Communication Support Strategies Research Articles

Exploring the Views of Barbers and Stylists on the Acceptability of Delivering Community-Based Interventions to Promote COVID-19 Testing and Vaccination in South Carolina

Background: The COVID-19 pandemic has underscored the need for effective community-based interventions to promote disease prevention and reach high-risk, underserved communities. Trusted community leaders like barbers and stylists may serve as effective conduits for intervention implementation. This study aimed to explore the perceived acceptability of an intervention to promote COVID-19 testing and vaccination delivered by barbers in South Carolina. Methods: We conducted exploratory in-depth interviews to ascertain barbers’ and stylists’ perceptions and identify potential barriers and facilitators. Data analysis used a deductive coding approach to identify themes and was guided by the Theoretical Framework of Acceptability. Results: Sixteen participants were interviewed. Participants expressed positive reactions towards the interventions. Acceptability was influenced by strong trust relationships with clients, perceived community influence, self-efficacy in providing the intervention, and a shared sense of responsibility for community health. However, potential barriers included declining public concern about COVID-19, vaccine hesitancy, and limited COVID-19 knowledge among barbers and stylists. Participants emphasized the need for training and incentives for effective and sustained intervention delivery. Conclusions: Barbers and stylists are well-positioned to promote COVID-19 testing and vaccination due to their trusted roles and community influence. Given the complacency from the waning perceived COVID-19 threat and the historical mistrust in health interventions, vaccine hesitancy must be addressed through supportive communication strategies.

Abstract 13533: Communication With Family Caregivers is Beneficial for Improving Health-Related Quality of Life in Patients With Heart Failure

I ntroduction: Supportive relationships within dyad members involved in heart failure (HF) self-management are beneficial in improving the outcomes of patients. Perceived control over a health condition and depressive symptoms are known to affect health-related quality of life (QoL). Little is known about how mutual support enhances health-related QoL in patients with HF. The purpose of this study was to examine the association between supportive relationship and QoL and whether the association is mediated by perceived control and depressive symptoms in patients with HF. Methods: A total of 155 patients with HF (mean age = 60 years, 65% male, 77% married) completed questionnaires including supportive relationships in communication, decision-making, and reciprocity (Shared Care Instrument [SCI]), perceived control (Control Attitude Scale-Revised), depressive symptoms (Patients Health Questionnaire), and QoL (Minnesota Living with HF). A parallel mediation model was conducted adjusted for age, sex, and functional status (Duke Activity Status Index). Results: Decision-making and reciprocity were not associated with QoL directly and indirectly through the two mediators. Communication was also not directly associated with QoL (Figure 1), but was indirectly related through perceived control (indirect effect = -.177, 95% CI -.288 to -.004) and depressive symptoms (indirect effect = -.576, 95% CI -.883 to -.310). It means that patients who were highly communicative with family caregivers were more likely to have better QoL because of increased perceived control over health conditions and decreased depressive symptoms. Conclusion: HF management involves interdependent interactions between patients and family caregivers. The findings suggest that the use of supportive communication strategies to increase perceived control and depressive symptoms between dyad members in HF management may be beneficial in improving the quality of life in patients with HF.

Prognostication in post-stroke aphasia: Perspectives of people with aphasia on receiving information about recovery

ABSTRACT Many people with aphasia (language impairment post-stroke) want to know their prognosis for recovery, yet current understanding of their experience of receiving prognoses is limited. Such insight is necessary to inform clinical practice in formulating and delivering aphasia prognoses, especially given the psycho-emotional distress and secondary adverse effects on recovery associated with conversations about prognosis. We sought an in-depth understanding of the perspectives of people with aphasia in relation to receiving prognoses post-stroke, with the aim of informing an evidence-based approach to aphasia prognostication in clinical practice. Semi-structured interviews, facilitated by communication support strategies, were conducted one-to-one with eight people with aphasia (ranging from mild to very severe) 3–12 months post-stroke. Reflexive thematic analysis was used to analyse the qualitative data, yielding two over-arching themes: (1) How would you know without knowing me?; (2) I need to know, but I don’t want to know. Our findings illustrate issues of mistrust within the patient–clinician relationship, and complex emotions relating to hope and post-stroke adjustment. The present insight into the lived experience of receiving aphasia prognoses highlights the need for focused consideration of personal definitions of normalcy, measures for fostering trust, and the role of prognostic uncertainty.

