Support for family members

Speech pathologists should offer support and training to family/ carers of people with aphasia to become skilled conversational partners.

Reference: Simmons-Mackie et al., 2010
NHMRC level of Evidence: I

Rationale: For family members/carers who are ready, conversation partner training should be provided. Research suggests that people with aphasia may be more able to participate in conversation with a skilled, supportive communication partner (Simmons-Mackie et al., 2010).

Communication Tips for Caregivers of People with Aphasia:

• Be a conversation partner, not a therapist
• Set up the environment to ensure good communication (e.g. good lighting, minimise distractions, relaxed atmosphere)
• Speak at a normal rate (don’t use “baby talk”) with pauses at phrases and at the end of sentences
• Use strategies.  Writing down key words may assist in comprehension
•  Get things going by providing choices (e.g. Are you talking about dinner tonight? Or about your birthday party at the weekend?)
• Be willing to accept any type of communication.  In addition to speech, respond to gestures, writing, drawing, different intonations or expressions or using of a communication notebook or board.
• Set aside a time at least once per day to have a pleasant conversation.  Perhaps while having morning tea, or after dinner at night.  (Hinckley, 2003)

RESOURCES:

1. Supporting Partners of People with Aphasia in Relationships & Conversation (SPPARC) Lock, S. Wilkinson, R. & Bryan, K. (2008).  SPPARC is a resource specifically designed to provide clinically effective tools to work with people with aphasia and their communication partners.  The SPPARC manual consists of a manual, CD and DVD and provides practical resources to provide support and conversation training programs, conversation assessment and treatment materials and video extracts of everyday conversations which can be used as a resource.  
2. Supported Conversation for Adults with Aphasia (SCA) Kagan, A. Black, S. E., Duchan, F. J., Simmons-Mackie, N. & Square, P. (2001). SCA is an intervention approach specifically design to help people with aphasia express their feelings and opinions in a way that makes them feel appreciated and heard.  SCA is a program which uses a set of techniques which aims to improve conversational interaction through body language and gesture, drawings, pictographs in addition to spoken and written words.
3. Learn more about Supported Conversation for Adults with Aphasia (SCA^TM)).
4. Self-directed learning module.

References:

1. Hinckley, J. (2003) Becoming a Communication Partner, Stroke Connection Magazine, American Stroke association.
2. Kagan, A., Black, S. E., Duchan, F. J., Simmons-Mackie, N. & Square, P. (2001).  Training volunteers as conversation partners using “Supported Conversation for Adults with Aphasia” (SCA): a controlled trial, J Speech Lang Hear Res, 44(3), 624-38.
3. Lock, S. Wilkinson, R. & Bryan, K. (2008).  SPPARC: Supporting Partners of People with Aphasia in Relationships & Conversation, A resource Pack, Bicester: Speechmark.
4. Simmons-Mackie, N. Raymer, A., Armstrong, E., Holland, A. Cherney, L. R. (2010).  Communication partner training in aphasia: a systematic review.  Arch Phys Med Rehabil, 91(12), 1814-37.