The self-determined and partner-predicted topic preferences of adults with Aphasia

Abstract

The impact of aphasia on the lives of the individuals with the disorder as well as their family and friends is significant. Augmentative and alternative communication (AAC) systems that use topics to organise the message content within the systems have been found to be an effective way of facilitating the communicative attempts of individuals with aphasia. These topics need to be pre-selected for storage in the AAC systems prior to their use in naturally occurring communication instances. Most frequently, the familiar communication partners of adults with aphasia are asked to act as informants and predict which topics their partner with aphasia would like to have included in their AAC system. Informant-input however, is not always accurate and the need for adults with aphasia themselves to be actively involved in this process has been stressed by many researchers. The main aim of the study therefore was to determine the topic preferences (on a threepoint semantic differential scale) of adults with expressive aphasia as indicated by both the adults themselves and their familiar communication partners. Participants with aphasia (n=10) were requested to choose someone that knew them well and with whom they communicated regularly to take part in the study with them. This person was termed a ‘familiar communication partner’ and was requested to participate in the study by predicting the topic preferences of their partner with aphasia with the use of the Talking Mats™ framework. These familiar communication partners (n=10) were also requested to think of any additional topics that their partners with aphasia would like to talk about that were not included in the 37 Pictographic Communication Resources (PCR) topics presented to them. These additional topics were then added to the 37 PCR topics and presented to the adults with aphasia for evaluation by means of the Talking Mats™ framework. Results of the study revealed that the participants with aphasia wanted to talk about the majority of the PCR topics presented to them (70.81%), with their familiar communication partners also predicting that the adults with aphasia would like to talk about the majority of the PCR topics (64.05%). Topics that the adults with aphasia wanted to talk about included those related to aphasia and physical impairment, as well as those related to work and other appropriate social roles. The average agreement of topic preferences, provided by both participant groups, over all topics and dyads was 65%. This indicates that in general, the familiar communication partners predicted their partner with aphasia’s topic preferences relatively accurately. Variations occurred across topics (30-100%) and dyads (48.65-89.19%). Knowledge of the topic preferences of adults with aphasia and the topic preference discrepancies within dyads can aid clinicians and AAC specialists in appropriately facilitating the pre-selection and storage of topics within AAC systems for use by adults with aphasia.