A multinational online survey of the goal setting practice of rehabilitation staff with stroke survivors with aphasia

ABSTRACT Purpose Goal setting is an essential rehabilitation activity. However, multidisciplinary rehabilitation staff goal-setting practice with stroke survivors with aphasia and associated training needs are not well understood. Methods We designed, piloted, and conducted a survey of stroke rehabilitation staff in the UK, Australia, Aotearoa New Zealand, Canada, Ireland. Analysis included descriptive statistics, chi-square and Fisher’s exact tests, and qualitative content analysis. Results We received 251 responses from 118 SLTs and 133 non-SLTs. Most reported setting goals with most or all people with aphasia (78%, 197/251); 57% (138/244) rarely or never provided an accessible copy of goals. All disciplines reported significantly less confidence setting goals with people with aphasia than without aphasia (p = 0.012, n = 119). Barriers to goal setting included the communication impairment (especially severe aphasia) and poor insight. Staff described feeling ill-equipped to support people with aphasia in goal setting; only 27% (67/251) had accessed training to do so. Conclusions Rehabilitation staff described involving stroke survivors with aphasia in goal setting but lacked confidence doing so and receive inadequate training and support. Training should target multidisciplinary staff confidence and communication support strategies and resources so that people with aphasia and families are supported as goal-setting partners.

Effects of Protective Measures against COVID-19 on Auditory Communication for People with Hearing Loss.

WHO has recommended various measures to combat the COVID-19 pandemic, including mask-wearing and physical distancing. However, these changes impair communication for individuals with hearing loss. We investigated the changes in auditory communication associated with COVID-19 measures in 269 patients (male: 45.7%, female: 54.3%, median age: 54 y.o.). Most patients with hearing loss had difficulty engaging in auditory communication with people wearing masks, especially in noisy surroundings or with physical distanc-ing. These difficulties were noticeable in patients with severe hearing loss. Developing communication support strategies for people with hearing loss is an urgent need while COVID-19 measures are in place.

College student attitudes and strategies for intervention with a hypothetical peer exhibiting disordered eating.

The present study assesses stigma, attitudes, and strategies of college students in intervening with peers demonstrating disordered eating behaviors. Four hundred and eighty nine college students (384 women) completed questionnaires that assessed eating disorder symptoms and bystander attitudes adapted for disordered eating. Participants read one of three vignettes of a 20-year-old hypothetical peer displaying symptoms of disordered eating aligned with bulimia nervosa, anorexia nervosa, or binge-eating disorder; participants then described whether the vignette subject had a problem, what the problem was, and strategies for intervention. Relationships among eating disorder history, bystander attitudes, demographics, and intention to intervene in disordered eating were assessed using descriptive and regressive analyses; peer intervention strategies were organized and evaluated for frequencies of responses. Demographics (female-identification) and familiarity with disordered eating were associated with likelihood to intervene in disordered eating. Most students recognized that the peer had a problem, but fewer than half believed the problem was disordered eating; nearly a quarter (22%) of the students stated that they would be uncomfortable talking to a peer about disordered eating. The majority of students cited vague or nonproblem-related intervention strategies (62%), followed by emotion-focused strategies (22.5%), or body and behavior-focused strategies (15%). College students, particularly women and those with previous exposure to eating disorders, are likely to intervene peers disordered eating. However, students tend to use vague or body-focused intervention strategies. Bystander intervention training that provides rationale and rehearsal for supportive communication strategies is needed to address students' lack of intervention skills, particularly among men.

