Preliminary analysis from a novel treatment targeting the exchange of new information within storytelling for people with non-fluent aphasia and their partners

摘要

Background: Therapy for people with aphasia (PWA) can encompass a wide range of aims and methodologies, from targeting the linguistic impairment, to strategic compensation to optimise communication, interaction and vocational rehabilitation. Across treatment type, one unifying area of interest relates to the generalisation of behaviours targeted in therapy to untrained tasks and contexts, particularly those related to everyday communication. Therefore, aphasia rehabilitation ultimately has a social goal of optimising the communication of the person with aphasia (PWA) within their typical environment. One important aspect of everyday communication relates to conveying new information and telling anecdotes/stories. Measures of transactional success in storytelling have previously demonstrated reliability and validity as anudanalytical method.udAim: The study aimed to extend previous work on transactional success in storytelling to a programme of therapy targeting both the PWA and the communication partner (CP).udMethods and procedures: Four participants with chronic non-fluent aphasia and their CPs were recruited and a novel dual-focus treatment was administered. For the PWA, therapy targeted storytelling using the principles of ‘thinking for speaking’ and story grammar. For the partner, therapy drew on the principles of conversation coaching to increase facilitative behaviours within storytelling to aid the construction of shared understanding. Quantitative measures were used to investigate effects of treatment in novel storytelling tasks for the group and within a single case study.udOutcomes and results: There were numerical gains in information exchange for three of four couples, where the conversation partner displayed improved understanding of the PWQ’s story, and a decrease for one couple. Evidence of likely direct effects of therapy across both simple and complex storytelling was consistent for two of the four couples. The single case study suggested change consistent with the aims of the treatment programme.udConclusions: The method of dual-focused therapy and outcome measurement outlined in this paper offers promise for targeting an important aspect of everyday communication in a standardised task. Potential for future investigation is discussed.