Communication Partner Training Programs Research Articles

An Online Communication Partner Training Program: POWR+ Intervention Results for Teachers, Paraeducators, and Children

Paraeducators frequently support children who use augmentative and alternative communication (AAC) but often lack access to effective training opportunities. Similarly, special education teachers are responsible for supervising paraeducators but often lack effective training on AAC and paraeducator supervision. The POWR+ (Prepare the activity and AAC, Offer opportunities for communication, Wait for the child’s communication, Respond to the child’s communication, + model AAC) intervention provides training to both paraeducators and supervising teachers to support communication for children who use AAC. In this study, a single-case multiple probe design was used to examine the effects of the POWR+ intervention (e.g., communication opportunities, responses to child communication, and plus AAC models provided by paraeducators) for three teacher–paraeducator–child teams. As a result of the POWR+ intervention paraeducator communication opportunities and paraeducator AAC models increased for all paraeducators. Increases were also noted for communication turns for one child and paraeducator responses to child communication for two paraeducators. Results indicate that the POWR+ intervention may be a viable training option for paraeducators and teachers who support children who use AAC.

Efficacy of online communication partner training package for student healthcare professionals.

People with aphasia are vulnerable recipients of healthcare. The nature of the communicative environment and the communication disability can adversely impact access to timely and quality healthcare. Student healthcare professionals are often underprepared to interact successfully with people with aphasia and may benefit from communication partner training (CPT). To investigate the potential effectiveness and acceptability of a brief, two-part introductory Supported Conversation for Adults with Aphasia (SCA™)-based CPT package, delivered to a sample of students across a diverse range of healthcare disciplines. A pre-post-within group experimental design was used to investigate the potential effectiveness and acceptability of an online CPT package (50 minute module + 1 hour workshop) for healthcare students. The Aphasia Attitudes, Strategies and Knowledge (AASK) survey measured participants' knowledge of aphasia, facilitative communication strategies and attitudes towards people with aphasia. Data were collected pre-training, following the training module and following the workshop, and 6 weeks post-training. Statistical analysis was conducted on the AASK data. In addition, participant feedback (ratings and open text responses) was collected after the workshop. Ratings were analysed descriptively, and thematic content analysis was used for open text responses. 236 participants completed the pre-training AASK and 106 completed the AASK at subsequent time points. Statistically significant gains were demonstrated from pre- to post-module completion. Between the end of the module and the end of the workshop, some gains were maintained and others showed further statistically significantly improvements. While all gains were not maintained at the 6-week follow-up, statistically significantly improvements from pre-training scores remained evident. Student feedback was predominantly positive, with suggested improvements for training content and length. The results provide preliminary evidence that a brief, online CPT package can support student healthcare professionals' knowledge and attitudes towards aphasia and communicating with people with aphasia. Online training was acceptable to students and feasible as an embedded or optional component of curriculum. Ongoing training (e.g., in the form of refresher sessions) and inclusion of a skills-based component are recommended to maximize communication skill development. What is already known on the subject Student healthcare professionals recognize the need to develop knowledge and skills to successfully support people with communication disability, such as aphasia, to participate effectively in their healthcare. Evidence in favour of online communication partner training for student healthcare professionals is currently limited. What this study adds to the existing knowledge This study demonstrates that a brief introductory online communication partner training program can be efficacious for improving knowledge and attitudes regarding communicating with people who have aphasia. What are the potential or actual clinical implications of this work? Students will likely need further ongoing refresher training with inclusion of practical components to develop and maintain the knowledge and skills required to be proficient communication partners with people with aphasia.

Results from a randomised controlled pilot study of the Better Conversations with Primary Progressive Aphasia (BCPPA) communication partner training program for people with PPA and their communication partners