Aphasia friendly Canada: The aphasia friendly business campaign

ABSTRACT Background Aphasia creates pervasive communication barriers that make participation in society difficult. There are well over 150,000 Canadians with aphasia, but very few people have heard of it. The consequences of this lack of knowledge is that businesses and organizations are ill-equipped to accommodate customers with this invisible disability. The present study introduces the Aphasia-Friendly Business Campaign (AFBC), which has been designed to address the lack of knowledge surrounding aphasia. This knowledge mobilization project assists businesses in increasing accessibility for people with communication disorders through business-specific training sessions. Aims The goal was to increase awareness of aphasia in businesses and to test the efficacy of our approach. The following questions were explored: (1) Does accessibility training about aphasia and supportive communication strategies increase employee’s knowledge of aphasia, and (2) do employees report increased self-efficacy in interacting with a customer with aphasia after participating in training? Method Businesses were offered on-site aphasia training and personalized toolkits/resources were designed to accommodate the needs of people with communication disorders. Participating businesses received a training session that included a PowerPoint presentation, video examples, activity-based role-play, and an opportunity for discussion. Pre-and post-training questionnaires assessed changes in employees’ declarative knowledge regarding aphasia and their perceived self-efficacy in the workplace. Results 226 participants across 15 organizations participated in the AFBC. Participant’s declarative knowledge of aphasia and perceived ability to work with people with aphasia or other communication disorders significantly improved after training. Further, the participants agreed the materials provided were adequate and helpful. Discussion and Conclusions The increase in public knowledge regarding aphasia and the perceived ability of local employees to use supportive communication strategies have set the stage for increasing the autonomy of people with aphasia in our community. Improved public understanding of aphasia should reduce stigma surrounding the disorder, facilitate community reintegration, and improve the quality of services provided for people with aphasia. Service providers can better facilitate communication and make appropriate accommodations to assist with vocational, social and community reintegration. Future research should consider assessing longitudinal factors related to training retention and transfer (i.e., do employees remember and use these skills on the job and do they teach new employees). Further, people with aphasia in other regions of Canada continue to find their problems to be misunderstood and unaddressed by extant services, and as such, the need for the expansion of the AFBC program is necessary.

"I'm smiling back at you": Exploring the impact of mask wearing on communication in healthcare.

BackgroundSurgical and respirator masks are worn to reduce the risk of droplet and airborne transmission of viral respiratory disease. As a result of the novel coronavirus (COVID‐19) pandemic, mask wearing has been designated mandatory for healthcare professionals working in UK hospitals for the foreseeable future. It is thus timely to consider the long‐term implications of mask wearing on communication within healthcare settings, from both a patient and a clinician perspective.AimsThe primary objective is to identify research evidence that corresponds to the mask‐wearing experiences of healthcare professionals working on the ground. By drawing together a summary of the literature illustrating the potential challenges associated with mask wearing, it is possible to make an application to various clinical cohorts and to formulate a set of preliminary, evidence‐based support strategies. The paper additionally explores the role for the Speech and Language Therapist (SLT) in supporting communication in the context of mask wearing.Methods & ProceduresThrough a scoping review of the relevant literature, this paper reflects holistically on the prospective challenges associated with mask wearing across a variety of healthcare settings and patient populations. The subsequent conclusions have been used to inform the proposed clinical guidelines for safe and effective practice.Outcomes & ResultsThere is a current research gap with regards to mask wearing in non‐medical and non‐clinical healthcare workers, and the impact this may have on both a professional and a personal basis. In the absence of preliminary data, the development of associated communication support strategies is hindered. This paper draws upon a variety of clinically conceivable issues faced by healthcare professionals, outlines important practical and ethical considerations, and proposes evidence‐based solutions to some of the challenges identified. Future research is required to gather evidence with regards to actual clinical experiences of mask wearing to substantiate hypotheses.Conclusions & ImplicationsAlthough undoubtedly essential in protecting the health of staff and patients, there are numerous logistical, physiological, psychological, social and economic complications associated with the wearing of masks. The ability of healthcare staff to successfully communicate with patients and with colleagues is jeopardized, which may adversely affect the efficiency, effectiveness, equitability and, most notably, safety of therapeutic intervention. The SLT has a distinct role in facilitating communication in order to safeguard the provision, accessibility and efficacy of services. What this paper addsWhat is already known on the subject Existing research explores the impact of mask wearing on medical doctors, surgeons and dentists, and upon the corresponding patient cohorts. Little is known about how mask wearing may affect Allied Health Professionals and their ability to deliver therapeutic interventions safely and effectively. With mandatory face covering potentially a long‐term requirement for UK healthcare staff, it is both timely and relevant to consider the consequences of mask wearing on communication across acute and community settings. What this paper adds to existing knowledge This paper identifies a range of prospective key issues associated with mask wearing across a variety of clinical and non‐clinical populations, with application specifically to vulnerable patient cohorts. Through evidence synthesis, this paper provides a summary of fundamental issues supported by relevant literature, and draws upon these in order to propose a preliminary set of evidence‐based clinical guidelines setting out potential solutions to the challenges faced. This review additionally assists in quantifying the role of the SLT within these extraordinary circumstances, with the aim of prompting unified practice, building upon professional guidance and increasing skill recognition. What are the potential or actual clinical implications of this work? In addition to their role in facilitating the development of individualised communication strategies for patients, SLTs should actively seek to provide widely accessible multidisciplinary education opportunities focusing on supporting communication; with specific reference to mask wearing and the associated communicative challenges. At a commissioning and managerial level, leaders within healthcare should acknowledge mask wearing as just one of the complexities associated with frontline working in the context of the COVID‐19 pandemic, and aim to support their workforce by delivering resources and protocols which maximize and promote staff safety, efficiency, resilience and well‐being in concurrence with positive patient outcomes.

