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

Abstract

BACKGROUND : Due to the challenges presented by the complex nature of aphasia, the familiar communication partners of these individuals often act as informants in the process of selecting topics for inclusion in an AAC system. However, informant input is not always accurate, and hence the active involvement of adults with aphasia in the preselection of topics for use in an AAC system has been advocated. In order to provide adults with aphasia the opportunity to participate in research and clinical practice, appropriate support is needed. Such support can be provided in the form of concrete materials and partner facilitation. AIMS : This study aimed to 1) determine the topic preferences of adults with aphasia by providing them with the opportunity to preselect their preferred topics of conversation and 2) compare the self-selected and partner-predicted topic preferences. METHODS AND PROCEDURES : This study employed a descriptive design to describe and compare the topic preferences provided by members of 10 dyads comprising an adult with moderate to severe aphasia and his/her familiar communication partner. The topic preferences of the participants were obtained by using the Talking MatsTM framework to rate 37 topics taken from the PCR Manual (Kagan, Winckel, & Shumway, 199625. Kagan, A., Winckel, J. and Shumway, E. 1996. Pictographic communication resources manual, Toronto, ON: Aphasia Centre, North York.

View all references) represented on topic cards. Spontaneous comments made by the participants were qualitatively analysed in order to better understand the way in which topic preferences were determined. OUTCOME AND RESULTS : The participants with aphasia revealed that they would like to talk about the majority of the topics presented to them. Partners predicted topic preferences of persons with aphasia with an average accuracy of 65%. The amount of time dyads spent together, the variety of activities performed together as well as the manner of selecting joint activities were all factors that appeared to have a significant impact on the level of accuracy of the partner's predictions. Furthermore, partners who demonstrated their belief in the communicative competence of the person with aphasia, despite the person's speech and language limitations, also tended to predict preferences more accurately. CONCLUSIONS : The adults with moderate to severe aphasia in this study were capable of communicating their topic preferences when provided with the Talking MatsTM framework. While partner input in topic selection is certainly important, various factors seem to influence the accuracy of partner's predictions. The results can serve to guide clinical practice when conversational topics are selected for persons with severe aphasia.