How a Speech Therapist Can Help You If Your Loved One Has Aphasia
Written by: Megan Smith / Aphasia (Stroke) / April 2019
For a person with aphasia, interacting with others can be difficult and frustrating. Communication partner training is a term describing a broad variety of strategies used to train the loved ones of that individual, and is often used to complement speech therapy that directly targets that person’s communication skills.
How is Communication Partner Training Helpful?
The body of evidence supporting communication partner training is primarily lower-level research. However, clinical expertise and patient reports further support its use as a treatment tool (for more information on why this is important, see our April 2019 article “Comparing the Two Main Practice Standards in Healthcare”). There is evidence that communication partner training does have a positive effect on the interactions between that communication partner and the person with aphasia, although any further impact on quality of life overall or the person with aphasia’s communication with other partners is unknown (Simmons-Mackie, Raymer & Chernie, 2016).
In a 2017 paper, Simmons-Mackie offered a potential way of understanding how communication partner training can be effective. She draws upon research on the better-understood Communication Accommodation Theory, which outlines the various ways in which people change their communication styles to better match their conversation partners, in order to establish a good relationship with their conversation partner. This theory may explain a potential relationship between communication partners’ use and full acceptance of their loved ones communication strategies and the likelihood that their loved one with aphasia will use them, in order to provide a potential rationale for why people with aphasia may prefer not to use the strategies that help them communicate effectively in their daily lives. Simmons-Mackie suggests that:
““When speaking partners fail to use or orient positively to augmentative communication modes, people with aphasia are likely to accommodate to the standard (largely spoken) communication style of the non-aphasic partner.”
(1215)
“Avoiding multimodal communication might be a form of convergence to the unaided communication style of the unimpaired partner. The consequence of such accommodation is less effective negotiation of meaning”
(1218)
”
Essentially, a failure to accommodate the speaking style of a loved one with aphasia may place pressure on the person with aphasia to match their partner’s speaking style, even if it reduces their chances of understanding the conversation. By learning strategies useful in communicating with a person with aphasia, you allow your loved one to communicate in the ways that work for them, with the understanding that you will accommodate their speaking style.
What Kinds of Strategies Are Used?
As the content of a training program will differ depending on your communication style, it is hard to predict exactly what you may learn without a brief assessment. However, these skills are often taught:
• Encouraging your loved one to communicate using their best strategies. This could include asking them to write the first letter of the word to help you identify the topic they would like to discuss, or simply asking if there is a strategy that could help when an issue comes up.
• Match your loved one’s communication style. If your loved one is using communication strategies, join them. Strategies such as gesturing or writing words down may support their understanding of what you say.
• Accept inefficiencies and errors. By removing time pressure from your loved one when they are communicating, you are giving them the space to say what they want at their own pace, without accommodating your faster speaking style. Focus more on the general message that your loved one is trying to say, rather than the accuracy of their pronunciation or grammar.
• Set up your communication environment for success. Removing sources of loud noise or other distractions can help your partner focus well on what you’re saying. Speaking about things in their ideal context (e.g. talking about dinner plans in the kitchen) can help as well.
• Restate what was said to you. Many miscommunications can be avoided simply by expressing what you understood! This gives your partner a chance to confirm that you understood well, or to signal that you’ve missed their point.
• Learn to relax and manage your emotions. Managing your frustration, sadness, or any other emotional responses that may surface when communication is difficult will help keep the conversation moving more effectively for you and your loved one.
If you have been struggling to communicate with a loved one, communication partner training may help make things a little bit easier. Working with a speech-language pathologist may be helpful for some recommendations, but working on your communication style can be as easy as checking in with your loved one and asking questions. “Is there anything that I can do that would make you feel better about our communication?” is a great place to start, if you are open to listening.
Citations:
Simmons-Mackie, N. (2018). Communication partner training in aphasia: reflection on communication accommodation theory. Aphasiology, 32(10), 1215-1224. DOI: 10.1080/02687038.2018.1428282
Simmons-Mackie, N., Raymer, A., & Cherney, L. R. (2016). Communication partner training in aphasia: an updated systematic review. Archives of Physical Medicine and Rehabilitation, 97(12), 2202-2221. DOI: https://doi.org/10.1016/j.apmr.2016.03.023
If you would like to contact a speech-language pathologist to talk about supporting a loved one’s communication well, you can book an initial consultation with us using the link below, or by calling (647) 795-5277.
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