Assumptions about Decision-Making Capacity and Aphasia: Ethical Implications and Impact.

This article explores the issue of aphasia and decision-making within the context of clinical ethics and patient rights. The cases described illustrate the danger of making assumptions about the inherent competence of people with aphasia and the life-altering consequences if no attempt is made to "accommodate" or support communication when competence may be masked by aphasia. Speech-language pathologists have a moral obligation and a key role to play in providing communication support that may serve to reveal a person's intact capacity to make specific decisions, as well as in supporting the steps involved in the decision-making process. This role also extends to providing guidance, education, and training for others involved in evaluating the decision-making capacity of people with aphasia. Communication support strategies useful at each stage of the decision-making process are detailed.

Parent-Implemented Communication Treatment for Infants and Toddlers With Hearing Loss: A Randomized Pilot Trial.

Purpose Despite advances in cochlear implant and hearing aid technology, many children with hearing loss continue to exhibit poorer language skills than their hearing peers. This randomized pilot trial tested the effects of a parent-implemented communication treatment targeting prelinguistic communication skills in infants and toddlers with hearing loss. Method Participants included 19 children between 6 and 24 months of age with moderate to profound, bilateral hearing loss. Children were randomly assigned to the parent-implemented communication treatment group or a "usual care" control group. Parents and children participated in 26, hour-long home sessions in which parents were taught to use communication support strategies. The primary outcome measures were the Communication and Symbolic Behavior Scales (Wetherby & Prizant, 2003), a measure of child prelinguistic skills, and parental use of communication support strategies during a naturalistic play session. Results Parents in the treatment group increased their use of communication support strategies by 17%. Children in the treatment group made statistically significant more gains in speech prelinguistic skills ( d = 1.09, p = .03) as compared with the control group. There were no statistically significant differences in social and symbolic prelinguistic skills; however, the effect sizes were large ( d = 0.78, p = .08; d = 0.91, p = .10). Conclusions This study provides modest preliminary support for the short-term effects of a parent-implemented communication treatment for children with hearing loss. Parents learned communication support strategies that subsequently impacted child prelinguistic skills. Although these results appear promising, the sample size is very small. Future research should include a larger clinical trial and child-level predictors of response to treatment.

Principals’ emotional support and teachers’ emotional reframing: The mediating role of principals’ supportive communication strategies

AbstractThe purpose of this research is to achieve a deeper understanding of emotional support in principal–teacher relations. The study aims to shed light on the role of principals’ supportive communication strategies in providing emotional support to teachers, and on the proximal affective outcome of such support. The study used quantitative data obtained from 190 schoolteachers to explore the effect of principals’ emotional support on teachers’ emotional reframing through principals’ supportive communication strategies (empathic listening and empowering and normalizing messages). The analysis indicated an indirect effect of principals’ emotional support on teachers’ emotional reframing through principals’ supportive communication strategies. The results and their implications are discussed.

