Facilitator Behaviors Leading to Engagement and Disengagement in Aphasia Conversation Groups

Abstract

Purpose Researchers have identified features of successful aphasia conversation groups and clinician behaviors leading to engagement and group cohesion. There has been less focus in the literature on facilitator behaviors that hinder participation or result in disengagement. This study aims to explore the behaviors of graduate student facilitators that contribute to and detract from engagement in aphasia conversation groups. Method Data were drawn from 4 conversation group sessions from 2 different university settings. Groups included 1 graduate student facilitator and 3 or more persons with aphasia. Sociolinguistic discourse analysis was applied to transcripts of group sessions. Results Three broad patterns detailing facilitator behaviors were identified. Several facilitator actions contributing to engagement were noted, including strategic use of topic elicitors, multimodal communication supports, and techniques to avoid interactional asymmetry. Behaviors associated with participant disengagement were also noted across sessions, including restricted discourse behaviors and difficulty managing the competing needs of participants. Engagement and disengagement were the product of several coordinating actions of the facilitator and group members that together influenced participation in conversation. Conclusion Results suggest that novice facilitators exhibit behaviors that contribute to and detract from participant engagement in aphasia conversation groups. Findings, discussed within the context of the literature on well-managed groups, highlight the skill required in managing the needs of participants with aphasia and knowing how and when to employ clinician-led strategies.

Game Technologies to Assist Learning of Communication Skills in Dialogic Settings for Persons with Aphasia

“…There is, however, a strand of research focusing on the effects of socially oriented and community-based conversation groups (hereafter "conversation groups") for persons with aphasiaenvironments that share some characteristics with philosophical dialoguesand the results are promising. According to researchers in the field [36,37], the value for persons with aphasia of participating in conversation groups is widely recognized. Previous studies support positive impact on communication skills for persons with aphasia that participate in conversation groups [36,37].…”

“…According to researchers in the field [36,37], the value for persons with aphasia of participating in conversation groups is widely recognized. Previous studies support positive impact on communication skills for persons with aphasia that participate in conversation groups [36,37].…”

“…Conversation groups tend to resemble authentic communication in everyday social life [37]. However, according to Lanyon, Worrall, and Rose [36, p. 526], "[m]ultiperson interactions are inherently complex for people with aphasia" and unsuccessful conversation groups can produce negative experiences, such as disconnectedness, stress, frustration, and perceived marginalization [36].…”

“…According to Lanyon, Worrall, and Rose [36], persons with aphasia strive to become active contributors but wish for varying levels of support in order to express thoughts and opinions, participate meaningfully, and demonstrate competence. Lee and Azios [37] studied the impact of different facilitator behaviours on the active participation of persons with aphasia. They found that facilitator behaviours with positive influence were continuous feedback and acknowledgement of the contributions of the participants, explicating conversation rules, standards or guidelines, promoting interactional symmetry, directing attention towards joint efforts to find lost words, using humour for different purposes, and communicating multi-modally through both verbal and visual expressions (for instance, spoken words, written keywords, gestures and pictures).…”

“…They found that facilitator behaviours with positive influence were continuous feedback and acknowledgement of the contributions of the participants, explicating conversation rules, standards or guidelines, promoting interactional symmetry, directing attention towards joint efforts to find lost words, using humour for different purposes, and communicating multi-modally through both verbal and visual expressions (for instance, spoken words, written keywords, gestures and pictures). Behaviours found to have negative impact included asking plenty of recycled questions (that is, approximately, repeated questions without connection to previous participants' contributions), a lot of closed questions with predetermined answer alternatives, test questions (following the IRE pattern) that signal power asymmetry, and exposing errors of the participants [37]. In line with several of these results, Lanyon, Worrall, and Rose [36] found that persons with aphasia themselves underlined the importance of promoting non-hierarchical interactions and equal opportunities for participation in conversation groups, where the "democratic feel" (p. 528) of the conversation is present and the responsibilities for the group process are distributed among the participants.…”