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Conversation Therapy with People with Aphasia and Conversation Partners using Video Feedback: A Group and Case Series Investigation of Changes in Interaction

Best, W; Maxim, J; Heilemann, C; Beckley, F; Johnson, F; Edwards, SI; Howard, D; (2016) Conversation Therapy with People with Aphasia and Conversation Partners using Video Feedback: A Group and Case Series Investigation of Changes in Interaction. Frontiers in Human Neuroscience , 10 , Article 562. 10.3389/fnhum.2076.00562. Green open access

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Abstract

Conversation therapies employing video for feedback and to facilitate outcome measurement are increasingly used with people with post-stroke aphasia and their conversation partners; however the evidence base for change in everyday interaction remains limited. We investigated the effect of Better Conversations with Aphasia (BCA), an intervention that is freely available online at https://extend.ucl.ac.uk/. Eight people with chronic agrammatic aphasia, and their regular conversation partners participated in the tailored 8 week program involving significant video feedback. We explored changes in: (i) conversation facilitators (such as multi-modal turns by people with aphasia); and (ii) conversation barriers (such as use of test questions by conversation partners). The outcome of intervention was evaluated directly by measuring change in video-recorded everyday conversations. The study employed a pre-post design with multiple 5 minute samples of conversation before and after intervention, scored by trained raters blind to the point of data collection. Group level analysis showed no significant increase in conversation facilitators. There was, however, a significant reduction in the number of conversation barriers. The case series data revealed variability in conversation behaviors across occasions for the same dyad and between different dyads. Specifically, post-intervention there was a significant increase in facilitator behaviors for two dyads, a decrease for one and no significant change for five dyads. There was a significant decrease in barrier behaviors for five dyads and no significant change for three dyads. The reduction in barrier behaviors was considerable; on average change from over eight to fewer than three barrier behaviors in 5 minutes of conversation. The pre-post design has the limitation of no comparison group. However, change occurs in targeted conversational behaviors and in people with chronic aphasia and their partners. The findings suggest change can occur after eight therapy sessions and have implications for clinical practice. A reduction in barrier behaviors may be easier to obtain, although the controlled case series results demonstrate a significant increase in conversation facilitators is also possible. The rehabilitation tool is available online and video technology was central to delivering intervention and evaluating change.

Type: Article
Title: Conversation Therapy with People with Aphasia and Conversation Partners using Video Feedback: A Group and Case Series Investigation of Changes in Interaction
Open access status: An open access version is available from UCL Discovery
DOI: 10.3389/fnhum.2076.00562
Publisher version: http://dx.doi.org/10.3389/fnhum.2076.00562
Language: English
Additional information: © 2016 Best, Maxim, Heilemann, Beckley, Johnson, Edwards, Howard and Beeke. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).
Keywords: Science & Technology, Social Sciences, Life Sciences & Biomedicine, Neurosciences, Psychology, Neurosciences & Neurology, aphasia, conversation, intervention, video feedback, agrammatic aphasia, therapy, outcome measure, RANDOMIZED CONTROLLED-TRIAL, SIGNIFICANT OTHERS, CONNECTED SPEECH, STROKE, REHABILITATION, COMMUNICATION, INTERVENTION, AGRAMMATISM, INFORMATION, RELIABILITY
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Language and Cognition
URI: https://discovery.ucl.ac.uk/id/eprint/1532100
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