Artful Moments: A framework for successful engagement in an arts-based programme for persons in the middle to late stages of dementia.

Art galleries are becoming more inclusive in their activities for those with specific needs. The interdisciplinary team on an inpatient behavioural health unit collaborated with artist-educators at the Art Gallery of Hamilton (Ontario, Canada) to create an arts-based programme. ‘Artful Moments’ involved using a combination of art appreciation and hands-on art making activities and took place on the unit at the hospital and at the art gallery. A pilot study of eight participants and their care partners who attended the programme is presented. The purpose of the study was to determine if ‘Artful Moments’ facilitated positive engagement ‘in the moment’ for persons in the middle-to-late stages of dementia. The perception of the programme’s impact from their care partners’ perspectives, as well as their satisfaction with the programme is also reported. Extensive education of art gallery staff and clinical staff preceded the programming, with each team sharing expertise with the other. Sessions (n = 27) took place about twice per month. Data were collected through systematic structured observations of patient participants during the activities and through surveys of care partners. Persons with dementia maintained interest, though not necessarily pleasure, during art appreciation and art making, rarely became sad or anxious, and never became angry. Generally the care partners felt that participants enjoyed the experience, and often they were surprised by the very positive response of the participants. Successful engagement was attributed to a dementia-friendly environment; supportive communication strategies; and a suitable, well-planned activity.

Parent-Implemented Communication Intervention

Collaboration with parents and caregivers to support young children’s communication development is an important component to early intervention services. Coaching parents to implement communication support strategies is increasingly common in parent-implemented interventions, but few studies examine the process as well as the outcomes. We explored the triadic relationships between interventionist, parent, and child within a parent-implemented communication for toddlers with Down syndrome (DS), autism spectrum disorder (ASD), or developmental delays (DD). Time-window sequential analyses revealed that parents were more likely to use communication strategies during or immediately following coaching strategies that encouraged the parents’ active role. Children were more likely to use targeted communication skills immediately following responsive parent interactions. Intervention occurred in similar frequencies across play and non-play routine contexts. This analysis provides preliminary information on understanding potential mediating variables in parent-implemented interventions. Implications for increasing parent capacity-building and child outcomes through coaching are discussed.

Evaluating the MESSAGE Communication Strategies in Dementia training for use with community-based aged care staff working with people with dementia: a controlled pretest-post-test study.

The study aims to evaluate the effects of a communication skills training programme on community aged care staff's knowledge of communication support in dementia and on staff's care experience. Dementia can lead to impairments in communication. Therefore, quality community-based dementia care requires that staff be skilled communicators, equipped to facilitate interactions with people with dementia. The current investigation evaluated the effectiveness of the MESSAGE Communication Strategies in Dementia for Care Staff training programme with respect to knowledge of communication support and the staff/caregiver experience. A multi-centre controlled pretest/post-test design with randomised cohort allocation was used. Outcome measures were completed at baseline, immediately after training (training group only), and at three-month follow-up. Thirty-eight care staff working in community aged care participated and completed all outcome measures (training = 22; control = 16).Training and control groups completed the following outcome measures: knowledge of communication support strategies, self-efficacy, preparedness to provide care, strain in nursing care and attitude to dementia care. Staff in the training group provided written feedback on the training. A significant improvement in knowledge scores from baseline was found for the training group both immediately after training and at three-month follow-up. There was also a significant training effect for self-efficacy and preparedness to provide care. No significant difference was found for the control group for any measure. No significant training effects were found for measures of strain or attitudes to dementia care. Feedback from staff suggests that the training was well received. The MESSAGE training was positively received by staff and had a significant effect on care staff knowledge, and confidence to provide care for people with dementia. The easily accessible multimedia training programme is well received by staff and has the potential to improve quality of care.