BackgroundThere has been a growing focus on functional communication interventions for primary progressive aphasia (PPA). These interventions aim to support individuals to participate in life situations. One such intervention, communication partner training (CPT) aims to change conversation behaviours in both the person with PPA and their communication partner (CP). CPT has a growing evidence base in stroke aphasia; however, these programmes are not designed to meet the needs of people with progressive communication difficulties. To address this, the authors developed a CPT program entitled Better Conversations with PPA (BCPPA) and undertook a pilot trial to establish for a future full trial; predicted recruitment rates, acceptability, an assessment of treatment fidelity and an appropriate primary outcome measure.MethodologyThis was a single-blind, randomised controlled pilot study comparing BCPPA to no treatment, delivered across 11 National Health Service Trusts in the UK. A random sample of eight recordings of local collaborators delivering the intervention were analysed to examine fidelity. Participants completed feedback forms reporting on acceptability. Pre- and post-intervention measures targeted conversation behaviours, communication goals and quality of life.ResultsEighteen people with PPA and their CPs (9 randomised to BCPPA, 9 randomised to no treatment) completed the study. Participants in the intervention group rated BCPPA positively. Treatment fidelity was 87.2%. Twenty-nine of 30 intervention goals were achieved or over-achieved and 16 of 30 coded conversation behaviours demonstrated change in the intended direction. The Aphasia Impact Questionnaire was identified as the preferred outcome measure.ConclusionThe first randomised controlled UK pilot study of a CPT program for people with PPA and their families demonstrates BCPPA is a promising intervention. The intervention was acceptable, treatment fidelity high and an appropriate measure identified. Results of this study indicate a future RCT of BCPPA is feasible.Trial registrationRegistered 28/02/2018 ISRCTN10148247.

A Communication Partner Training Program Delivered via Telehealth for People Living With Parkinson's (Better Conversations With Parkinson's): Protocol for a Feasibility Study.

Parkinson's can impact people's speech, cognition, pragmatics, and language, significantly affecting their conversations with others. The speech and language therapy approach called communication partner training (CPT) is effective for a range of communication difficulties. However, speech and language therapy interventions for people with Parkinson's predominantly focus on impairments, with little provision of CPT for this population. Better Conversations is a CPT approach that involves working with a dyad (the person with the communication difficulty and a conversation partner [CP]) to build conversation skills. It is effective at reducing barriers to conversation, and for some, it significantly increases targeted facilitatory strategies. Some approaches to CPT have been adapted to be delivered via telehealth. This can maximize ecological validity and convenience. Furthermore, telehealth is widely accepted as a delivery method for other interventions for Parkinson's. This study presents the protocol for a pilot feasibility study of a Better Conversations CPT delivered via telehealth to people living with Parkinson's and their CPs, called Better Conversations with Parkinson's (BCP). The primary aim is to evaluate the feasibility of the BCP program delivered via telehealth with a treatment group from a collaborating National Health Service (NHS) site to establish for a main trial whether BCP can be delivered as intended in an NHS setting. The aim is to establish: (1) the acceptability of the program for people living with Parkinson's, family members, and speech and language therapists (SLTs); (2) the feasibility of delivering the BCP program; (3) the recruitment and retention rates; (4) a sample size calculation; and (5) the most appropriate primary outcome measure. Ethical approval for this study was obtained from London-Central Research Ethics Committee (reference: 22/LO/0332). This case-series feasibility pilot study will recruit 10-12 dyads to ensure 10 complete data sets. Participants will be recruited by a collaborating NHS site located in England. Participants will be involved for 16 weeks (weeks 1-2 preintervention measures, weeks 3-8 intervention, weeks 10-12 postintervention measures, week 16 follow-up interview). Quantitative and qualitative methods will be used to analyze the study data. Speech, communication, and quality of life assessment data will be analyzed statistically to determine a suitably sensitive outcome measure. Descriptive statistics will be used to report on recruitment, attendance, and attrition. Finally, acceptability and feasibility will be evaluated using participant feedback, interviews, and the reflective diary and feedback of the SLT administering the therapy (by the research assistant who is the first author). This data will be analyzed using descriptive statistics and reflexive thematic analysis. This study was approved for funding from Parkinson's UK. Study recruitment commenced in July 2022. The results of the data analysis are expected to be available by September 2024. Insights from this study will provide valuable information about the acceptability and feasibility of a remotely delivered Better Conversations CPT approach for people living with Parkinson's and their CPs. An outcome of this study will be a manualized BCP program coproduced by people living with Parkinson's, their families, and a group of expert SLTs. The study results will guide the next stages of intervention development. PRR1-10.2196/41416.

"Communication Is Not Exactly My Field, but It Is Still My Area of Work": Staff and Managers' Experiences of Communication With People With Traumatic Brain Injury.

