Factors that influence the effectiveness of conversation training for people with aphasia: who benefits most and which tasks really help people to learn new strategies?

Fellow: Firle Beckley

Conversation training is a specific type of intervention provided by speech and language therapists to help people with aphasia and their conversation partners have more successful and enjoyable conversations. Aphasia, a language disorder most commonly caused by stroke, can make participating in everyday conversation very difficult.

My project is building on the findings of a previous Stroke Association funded study (TSA 2005/07, 2008-2011), on which I was the research assistant, that developed and evaluated a new type of conversation therapy. The therapy actively taught strategies to a person with aphasia, as well as their conversation partner^1,2. Commonly, conversation training is just offered to the non-aphasic partner. This prior study showed that people with aphasia were able to learn new strategies to improve conversation, with five out of eight showing statistically significant positive changes in their conversational abilities after therapy. However, what we do not yet fully understand is (a) why some people did not improve, and (b) exactly which tasks within the therapy programme are required for positive conversation change. The results suggested cognitive flexibility, i.e. the ability of a person with aphasia to “switch” from one plan of action or thought to another, may be important.

My PhD project aims to explore in greater detail which people with aphasia are most suited to this type of therapy, and which therapy tasks are key to achieving reliable positive conversation changes. I will be recruiting eight people with aphasia and their conversation partners. Participants will undergo cognitive screening, to investigate how cognition impacts on strategy use in conversation, and will have their language and conversation skills assessed. They will then take part in an eight-week therapy programme where tasks will be divided into two components (a) education about the way that conversation works, and (b) training in conversation strategy use. After therapy, people will repeat the assessments of language and conversation skills.

In doing this I hope to assist speech and language therapists’ understanding of which people with aphasia are most appropriate for this therapy, and to ensure that the therapy offered is as effective and economically viable as possible.