The Effects of Home-Based Literacy Activities on the Communication of Students with Severe Speech and Motor Impairments

This study examined the effects of using sensory, augmentative, and alternative communication (AAC), and supportive communication strategies on the rate and type of communication used by three students with severe speech and motor impairments (SSMI). Using a multiple baseline across behaviour design with sensory and AAC intervention phases, students were paired with a family member during shared reading activities using familiar and unfamiliar storybooks in their homes. All reading activities were video-recorded for analysis. Examination of recorded readings revealed that students demonstrated increases in their overall rates of communication. Further, these students successfully integrated communication devices into the reading process. The results suggest that students with severe disabilities can benefit from these forms of literacy strategies to increase their participation in reading tasks. Implications for research and practice are discussed.

Perceptions of success of a local UK public health collaborative†.

SummarySuccessful public health initiatives require multi-sector collaboration. AVONet was a UK collaborative developed to provide evidence-based strategies for active ageing. This study explored the success of AVONet in the achievement of its objectives as perceived by all partners. A convergent parallel mixed-methods design was employed, utilizing a quantitative survey and qualitative semi-structured interviews. Data collection was undertaken in September 2010, 18 months after establishing the collaborative and 6 months after funding had ceased. AVONet partners (n = 24) completed a 27-item survey. A sub-sample of four academics and four practitioners participated in semi-structured interviews. Quantitative and qualitative comparisons were made between academics' and practitioners' perceptions of success, potential for sustainability and satisfaction with structure and relationships. Participants perceived the AVONet collaborative positively. Significant between-group (academic v practitioner) differences in survey responses were observed for success (U = 19.5; p = 0.003) and structure (U = 125.5; p = 0.001). Strong positive correlations were observed between success and structure and balance between information transfer and exchange (r = 0.756; p < 0.001). Interviews confirmed positive perceptions and perceived importance of the collaborative and highlighted the need for further integration and tangible outcomes for practitioners. Suggestions to enhance sustainability were provided, such as smaller working groups and local council-led governance. Perceived success in building a multi-sectoral collaborative can be achieved during a 10-month period, despite differing needs of contributors. For collaboratives developed as a result of external funding aimed primarily at facilitating research, involvement of practitioners at an early stage may help set more comprehensive goals, supportive communication strategies, and increase potential for sustainability.

Informal caregivers' needs on discharge from the spinal cord unit: analysis of perceptions and lived experiences

Purpose: Spinal cord injuries (SCI) are one of the most complex and disabling diseases, implying severe consequences on aspects of life of people affected by SCI and their caregivers. The aim of our study was to explore the situation of informal caregivers of persons with SCI when discharged home from a SCI Unit, in relation to needs, emotional experiences, difficulties and subsequent reactions to discharge. Methods: A purposive sample of 11 caregivers were interviewed on patients' discharge home from the Spinal Injury Care Unit and at 6 months. The semi-structured interviews were analyzed using a qualitative phenomenological methodology as described by Giorgi. Results: Five main themes emerged from the caregivers' experiences including their implicit and explicit needs. Problems concerning communication with healthcare professionals and the need for an adequate multidisciplinary taking charge of caregivers in order to support their new role emerged within all the themes. Conclusions: Results suggest that greater caregiver involvement in the rehabilitation process and their preparation for discharge are required. Communication with healthcare professionals needs to be enhanced. It would be useful to organize follow-up visits after discharge to assess intervention effectiveness.Implications for RehabilitationUnderstanding the importance of discharge from the spinal cord unit as a meaningful step in the rehabilitation path for both patients and their informal caregivers.Orientating healthcare professionals towards a better caregiver involvement during the rehabilitation process.Promoting rehabilitation interventions addressed to the patients and their caregivers concerning supportive communication strategies as well as providing meaningful information, psychological and social support, educational intervention besides the physical aspects of care.Understanding SCI survivors caregivers' needs can assist healthcare professionals in planning and improving taking charge of this core aspect of nursing care.