Communication between people with traumatic brain injury (TBI) and rehabilitation staff can be impacted by cognitive-communication disorders. Communication partner training (CPT) programs hold potential to improve communication between people with TBI and their communication partners. To tailor CPT programs to the rehabilitation environment, it is critical to understand the nature of communicative interactions for staff members. This study explores staff and managers' experiences of communication with people with TBI in the rehabilitation setting. Individual semistructured videoconference interviews were carried out with staff members (n = 22) and managers (n = 4) varying in terms of professions and length of work experience. Interviews were guided by a phenomenological approach to gain comprehensive knowledge of staff and managers' lived experiences of communication with people with TBI. Four themes with nine subthemes were generated: (a) cognitive-communication disorders challenge interaction (communication is socially inappropriate, the diversity of presenting symptoms associated with TBI is demanding), (b) staff struggle in communication (there is a breakdown of communicative collaboration, communication increases staff's workload, emotional well-being of staff is at risk), (c) communication context is crucial (tasks affect communication, extending the professional roles), and (d) staff want communication knowledge and skills (needs vary according to work experience, access to tailored strategies, and feedback). Staff and managers experienced communication with people with TBI as highly demanding. The socially inappropriate communication in people with TBI was perceived to disturb the collaborative aspects of communication and create negative emotional impacts for staff. Staff experiences varied according to discipline, work experience, rehabilitation tasks, and facility. Consequently, staff and managers expressed a need for specific communication strategies to help them overcome the communicative challenges. https://doi.org/10.23641/asha.21579159.

Conversation books for improving social interaction and social acceptance of children with complex communication needs in India

Introduction: This study draws on data from a community-based participatory action research project conducted to develop and evaluate a communication partner training program for supporting parents of children with complex communication needs in South India. Method: The article focuses on one participant with cerebral palsy and his mother. The participant child’s communicative participation and social interaction opportunities were enriched using a conversation book co-constructed by him, his mother, and the trainer-researcher speech-language pathologist during the training program. Data were collected throughout the action research project, including interviews, group meetings, observations, and a trainer-researcher journal. Results and discussion: Applied thematic analysis was employed to analyze the longitudinal data, in order to highlight the changes in the participant child’s social interaction and communicative participation. By describing the process of developing the conversation book as a means of increasing communication and social interaction opportunities for the child, our data illustrate how personalized low-tech augmentative and alternative communication options can be a way to improve social participation for children with disabilities in culturally diverse and low resource contexts, where stigma toward disability provides significant obstacles to social inclusion.

Exploring the effects of a communication partner training programme for adapted transport drivers

ABSTRACT Background Public transportation plays an essential role in the social participation of people living with a communication disability. However, the attitudes and communication skills of public transport drivers may influence access to the service. A communication partner training programme offered to public transportation staff may help drivers better interact with people living with a communication disability. Aims To explore the effects of communication partner training on adapted transport drivers: 1) knowledge about communication and strategies to use with persons living with a communication disability, 2) relational communication, and 3) communication behaviours with passengers living with a communication disability in authentic communication contexts. Methods & Procedures An exploratory single group naturalistic design was used. Thirteen drivers were provided with a novel communication partner training programme. Participants’ knowledge about communication with individuals living with a communication disability was assessed with written situational scenarios presenting passengers with either an expressive, receptive, or pragmatic communication profile. Videos of the participants interacting with passengers living with a communication disability during real-life trips were captured and analysed using the Relational Communication Scale. The videos were further analysed to determine if the participants’ use of gestures had changed after training. Paired-sample t-tests were undertaken for each measure to identify any post-training changes. Outcomes & Results Drivers’ knowledge about communication with people living with a communication disability significantly increased after training. Also, significant behavioural changes occurred in drivers post-training videos as indicated by the better evaluation of all dimensions of the Relational Communication Scale and the increased use of gestures. Emblematic gestures were the most frequently employed. Conclusions This study suggests that the communication partner training programme for adapted transport drivers could improve their communication with people living with a communication disability. Future studies are needed to replicate these findings and further determine their external validity.

Unpacking the varied roles of mothers of children with developmental disabilities in South India

