Treatment of aphasia through family member training

Abstract

Background: Studies describing communication between people with aphasia and family members have suggested that family members are not always skilled communication partners. For example, spouses or significant others sometimes adopt conversational strategies that do not facilitate communication with their aphasic loved one. Therefore, management of aphasia should address the communication skills of regular communication partners in order to maximize communication with individuals with aphasia.Aims: This study was designed to provide communication training to the wife of a man with aphasia in order to reduce the occurrence of her behaviors identified as “nonfacililative.” Nonfacilitative behaviors of the wife included spouse interruptions, convergent questions and negative teaching.Methods & Procedures: A single subject multiple baseline design examined the effects of training on the occurrence of three nonfacilitative behaviors across several conditions (spontaneous conversation in the clinic, discussion of television programs in the clinic and conversation at home).Outcomes & Results: Training the spouse resulted in reduced occurrence of the target behaviors (spouse interruptions, convergent questions) in probes of the training condition (news discussions). These improvements consistently generalized from the treatment situation to untrained conditions such as spontaneous conversations with her husband. In addition, this improvement was observed in an untrained behavior (negative teaching). Improvements in both trained and untrained behaviors were maintained on follow-up probes. Furthermore, this training resulted in improvements not only in the spouse's conversational interaction, but also in her aphasic husband's expressive communication during their conversations even though he was not included in the training.Conclusions: Direct training of interactive behaviors of a speaking partner might be an effective and efficient means of enhancing communication between family members and people with aphasia.