Communication therapy for people with aphasia and their partners (APPUTE)

Abstract

Background: Severe aphasia is a chronic condition and can have a big effect on how people with severe aphasia (PWSA) succeed in their communication. The communication partner’s support for the person with aphasia has been shown to be essential in achieving successful communication. However, interventions combining training both the partner and the PWSA to use hierarchical strategies in nonverbal communication are still needed.

Aims: The aim of the present paper is to describe a new intervention (APPUTE) where both the person with aphasia and the partner receive therapy equally and practise finding functional communication strategies to convey everyday messages or more complicated ones. The data collection during the APPUTE intervention is also presented.

Methods & Procedures: The data were collected during a development project including an evaluation period, two rehabilitation periods and follow-up measurement. Thirty-four PWSA and their partners participated. The linguistic functions and communication efficiency of PWSA were evaluated three times during the rehabilitation. The communication skills of the partner were also assessed, along with the success of the mutual communication.

Outcomes & Results: The communication skills and communication efficiency of the PWSA and their partners improved significantly during the rehabilitation period, and the acquired skills were retained for 6 months after the intervention. The linguistic skills of the PWSA also improved. The advanced age of the partner explained both the variance of the partner’s communication skills and the success in the mutual communication. The amount of earlier outpatient speech therapy explained the variance of the communication efficiency of PWSA as evaluated by the partners. Regarding success in mutual communication, all of the couples were able to communicate at least simple issues at the end of the rehabilitation period. The more demanding the tasks, the more difficult it became for them to succeed, especially for older PWSA with severe motor paralysis. Both the people with aphasia and their partners mainly experienced benefits from the APPUTE intervention and for the most part, the benefits were retained during follow-up.

Conclusions: The APPUTE method appears to improve the communication skills of PWSA and their partners, as well as the linguistic skills of PWSA.

Keywords:

• Aphasia
• Communication therapy
• Partner training.

This project was supported by Finland’s Slot Machine Association (RAY). We thank Professor Anu Klippi, Ph.D. and Riitta Vartiainen, Lic.Phil., speech and language therapist, for advice during the project, as well as for constructive criticism of the manuscript, and Jouko Katajisto, M.Sc., statistician, for statistical consultations.