This research illustrates the diverse parenting roles and responsibilities assumed by mothers while caring for and facilitating the development of their children with Developmental Disabilities (DDs) and associated Complex Communication Needs (CCNs) in South India. Data collected during a participatory action research (PAR) project to develop and evaluate a communication partner training program for parents of children with DDs and CCNs, were analyzed to understand diverse parenting roles and how they relate to early intervention. Applied Thematic Analysis showed that mothers assume various roles as tutors, case managers, disciplinarians, nurses, and orchestrators of home training. Reasons for taking uncommon roles and responsibilities included filling gaps in services and facilitating the habilitation journey of their children with DDs. Role conflicts, role strains, and role overload experienced by participant mothers while trying to parent and provide intervention for their children with DDs were identified. Points of interest This study draws from the perspective of the mothers themselves to provide a unique depiction of their roles navigating habilitation care for their children with Developmental Disability (DD) in India. Data illustrated socio-cultural and historical perspectives, beliefs, values, and practices regarding the mothers’ role in children’s habilitation and development. The typical maternal roles identified included a tutor, nurse, and disciplinarian in line with existing research. However, the magnitude of responsibilities associated with these roles while caring for a child with developmental disabilities in the local context with limited resources was challenging. Additional roles mothers played included being a case manager for their children and providing home therapy. The participant mothers experienced role overload, role strain, and role conflicts in discharging their many responsibilities. The need for parents to receive formal and informal support in order to improve their personal quality of life and that of their children is identified.

Delivering an iterative Communication Partner Training programme to multidisciplinary healthcare professionals: A pilot implementation study and process evaluation.

Despite evidence that Communication Partner Training (CPT) can enable health professionals to communicate more effectively with people with aphasia (PWA), an evidence-practice gap exists. To address this, a tailored implementation intervention was developed and trialled to improve health professionals' implementation of communication strategies in a subacute setting. To explore the outcomes and perceived feasibility, acceptability and potential effectiveness of an iterative CPT implementation intervention on multidisciplinary healthcare professionals' communication with PWA. The CPT implementation intervention was delivered to two groups of healthcare professionals (n = 6 and 7) approximately 6 months apart. The intervention underwent two iterations targeting emerging barriers to implementation success, with Group 2 receiving a modified version of the Group 1 intervention. A concurrent qualitative process evaluation was conducted to understand key factors determining implementation outcomes. Quantitative outcomes were recorded at baseline and 3-month follow-up, including the Measure of Skill in Supported Communication (MSC), a customized behavioural determinants survey mapped to the Theoretical Domains Framework (TDF) and the Organizational Readiness for Change survey. Focus groups and semi-structured interviews were conducted with health professional participants and the speech-language therapist trainer to explore perceptions of feasibility, acceptability and potential effectiveness. Content analysis was used to analyse the qualitative data, with categories and themes generated. The Group 2 implementation intervention was adapted based on feedback and reflections from Group 1 participants to incorporate more time for practice interactions and discussion during training, individual follow-up sessions and provision of accessible resources to aid communication attempts. There were greater improvements seen in the Group 2 outcomes on both the MSC and the TDF survey, suggesting that the iterative tailoring of the intervention was successful in addressing the barriers to change and led to improved implementation. The difference between the group's outcomes may also partly be explained by the impact of organizational readiness, which decreased during Group 1's implementation period. Despite similar themes emerging from the stakeholder perspectives in both groups (training factors, implementation facilitators, implementation barriers, and changes in knowledge and practice), these diverted in ways which served to explain the different implementation outcomes. An iteratively adapted CPT implementation intervention targeting healthcare professionals' use of supported communication strategies was feasible and acceptable for most participants. The implementation intervention was potentially effective in changing participants' communication with PWA, particularly for Group 2. Future CPT implementation efforts should continue to incorporate stakeholder input and tailor strategies to the organizational context, and measure whether outcomes are sustained in the long term. What this paper adds What is already known on the subject CPT is a complex intervention that can improve communication access and outcomes for PWA. However, there are barriers to both delivering CPT programmes to staff, and for staff in modifying their communication behaviours. Despite increasing efforts to improve CPT implementation, it remains largely unclear whether CPT implementation interventions are effective in improving interactions between staff and patients, and what elements of an implementation intervention result in changed behaviour. What this study adds to existing knowledge This study showed that adopting an iterative, barriers-focused approach to implementation facilitated practice change for one of the groups that participated in the programme. Incorporating stakeholder feedback in an ongoing way led to improvements in feasibility, acceptability and potential effectiveness, with several of the main barriers being effectively addressed by the intervention. Some key mechanisms of change were identified. What are the potential or actual clinical implications of this work It is necessary to develop active, targeted implementation strategies to support healthcare professionals to modify their communication, monitor implementation barriers as they arise and modify behaviour-change strategies accordingly. In a similar context, it is suggested that CPT implementation interventions should incorporate the use of audit feedback, physical resources and educational lectures paired with interactions with PWA in order to bring about change, with ongoing support and facilitation.

A pilot randomized controlled trial comparing online versus face-to-face delivery of an aphasia communication partner training program for student healthcare professionals.

