Effects of conversational topic choice on outcomes of augmentative communication intervention for adults with aphasia

Abstract

Few variables have been found to predict successful use of augmentative and alternative communication devices (AAC) by persons with aphasia. The present study used a single case alternating treatment design to test whether choice of conversational topic improved the ability of three adults with aphasia to use symbol-based communication aids in clinical dialogues with familiar and unfamiliar partners, and in natural environment conversations with family members and friends. Results showed that the youngest participant with most recent onset of aphasia benefited clinically from choice in communication aid training. However, the benefit of topic choice did not extend to natural environments. At home and in other natural environments, use of communication aids was dependent on multiple social and contextual factors. Findings of this study were interpreted using a model of human motivation that considers both personal and environmental influences on achievement.

The self-determined and partner-predicted topic preferences of adults with aphasia

“…Informant-input is not unproblematic and the active involvement of adults with aphasia themselves in this process is advocated (Fox et al, 2001). Unique and creative methods of assisting their active participation are needed and such techniques typically make use of partner involvement and concrete resources.…”

“…Participant selection criteria for the present study were derived and adapted from those used in a study conducted by Fox, et al (2001). Table 3.2 summarises the participant selection criteria for Group B, as well as the justification thereof and the method used.…”

“…Personal event topics were discussed for longer periods of time, and the participant with aphasia was found to initiate more frequently when personal event topics were discussed. Fox et al, (2001) documented the effects of conversational topic choice on the outcomes of augmentative communication intervention for adults with aphasia. Results of their study suggested that topic choice may be a variable that increases enjoyment and perceived control in training and the limited opportunities provided to the individual with aphasia and his or her communication partners to provide input on the book's content and organisation frequently result in minimal functional use of communication books (Rogers et al, 2000).…”

“…hence the active involvement of adults with aphasia in the pre-selection of topics for use in an AAC system has been advocated (Fox et al, 2001). In order to provide adults with aphasia the opportunity to participate actively in research and clinical practice, appropriate support is needed (Fox & Fried-Oken, 1996).…”

“…In order to address this, it has been suggested that adults with aphasia should be actively involved in the process of pre-selecting their preferred topics of conversation (Fox, et al, 2001). Due to the complex nature of aphasia, this is not an easy task and requires creativity and ingenuity on the part of researchers and clinicians.…”