Training total communication

ABSTRACT

Background: Many people with severe or moderate aphasia begin to use nonverbal methods of communication spontaneously, but some need special training to do so. Use of total communication, including different nonverbal techniques, is often recommended to enable communication and participation in social interaction. Emphasis has also been placed on the importance of a communication partner in facilitating interaction and co-constructing the meaning in a discussion.

Aims: The aim of the present study was to examine the way people with severe or moderate aphasia perceive they communicate, and if they and their partners perceive changes in the use of different means of communication during an intervention where the aphasic participants are stimulated to use total communication and the communication partners are guided to support the interaction and to facilitate the use of different means of communication.

Methods & Procedures: The data were collected during a regular rehabilitation course. The course was carried out in two parts (8 + 4 days) with a 3-month interval. A total of 38 aphasic respondents, mainly with severe or moderate aphasia, aged 26 to 65 years, and 38 of their partners aged 29 to 71 years participated in the study. The research involved an initial, interim, and delayed post-test questionnaire design stretched over a 9-month period. An investigator-constructed, self-assessment questionnaire called Use of Different Communication Methods (UDCM) was used. With the aphasic participants a pictorial version of the questionnaire was administered in the form of an interview. The partners completed the questionnaire independently.

Outcomes & Results: The results indicate that persons with aphasia and their partners perceive the use of different communication methods quite similarly. The participants with aphasia perceive they use mostly the remaining ability of speech they possess and spontaneous nonverbal communicative methods and in lesser degree low-tech and high-tech devices. Both parties perceived that the use of spontaneous nonverbal means of communication and low-tech devices increased during and after the intervention.

Conclusions: The results indicate that people with severe and moderate aphasia and their partners perceive that total communication, i.e., all available means of communication as for instance, limited speech, spontaneous nonverbal means of communication and low-tech devices is often in use. They also perceive that the use of these different communication methods can further be increased by training and by guiding the communication partner to facilitate and support the use of them.

Keywords:

• Aphasia
• Nonverbal communication
• Total communication
• Group intervention
• Self-assessment

This study was supported by grants from the Finnish Cultural Foundation. The author would like to offer her sincere thanks to the participants who contributed their time to the project, and to the Finnish Stroke and Dysphasia Association.

Notes

¹According to the Finnish law on services for disabled people, people with communication disorders may use the services of a speech interpreter to help them communicate and in reading and writing.