Training conversation partners of people with aphasia who use facilitative communication strategies is one method that can improve access to healthcare for people with aphasia. However, the efficacy of communication partner training (CPT) has been investigated almost exclusively in the context of face-to-face (F2F) delivery. Online training may offer more cost-effective and accessible options to a wider range of conversation partners, including student healthcare professionals. To conduct a pilot randomized controlled trial with student healthcare professionals comparing (1) an online aphasia CPT program, (2) a F2F CPT program and (3) no program (control group) on outcomes relating to attitudes and knowledge of aphasia. A 45-min introductory aphasia CPT program was developed using the theories and techniques of Supported Conversations for Adults with Aphasia (SCA)™. A total of 30 first-year undergraduates studying occupational therapy at The University of Sydney were randomly allocated to one of three conditions: online CPT delivery, F2F delivery or delayed training control (no program). Outcomes measures included pre-post-testing with the Aphasia Attitudes, Strategies and Knowledge (AASK) survey. A significant difference existed for the AASK survey pre-post-change scores between the online, F2F and control groups (χ2 (2) = 20.038, p = 0.000). Post-hoc analysis revealed that, compared with the control (Ctrl) group, participants in both the online and F2F groups had significantly higher knowledge of aphasia (Online versus Ctrl: p = 0.000; F2F versus control: p = 0.002), knowledge of facilitative strategies (Online versus Ctrl: p = 0.000; F2F versus Ctrl: p = 0.002), and positive attitudes towards aphasia (Online versus Ctrl: p = 0.031; F2F versus Ctrl: p = 0.032). No significant difference was observed between the online and F2F groups for the Total or any subtotals (p = 1.000). The results from this pilot randomized controlled trial indicate that online delivery of the 45-min introductory CPT is equally as efficacious as F2F delivery, and thus may be a viable mode of delivery for future aphasia CPT programs. These pilot results pave the way for a larger study that will comprehensively evaluate the efficacy of an online aphasia CPT program for improving attitudes, knowledge and skills in a broad range of student healthcare professionals. What this paper adds What is already known on this subject The efficacy of F2F CPT for aphasia is well established. Online delivery of CPT programs may offer more cost-effective and accessible services when compared with F2F approaches; however, there is a need to explore the efficacy of online programs. What this paper adds to existing knowledge The 45-min online aphasia CPT program was found to be efficacious for improving student healthcare professionals' knowledge and attitudes towards aphasia and communication, and produced equally successful outcomes when compared with F2F delivery. This is the first study to report the efficacy of an online CPT program that is aligned with SCA for use with student healthcare professionals that also uses a self-report outcome measure with validated psychometric properties. What are the potential or actual clinical implications of this work? Online CPT programs may be useful in both clinical and education contexts to support improved efficiency of services and to enhance communication environments for people with aphasia in healthcare contexts.

Exploring the outcomes and perceptions of people with aphasia who conversed with speech pathology students via telepractice: a pilot study

ABSTRACT Research has found that people with aphasia (PWA) may experience psychosocial benefits from participating in communication partner training (CPT). It is unknown whether similar benefits are found if components of the CPT are delivered via telepractice. This pilot study aimed to explore PWAs’ perceptions of: (a) their communication confidence and self-esteem after communicating with speech-language pathology (SLP) students via telepractice as part of a CPT programme; (b) whether it is important for SLP students to converse with PWA; and (c) the suitability of using telepractice to facilitate these conversations. Five adults with aphasia participated. A single group, pre-test post-test design was utilised. Standardised measures were used to capture changes in the participants’ self-reported communication confidence and self-esteem. A verbal questionnaire was used to obtain participants’ perceptions of the programme. Post-CPT, a significant decrease occurred on one confidence item. Non-significant improvement was noted on other items. All five participants believed it was important for SLP students to converse with PWA. Content analysis of the participants’ responses revealed two categories: (a) aphasia being a chronic communication difficulty and (b) conversing with PWA can be scary and different from conversing with adults without aphasia. Four out of five participants thought that telepractice was suitable for conversing with students. Results suggest that PWA may experience psychosocial benefits from conversing with students via telepractice. Confirmation of these findings from a larger scale study would have implications not only for PWA, but also for SLPs providing clinical services to PWA and for educators of SLP students.

Conversations between people with aphasia and speech pathology students via telepractice: A Phase II feasibility study.

