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. Aphasia rehabilitation ultimately has a social goal of optimising the communication of PWA within their typical environment. Therefore, 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. Two important aspects of everyday communication relate to conveying new information and telling anecdotes/stories. Measures of transactional success in storytelling have previously demonstrated reliability and validity as an analytical method.
Aims: 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). The effects of therapy were measured in untrained novel storytelling tasks.
Methods & Procedures: Four participants with chronic nonfluent 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 CP, therapy drew on the principles of conversation coaching to increase facilitative behaviours within storytelling to aid coconstruction of the story.
Outcomes & Results: Outcomes were influenced by the complexity of the target stimuli: following therapy, three PWA demonstrated increased transfer of new information within untrained simple storytelling. For the untrained complex storytelling stimuli, improvements were limited to two PWA. There were also changes in how PWA produced stories (i.e., the order of events within the story), with simple stories becoming more inline with the sequence used by control participants. Regarding the CPs, again there was an effect of complexity: for the untrained simple story, three CPs improved the accuracy of their understanding while for the untrained complex story, two CPs improved. Interestingly, one CP consistently demonstrated a decrease in the amount of information successfully understood following therapy, despite improved information exchange by her partner with aphasia.
Conclusions: The preliminary findings of this dual-focused therapy offer promise in terms of targeting a range of skills relating to both the PWA and CP, whilst the context of information exchange and storytelling promotes likelihood of generalisation of targeted behaviours to untrained tasks.