, Sandra E.; Duchan, Judith Felson; Simmons‐Mackie, Nina; Square, Paula A.

doi:10.1310/cl3v-a94a-de5c-cvbe

Cited by 112 publications

(93 citation statements)

References 23 publications

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“…This study identifies the desire for an outcome measure to validate conversation therapy, but few respondents reported using published measures such as the observational measures (Kagan et al, 2004), and CAPPA (Whitworth et al, 1997). Other researchers have also reported a lack of clarity about how to measure conversation, which can lead to limited use of conversation therapy (Collis & Bloch, 2012;Simmons-Mackie et al, 2005;Verna et al, 2009).…”

Section: Delivering Conversation Therapymentioning

confidence: 99%

“…Training involves education about how conversation works, dyad self-reflection using video recordings of their own conversations, and practice of jointly identified strategies to deal with specific conversation barriers. SCA™ involves training partners to acknowledge the competence of speakers with aphasia using a natural and adult communicative style, using a range of generally applicable techniques and tools to facilitate responses, and is linked to observational outcome measures (Kagan et al, 2004). The ultimate goal is to provide access to good quality conversation to promote well-being and quality of life.…”

Section: Introductionmentioning

confidence: 99%

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Professionals’ perspectives on delivering conversation therapy in clinical practice

2017

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Background: Aphasia and other acquired language impairments have the potential to impact greatly on quality of life by disrupting everyday conversation. Different intervention approaches are available to speech and language therapists (SLTs), such as targeting the language impairment itself and/or addressing activity or participation barriers. Conversation therapy is one approach that is gaining in popularity, with a growing evidence base. However, it is not clear how SLTs currently use conversation approaches and what factors may influence delivery. Aims: To investigate how SLTs (i) define conversation therapy, (ii) deliver it in clinical practice, and identify (iii) any challenges faced. Methods & Procedures: An online survey and focus group explored how SLTs working in the south east of England currently deliver conversation therapy to support people with a range of communication disorders, in particular aphasia. Data were analysed using descriptive statistics and thematic content analysis. Outcomes & Results: A total of 50 SLTs completed the survey and 6 participants attended the focus group. Conversation therapy was found to be widely employed by participants, however there was considerable variation in the approaches used, and a number of major challenges were raised. SLTs reported delivering conversation therapy with a range of client groups and preferably working with the client and partner together. Conversation goals predominantly reflected an approach based on: (i) strategy use and/or total communication (TC), and (ii) Conversation Analysis. Three overarching themes around conversation therapy emerged from the focus group: (1) What is conversation therapy? (2) showing it works, and (3) complexities of delivering it. SLTs acknowledged the benefit of conversation therapy but felt they lacked the tools and skills needed to deliver it. Conclusions: SLTs wanted to use conversation therapy and desired clear outcome measures to demonstrate its effectiveness, but were not accessing the available evidence base, highlighting the ongoing difficulty of translating research into clinical practice. Whilst these data are limited by the small number of participants, the study provides a first view of how conversation therapy is articulated in practice. Further investigation of conversation therapy delivery is warranted with a larger sample of SLTs based across the United Kingdom, as is comparison with practice in other countries.

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Section: Delivering Conversation Therapymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Professionals’ perspectives on delivering conversation therapy in clinical practice

2017

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“…Experimental studies have provided important information about the impacts of conversation approaches on large samples with potential aggregation across individuals and situations (Kagan et al, 2001(Kagan et al, , 2004Rayner & Marshall, 2003). Qualitative designs, on the other hand, are flexible and non-sequential allowing participants to influence the research process across iterations.…”

Section: Evaluating Conversation Approachesmentioning

confidence: 99%

“Who decides what criteria are important to consider in exploring the outcomes of conversation approaches? A participatory health research study”