Speech pathology students can experience low confidence when communicating with people with aphasia. Communication partner training (CPT) is one method to increase confidence and skills when communicating with people with aphasia. There is a paucity of research exploring the effects of delivering CPT to students via technology, such as telepractice. To explore the feasibility (acceptability, demand, implementation, practicality, limited efficacy) of a conversation with a person with aphasia via telepractice as part of a CPT programme with speech pathology students. A secondary aim was to explore the effects of feedback from the people with aphasia (i.e., patient feedback) on students' perceived confidence and proficiency in communicating with people with aphasia. A Phase II feasibility study design was used, where both quantitative and qualitative data were collected. A total of 33 speech pathology students attended a lecture about the strategies used to communicate effectively with people with aphasia. They then participated in a 10-min conversation via videoconferencing with a person with aphasia 1 week later. Students were randomly allocated to patient feedback or no patient feedback conditions. They completed a custom designed questionnaire pre- and post-conversation. The study had a low recruitment rate but good retention. The programme was delivered as intended. Students reported that they found the conversations to be a positive but challenging experience. Post-conversation, statistically significant increases were found in students' self-rated confidence communicating with people with aphasia, proficiency at engaging in an everyday conversation and proficiency obtaining a case history (all p < 0.001). There were no significant differences for these ratings between the groups according to feedback condition (all p > 0.01). CPT involving a conversation with a person with aphasia via telepractice is feasible and can provide a valuable learning experience for students. Further research is required.

Telepractice communication partner training for health professionals: A randomised trial

Purpose: Communication partner training can be beneficial in reducing accessibility barriers for people with aphasia The aim of the present study was to determine whether face-to-face or telepractice (real time video-teleconference system) delivery of a communication partner training program was associated with greater improvements in confidence and knowledge of effective communication strategies among allied health professionals.Method: 55 health professionals were randomly allocated to receive face-to-face (n = 27) or telepractice (n = 28) communication partner training. All participants completed their allocated training. A customised mixed-methods self-completed questionnaire was used before and after receiving communication partner training for participants to rate their confidence when communicating with people with aphasia using a 100mm visual analogue scale and answer an open-ended question about knowledge of communication strategies. Results: At baseline, there was no significant differences between groups in confidence ratings (median (IQR), face-to-face 48mm (32mm, 54mm), telepractice 43mm (29mm, 56mm)) or number of strategies identified (face-to-face median=4, IQR 3-5; telepractice median=3, IQR 2-4). At the post-intervention assessment, confidence was significantly higher (p<0.001) for both groups (median (IQR), face-to-face 95mm (90mm, 97mm), telepractice 93mm (88mm, 97mm)), but no significant effect of group allocation was present. Similarly, more communication strategies (p<0.001) were identified (face-to-face median=9, IQR 8-12; telepractice median=9, IQR 8-11) but no significant effect of group allocation was present.Conclusions: This study demonstrated health professionals confidence for communicating with people with aphasia and knowledge of strategies to facilitate communication improved immediately after receiving communication partner training via either face-to-face or telepractice, but neither approach was superior.

‘I've got to get something out of it. And so do they’: experiences of people with aphasia and university students participating in a communication partner training programme for healthcare professionals

Communication partner training (CPT) has been used to support communication partners to interact successfully with people with aphasia (PWA). Through successful CPT interaction PWA's accessibility to healthcare is notably improved. The present study sought to build on prior studies by investigating the experiences of individuals with aphasia and healthcare providers to ascertain what they deemed to be beneficial from CPT and what could be refined or improved, dependent on the setting and skill set of those participating. To gain an understanding of the experiences of PWA involved in the provision of CPT to health professional (HP) students. Also to investigate the experiences of HP students who participated in the CPT programme. Eight PWA and 77 HP students who had completed a CPT programme participated in a focus group/semi-structured interview (PWA) and feedback session (HP students) moderated by two speech-language pathologists (SLPs). These sessions were recorded (audio and video), transcribed verbatim, including non-verbal communication, and analyzed using qualitative content analysis. Overall, the study sought to understand experiences of the training. Both the PWA and HP students reported positive experiences of CPT. PWA discussed their perception that CPT improved HPs and HP students' understanding and interactions conversing with them and emphasized the need for training and education for all health related professions. HP students enjoyed the opportunity to experience interacting with PWA, without being 'assessed' and felt it consolidated their learning based on lecture content. Inclusive and accessible healthcare is paramount to ensure the engagement of patients and providers. Based on the experiences and feedback of the participants in this current study, CPT offers a salient and practical training method with potential to improve practice. Participants perceived CPT to be beneficial and validated the need for the training to support PWA accessing healthcare.