The implementation of a learner-centred conversation training programme for spouses of adults with aphasia in a community setting

Background: Conversational training programmes are increasingly being reported for partners of people with aphasia. The approach, formats used and ways in which these programmes have been evaluated vary. The literature to date provides evidence that conversation partner training can be effective, but it remains unclear as to what specific components contribute to successful outcomes. In this regard, the effectiveness of a learner-centred training programme was demonstrated in the author’s previous work with five couples living with chronic aphasia. Results of this programme, which was delivered in a one-to-one format, included improvements in the quality of conversation for the couples who participated.Aims: The aim of this study was to determine whether similar results could be obtained if the programmes’ original format was modified to include a combination of both individual and group sessions. An additional aim was to describe the content and contribution of both the types of sessions.Methods & Procedures: Four couples living with aphasia participated in this study with a case series descriptive design. The training, delivered by a speech-language pathologist (SLP) and communicative disorders assistant (CDA), consisted of an 8-week communication training programme incorporating content and adult learning strategies similar to the original programme. The modified format included four individual and four group sessions. Couples were seen once a week and were encouraged to practice conversation strategies at home.Outcomes & Results: Results were consistent with those previously reported using the one-on-one format and included an increase in spouses’ use of supportive conversation strategies and an increase in the partner with aphasia’s participation in conversation. Couples reported improved ability to discuss more complex topics, increased positive feelings about conversation and perceived the supportive communication strategies as being useful in their interactions at home. Additional positive effects were reported related to the group experience including the reinforcement of communication strategies learned in training sessions as well as mutual aid and peer support.Conclusions: The use of a format incorporating both individual and group learner-centred training sessions demonstrated positive changes in attitudes and communication behaviours for couples in this study. The group process enhanced the value of the programme by promoting mutual aid and the validation of the personal experiences of each couple. These results have implications for SLPs’ work with couples living with aphasia in the community and demonstrate the benefits of using an adult learning approach that includes both individual and group sessions.

Teaching children about dementia: Pilot findings from the hip hop old S.C.H.O.O.L. (Seniors Can Have Optimal aging and Ongoing Longevity) program

Background: Progressive deterioration of communication abilities can contribute to social isolation, reduced quality of life and increased behavioural disturbances for people with dementia, and subsequently lead to placement in residential care. Training community-based aged care staff to use strategies that facilitate communication with people with dementia can help to reduce these negative effects, prior to placement in residential care. Based on research and clinical evidence, the MESSAGE Communication Strategies in Dementia training has been developed to provide staff with evidence-based strategies to facilitate communication with people with dementia. This training provides an opportunity to improve staff communication and support their ability to provide person-centred care, while maintaining people in their own home for as long as possible. Methods: A controlled pre-test/post-test design was used to evaluate the benefits of providing communication skills training to staff providing community-based aged care to people with dementia. The training group (n1⁄413) watched the video-based MESSAGE training, and were provided with individual feedback on strategy use in conversations with clients. Staff in the control group (n1⁄417) continued with care as usual. Outcomes were measured at baseline and 3-months later at follow-up, and included measures of knowledge of communication support strategies, preparedness to provide care, and attitudes to dementia care. Staff knowledge was assessed again for the training group immediately after watching the training video. Results: Staff in the training group demonstrated a significant improvement in their knowledge of communication strategies between baseline and immediately after training (Z1⁄4-2.451, p1⁄40.014), and also, for those training group participants that have completed the 3-month follow-up to date (n1⁄47), between baseline and follow-up (Z1⁄4-1.992, p 1⁄40.046). The training group also showed a significant increase in preparedness to provide care following training (Z1⁄4-2.366, p 1⁄40.018). The control group showed no significant changes in outcomes between baseline and follow-up. Conclusions: The MESSAGE training resulted in increased staff knowledge of communication support in dementia, and improved staff ratings of preparedness to provide care to people with dementia. This training has the potential to lead to sustainable changes in both staff confidence and quality of care when working with people with dementia.

Enhanced Milieu Teaching: Incorporating AAC Into Naturalistic Teaching With Young Children and Their Partners

Abstract Enhanced Milieu Teaching (EMT) is an evidence-based naturalistic intervention strategy that teaches functional communication and language skills in everyday interactions with partners. In this manuscript, we describe the key communication support strategies used in EMT and how individuals can use these strategies with augmentative and alternative communication systems. We also present strategies for teaching partners to use EMT with AAC in interactions with young children.