2015

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BackgroundOne of the most devastating consequences of aphasia is the disruption to normal conversation. The Conversation Partner Programme emphasises communicative competence and life participation. Currently there is no recognised system for evaluating this intervention. Following policy imperatives for patient and public involvement, it is important to include service users in the development of evaluation criteria. However, people with aphasia are often excluded from such research and service development initiatives because of their communication disability. This study was designed to include people with aphasia and other key stakeholders as co-researchers in the development of evaluation criteria for a Conversation Partner Programme. AimsTo describe the multi-perspectival co-generation of Conversation Partner Programme evaluation criteria using a participatory research approach. Methods & ProceduresFollowing a pilot study, the generation and analysis of qualitative data involved a Participatory Learning and Action (PLA) approach based on the interpretive paradigm. Using purposeful sampling participants (n = 20) included: people with aphasia (n = 5); speech and language therapists (n = 5); speech and language therapy graduates and undergraduates (n = 9) and university coordinator (n = 1). Through (n = 18) individual and interstakeholder data generation episodes (PLA focus groups and interviews) using participatory techniques (Flexible Brainstorming, Card Sort, Direct Ranking, Seasonal Calendar), evaluation criteria were identified. The R. Mc Menamin et al. 2015principles of thematic analysis guided the co-analysis of data with participants. Data generated in Ireland were presented to an international inter-stakeholder group at Connect, UK, for preliminary exploration of transferability of findings. Outcomes & ResultsConversation Partner Programme evaluation criteria agreed and prioritised by co-researchers in order of importance included: (1) shared understanding of structure, (2) clarity about the programme, (3) agreed evaluation mechanism, (4) linking with other organisations, and (5) feedback. "Shared Understanding of Structure" was ranked the most important criterion and related to the nature and number of participants, opportunities for group meetings, socialising, and stakeholder interaction."Feedback", the criterion ranked least important, detailed responsibilities about summarising programme experiences and sharing this information between stakeholders. ConclusionsPeople with aphasia and other key stakeholders were meaningfully involved in the identification of evaluation criteria for a Conversation Partner Programme. The outcomes of this collaborative work bridge the gap between policy imperatives around involvement and actual practice and will impact the design, delivery, and evaluation of the programme for all stakeholders. Findings will be of interest to professionals in this clinical area and to those exploring innovative methodologies to include marginalised service users, especially pe...

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“…The present negotiations took different directions and as is discussed in 4.1 through 4.4 the people with PD were in a vulnerable position. This finding underlines the importance of supporting their interactions by, for example, raising conversation partners' awareness of potential difficulties (Forsgren et al, 2013;Kagan et al, 2004). …”

Section: Different Issues Are Made Relevantmentioning

confidence: 59%

Negotiating disagreement in picture symbol supported decision making

Ferm

Bloch

Saldert

2016

JIRCD

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This study explores how meaning is co-constructed and negotiated when couples affected by Parkinson’s disease use a symbol supported decision making process (Talking Mats) to talk about their daily lives. Interaction data from three couples of men with Parkinson’s disease, their female partners and a facilitator were examined using Conversation Analysis (CA). Three negotiation sequences in which the partners disagreed regarding the ability of the person with Parkinson’s disease were used to explore the management of divergent views. Negotiation was an individualized process in which the men with Parkinson’s disease were at risk of not being fully involved. Negative assessment and disagreement were displayed in different ways. Strategies such as the use of pronouns and proper names seemed to play important functions in negotiation. Use of pictures such as with Talking Mats may support the handling of different views but partners need to be aware of the potential difficulties involved.

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A Set of Observational Measures for Rating Support and Participation in Conversation Between Adults with Aphasia and Their Conversation Partners

Cited by 112 publications

References 23 publications

Professionals’ perspectives on delivering conversation therapy in clinical practice

Professionals’ perspectives on delivering conversation therapy in clinical practice

“Who decides what criteria are important to consider in exploring the outcomes of conversation approaches? A participatory health research study”

Negotiating disagreement in picture symbol supported decision making

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