Does communication partner training improve the conversation skills of speech-language pathology students when interacting with people with aphasia?

BackgroundAphasia is a common consequence of stroke. Despite receiving specialised training in communication, speech-language pathology students may lack confidence when communicating with People with Aphasia (PWA). This paper reports data from secondary outcome measures from a randomised controlled trial. ObjectiveThe aim of the current study was to examine the effects of communication partner training on the communication skills of speech-language pathology students during conversations with PWA. MethodThirty-eight speech-language pathology students were randomly allocated to trained and untrained groups. The first group received a lecture about communication strategies for communicating with PWA then participated in a conversation with PWA (Trained group), while the second group of students participated in a conversation with the PWA without receiving the lecture (Untrained group). The conversations between the groups were analysed according to the Measure of skill in Supported Conversation (MSC) scales, Measure of Participation in Conversation (MPC) scales, types of strategies used in conversation, and the occurrence and repair of conversation breakdowns. ResultsThe trained group received significantly higher MSC Revealing Competence scores, used significantly more props, and introduced significantly more new ideas into the conversation than the untrained group. The trained group also used more gesture and writing to facilitate the conversation, however, the difference was not significant. There was no significant difference between the groups according to MSC Acknowledging Competence scores, MPC Interaction or Transaction scores, or in the number of interruptions, minor or major conversation breakdowns, or in the success of strategies initiated to repair the conversation breakdowns. ConclusionSpeech-language pathology students may benefit from participation in communication partner training programs.

A Pilot Study to Teach Siblings to Support Children With Complex Communication Needs

Siblings play an important role in the lives of children with disabilities, especially those with complex communication needs (CCN). However, children with CCN require support to learn social and communication skills. Like other communication partners, typically developing (TD) siblings may struggle to understand how to best interact with a child with CCN and may benefit from training to learn communication strategies. This pilot study evaluated a newly created sibling communication partner training program to help TD siblings learn the strategy Plan, Talk, Wait, and Respond to support the communication of their siblings with CCN. A single-subject multiple probe design was used with three TD siblings and their siblings with CCN. Although results varied for sibling pairs, an increase in communication supports from TD siblings and communication gains for children with CCN were noted with all sibling pairs. Limitations, adjustments to the training, and future research directions are discussed.

Communication partner training for health care professionals in an inpatient rehabilitation setting: A parallel randomised trial

Purpose: The purpose of this study is to determine if the E-Learning Plus communication partner training (CPT) programme is as effective as the Supported Conversation for Adults with Aphasia (SCATM) CPT programme in improving healthcare professionals’ confidence and knowledge communicating with patients with aphasia.Method: Forty-eight healthcare professionals working in inpatient rehabilitation participated. Participants were randomised to one of the CPT programmes. The three outcome measures were self-rating of confidence, self-rating of knowledge and a test of knowledge of aphasia. Measures were taken pre-, immediately post- and 3–4 months post-training. Data were analysed using mixed between within ANOVAs.Result: Homogeneity of variance was adequate for self-rating of confidence and test of knowledge of aphasia data to continue analysis. There was a statistically significant difference in self-rating of confidence and knowledge of aphasia for both interventions across time. No statistically significant difference was found between the two interventions.Conclusion: Both CPT interventions were associated with an increase in health care professionals’ confidence and knowledge of aphasia, but neither programme was superior. As the E-Learning Plus CPT programme is more accessible and sustainable in the Australian healthcare context, further work will continue on this CPT programme.

A pre–post intervention study investigating the confidence and knowledge of health professionals communicating with people with aphasia in a metropolitan hospital

