Self-perceptions of functional communication performance during total communication intervention

Abstract

Background: ICF dimensions Activity and Participation could be used to describe or assess functional communication. The new definition of functional communication contains all the available means of communication, total communication, as well as the support from environmental factors, for example communication partners. However, there are not many studies on how the participants self-assess the possible changes in functional communication performance after practising the use of total communication and guiding the communication partner. Aims: The aim of the present study was to examine how people with moderate and severe aphasia perceive their functional communication performance and how their communication partners perceive it. The possible changes in this performance were also examined during an intervention concentrating on stimulating the use of total communication and guiding the communication partners to facilitate the use of different communication methods and support the interaction. The self-perceptions of the aphasic participants and the perceptions that the partners reported were also compared. Methods & Procedures: The data were collected during regular rehabilitation courses, which were carried out in two parts (8 + 4 days) with a 3-month interval. A total of 38 respondents, mainly with moderate or severe aphasia, aged 26 to 65 years, and 38 of their partners aged 29 to 71 years participated in the study. The research involved an initial, interim, and delayed post-test questionnaire design stretched over a 9-month period. The Finnish version of the Communicative Effectiveness Index (CETI) (Lomas et al., 1989) was used. With the aphasic participants a pictorial version of the questionnaire was administered in the form of an interview. Outcomes & Results: On a group level people with moderate and severe aphasia and their communication partners perceived major limitations in functional communication performance after aphasia. The communication partners perceived significant improvement in this performance during an intervention. Before the intervention people with aphasia estimated their functional communication performance to be significantly better than the partners did, but this difference disappeared during the intervention. This study was supported by grants from the Finnish Cultural Foundation. The author would like to offer her sincere thanks to the participants who contributed their time to the project, and to the Finnish Brain Association. Conclusions: People with moderate and severe aphasia and their communication partners perceive major limitations in functional communication performance after aphasia. However, the communication partners in particular perceive improvement in it during intervention concentrating on total communication and guiding the partner. People with aphasia become more aware of the problems in their communication performance during the rehabilitation.