Beckley, Firle;
(2024)
Communication Partner Training, cognition and aphasia: What are speech and language therapists doing in clinical practice and what are the outcomes for everyday conversation and functional communication compared with Better Conversations with Aphasia?
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
BACKGROUND: Effective conversation is a key rehabilitation outcome for a person with aphasia (PwA) and communication partner (CP). Increasingly evidence suggests that communication partner training (CPT) changes CP compensatory behaviours, improving PwAs’ participation in conversation, and that PwAs’ cognitive flexibility (CF) may influence outcomes. This study manualised UK aphasia treatment as usual for compensatory behaviours referred to as Communication training for Everyday Activities (CteA). CteA was compared to Better Conversations with Aphasia (BCA) Express, adapted from BCA for this study. Functional communication and conversation outcomes were investigated. The relationship between PwAs’ CF and compensatory behaviour use was explored. METHOD: A consensus study with UK speech and language therapists led to the manualisation of CteA. A multiple baseline cross-over design compared CteA and BCA Express in five PwAs and CPs. Primary outcome measures were The Scenario Test-UK and a novel conversation measure, the Compensatory Behaviour Measure. Each PwA underwent cognitive profiling to explore the relationship between CF and compensatory behaviour use. RESULTS: CteA targets PwAs’ use of compensatory behaviours using quasi-contextualised tasks designed to mimic functional activities. The CP is not actively involved. After BCA Express, conversation changes occurred in three of five PwAs and two PwAs after CteA. PwAs whose conversation changed had CPs whose conversation also changed. Evidence suggests PwAs frequently using compensatory behaviours before CPT, regardless of success, respond well to CPT. None of the five CPs used implicitly modeled compensatory behaviours after CteA. Two PwAs showed positive conversation change after BCA Express, despite severely impaired CF. CONCLUSIONS: BCA Express positively changed three PwAs’ conversation behaviour, impaired CF did not impede two of those PwAs’ gains. CteA positively changed two PwAs’ conversation behaviour. In both interventions positive PwA conversation outcomes occurred alongside positive CP conversation outcomes. This suggests an active focus on the PwA and CP is optimal for CPT.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Communication Partner Training, cognition and aphasia: What are speech and language therapists doing in clinical practice and what are the outcomes for everyday conversation and functional communication compared with Better Conversations with Aphasia? |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2024. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| Keywords: | Aphasia, communication partner training, better conversations with aphasia, conversation, cognition |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10187406 |
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