ABSTRACTBackground: Communication partner training (CPT) is a social intervention approach that can be used to educate and train volunteers, family members, significant others and professionals, in addition to providing skills and strategies for people with aphasia (PWA). This body of CPT research extends the current research in the area by implementing CPT with health professionals (HPs) in using PWA as trainers in a sub-acute care setting, but some previous research in acute care setting has primarily focused on caregivers and volunteers in a community setting.Aims: The aim of this study was to investigate implementing a CPT programme in an Australian metropolitan hospital by training professionals and utilising PWA as a key component of the training to facilitate “real-time” practical skill acquisition.Method & Procedures: Fifty-two HPs from multidisciplinary teams (allied health assistants, audiology, dietetics, occupational therapy, pharmacy, physiotherapy, social work and nursing staff in a rehabilitation unit) participated in a pre–post intervention study. HPs completed a questionnaire to collect demographic information, identify current knowledge of aphasia-related communication strategies and ascertain their confidence levels (using a 100-mm visual analogue scale) related to interacting with people with communication impairments and list any strategies/resources that could be used as an adjunct to facilitate exchanges with PWA. These open-ended responses were categorised into four main groups using content analysis. The CPT component, adapted from two programmes run by “Connect—Communication Disability Network” in the United Kingdom, consisted of an educational lecture on communicating with PWA given by a speech-language pathologist and a practical conversation with a person with aphasia. The PWA provided “expert” practical feedback to the professionals participating in the training.Outcomes & Results: HPs reported mean confidence levels of 46.56 mm (SD = 15.71) prior to training and 75.81 mm (SD = 12.16) post-training, t(51) = 12.479 (p < .001). More HPs were able to identify relevant strategies to assist with communication following the training (median total responses = 52, interquartile range [IQR] = 50–52), than prior to the training (median total responses = 15, IQR = 9–38).Conclusions: The results provide preliminary evidence to suggest that a CPT programme may be an effective method to increase the confidence and knowledge of communication strategies of HPs, in an acute care setting, when interacting with PWA.

On the diverse outcome of communication partner training of significant others of people with aphasia: an experimental study of six cases

Communication partner training (CPT) has been shown to improve the communicative environment of people with aphasia. Interaction-focused training is one type of training that provides an individualized intervention to participants. Although shown to be effective, outcomes have mostly been evaluated in non-experimental case studies. The aim of the controlled experimental intervention study was to evaluate an individualized approach in a CPT programme directed to significant others of people with aphasia. Specifically the effects on conversation partners' ability to support the person with aphasia in conversation and on the individuals with aphasias' perception of their functional communication were explored. Six dyads consisting of a person with aphasia and a significant other were included in a replicated single-subject design with multiple baselines across individuals. The intervention followed the interaction-focused communication training programme included in Supporting Partners of People with Aphasia in Relationships and Conversation (SPARRC). The main elements of the training consisted of supervised viewing of the couples' own video-recorded natural interaction and the formulation of individual goals for the adaptation of particular communicative strategies. Outcome was measured via blinded ratings of filmed conversational interaction obtained once a week throughout the different phases of baseline, intervention and follow-up. A rating scale to assess overall quality of conversation was used, taking into account both transfer of information and social aspects of conversation. Measures of perceived functional communication in the persons with aphasia were also collected from the individuals with aphasia and their conversation partners. The results were mixed, with two of the six participants showing small improvements in ability to support their partner with aphasia in conversation. Half the participants with aphasia and half the significant others reported improvements on perceived functional communication in the person with aphasia after intervention, but no changes were statistically significant. This study adds to the growing body of research concerning CPT by pinpointing the importance of careful consideration regarding set-up of training, suitability of participants and evaluation of outcome.

Communication partner training of enrolled nurses working in nursing homes with people with communication disorders caused by stroke or Parkinson’s disease

Purpose: To evaluate the effect of a communication partner training programme directed to enrolled nurses working with people with communication disorders in nursing homes, using an individualised approach. Method: Five dyads consisting of a person with stroke-induced aphasia (n = 4) or Parkinson’s disease (PD) (n = 1) living in different nursing homes and his/her enrolled nurse participated in the study, which had a replicated single-subject design with multiple baselines across individuals. The main element of the intervention was supervised analysis of video-recorded natural interaction in everyday nursing situations and the formulation of individual goals to change particular communicative strategies. Results: Outcome was measured via blinded assessments of filmed natural interaction obtained at baseline, intervention and follow-up and showed an increased use of the target communicative strategies. Subjective measures of goal attainment by the enrolled nurses were consistent with these results. Measures of perceived functional communication on behalf of the persons with communication disorders were mostly positive; four of five participants with communication disorders and two of five enrolled nurses reported improved functional communication after intervention. Conclusions: The use of an individualised communication partner training programme led to significant changes in natural interaction, which contributes importantly to a growing body of knowledge regarding communication partner training.Implications for rehabilitationCommunication partner training can improve the communicative environment of people with communication disorders.For people with communication disorders who live in institutions, the main conversation partner is likely to be a professional caretaker.An individualised approach for communication partner training that focussed on specific communication patterns was successful in increasing the use of supportive strategies that enrolled nurses used in natural interaction with persons with communication disorders.The training also positively affected the perceived functional communication of the persons with communication disorders.