Supported conversation for adults with aphasia§T§M, methods and evaluation

grantor: University of TorontoThis thesis reports the development and evaluation of a new intervention termed 'Supported Conversation for Adults with AphasiaTM' (SCATM). The approach is based on the idea that the inherent competence of people with aphasia, an adult neurogenic language disorder, can be revealed through the skill of a conversation partner. The intervention approach was developed at a community-based aphasia center where professionally trained volunteers interact with individuals with chronic aphasia and their families. Current evaluative tools focus exclusively on the person with aphasia and do not capture the impact of the conversational partner on communication. Two complementary evaluative instruments were therefore developed. One was designed to measure the skill of the conversation partner in providing conversational support to the person with aphasia. The second was designed to measure the aphasic individual's level of participation in conversation. Preliminary psychometric evaluation of these measures indicated that they were adequate for the purpose of an experimental study of the efficacy of SCATM''. The experimental study was designed to test a primary hypothesis related to the following question: Do volunteer conversation partners trained in SCA TM score higher than untrained volunteers on a 'Measure of Supported Conversation for Adults with AphasiaTM'? Secondary hypotheses related to the following two questions: (a) Do adults with aphasia, in conversation with trained volunteers, score higher than those with untrained volunteers, on a 'Measure of Aphasic Adults' Participation in Conversation' and (b) Are changes in volunteers' scores related to changes in the scores of their partners with aphasia? The study (n = 40 dyads) utilized a pre-post randomized control group design. Experimental volunteers received SCATM training and control volunteers were merely exposed to people with aphasia. Results provide substantial support for the efficacy of SCATM in training volunteer conversation partners. The methods also appear to be efficient in that training volunteers produced some positive change in the individuals with aphasia even though these individuals did not receive therapy. Implications for the treatment of aphasia and an argument for a social model of intervention are presented.Ph.D