Communication Partner Training - Thomson Rogers ?· behavioural issues ... • Communication issues…

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  • CommunicationPartnerTraining

    PresentedbyJeanettePodolsky,SLPReg.CASLPOClinicalDirector

    TheSpeechTherapyCentresofCanadajeanette@tstcc.ca

  • Inthebeginning Communicationissuesmaynotbeaddressedimmediately

    followinganacquiredbraininjury Peopleinthehospitalsettingmayhavepain,mobilityand

    behaviouralissues Complexcommunicationissuesmaybeinvisible Intheearlystageswemaybeawareofsomelanguageissues

    (word finding)andnotlanguagefunctionswhichinvolvethedynamicnatureofcommunication

    Communicationissuesbecomemoreobviouswhenmovingfrompatienttopersoninthecommunity

    CommunicationissuesaffectthepersonwiththeABIANDcommunicationpartners

    Communicationissuesneedtobeaddressedfromthebeginning

  • Incidence

    SheilaMacDonald(2009) CommunicationDisordersareprevalentfollowingABIwithprevalenceratesashighas80%dependingonmeasuresused.

    OBIAImpactReport(2012) 82%ofABIsurvivorshavetroublehavingconversationinagroup

    91%havetroublemakingdecisionssomeormostofthetime

  • Cognitivecommunicationataglance

    AttentionOrientationMemory

    OrganizationReasoningJudgmentAnalysis

    ExecutiveFunctions

    UnderstandingSpeakingReadingWriting

    ConversationalInteraction

    SocialCommunication

    MacDonald,2009

    CCD

    Cognition Communication

  • Cognitivecommunicationchallenges

    CognitivecommunicationchallengesofteninteracttoproducethemosttroublingobstaclestoACADEMIC,SOCIAL,and

    VOCATIONALsuccess.

    Togher, 2011SAFETY

  • Treatmentapproaches

    TraintheindividualwithABI Traincommunicationpartners Trainbothconcurrently

    Togher,2011

    Inhospitalandathome

  • CommunicationPartnerTraining(CPT)

    OT,PT,RSW,SLP,socialworker,doctor,volunteer,friend,familymember,nurse,etc Agoodpartnerhelpsperson(withABI)getthemessageacross

    Communicationpartnertrainingmustbebuiltintoanyprogramwhetherinthehospitalorthehome

    Togher,2011

  • CommunicationPartnerAssessmentandTraining

    ModifiedTBIMSCBehaviouralGuidelines:Summary adaptedfromKagan et.al(2004;2001)

    AcknowledgingCompetence RevealingCompetenceModifiedTBIMPCBehaviouralGuidelines:Summary adaptedfromKagan et.al(2004;2001)

    Interaction Transaction

    Togher,2011andTogher etal.2010

  • Acknowledgingcompetence

    Naturaladulttalk appropriatetocontexte.g.socialchatvs.interview

    Usestruequestionsratherthantestingquestions

    Togher,2011andTogheret.al2010

  • Acknowledgingcompetence Feelandflowofnaturalconversation

    notoververifying Toneofvoice Rateandenunciation Establishesequalleadershiprolesinthe

    conversation Useofcollaborativetalk usemore

    commentsandlessteachingmoments

    AdaptedfromTogher,2011andTogheretal.2010

  • Acknowledgingcompetence

    Showenthusiasmforpartnerscontribution Takeappropriateconversationalturns Demonstrateactivelisteningacknowledging,back channeling

    Acknowledgecompetencewhenadultisfrustrated,acknowledgedifficulty

    AdaptedfromTogher,2011andTogheretal.2010

  • Revealingcompetence

    IN

    OUT

  • RevealingcompetenceEnsurethatthepersonunderstands gettingthemessagein Givethepersontimetoprocesstheinformation Verbal

    Short,simplesentences,repetition,noidioms Nonverbal

    Gestures slightlyexaggerated Writing usekeywordstomaketopicconnections Yes/Nokeywords

    Resources iPhone,computer,calendar,map Summarize

    AdaptedfromTogher,2011andTogher et.al2010

  • RevealingcompetenceEnsuringthatthepersonhasameansofrespondinggettingthemessageout

    Givethepersontimetorespond Allowforequalconversationalturns Encourageelaboration(open endedquestions) Maintainthetopicbyaddinginformation Createanappropriatecommunicationenvironmentmaps,

    IPhone,penandpaper,computeretc.

    AdaptedfromTogher,2011andTogheret.al2010

  • Othercommunicationtips

    Uselaughter,chatting,joking Includefriends(mayincreaselanguagepotential)

    Remindtheclientthatyouareintheconversationtogether

    Shiftattentionsharepersonalinformation

    Togher,2011

  • BenefitsofCommunicationPartnerTraining

    TrainingeverydaycommunicationpartnersisanimportantcomplementarytreatmentforpeoplewithTBIandtheirfamiliestofacilitateandpromoteimprovedcommunicationoutcomes(Togher,2011)

    Sharingofconversation(equalturntaking) Powertocommunicate Senseofcontrol Morefocusontheexchange Opportunitytogiveinformation(asopposedto

    gettinginformation) IncreasedabilitytoPARTICIPATE

  • Whyisthisimportant?

    SLPscantrainpeopletocreateanenvironment(regardlessoflevelofcommunicationdifficulty)wheretheindividualfeelsthathecanexpresshiswants,needs,opinionsandideas

    Reducedpsychosocialdistressinfamilymembersresultinginfewerdemandsonsupportservicesinthelongterm(Togher et.al2004)

    Theinteractionbetweendirectinterventionandpartnertrainingistheideal

    Peopleinruralandunder servicedareascanbetrained bySLPs Canbeusedtotraincommunicationpartnersviatheweb

    Togher,2011

  • Inconclusion

    CommunicationPartnerTrainingisanessentialpartofatreatmentprogram Cooperationandenjoymentwillincrease ThisinturnpromotestheopportunityforcommunityreintegrationSLPsthroughCommunicationPartnerTraininghelpcreateaccesstosuccessful

    living.

  • ReferencesMacDonald,Sh.(2009).Assessmentandtreatmentofcognitivecommunication

    disorders(Level1):Evidencebasedpracticeandclinicalinsights.APostGraduateCourseforSpeech LanguagePathologists.Feb2009,Toronto.

    TheOBIAImpactReport(2012):AStatisticalSnapshotofacquiredbraininjuryanditseffectsonsurvivorsandcaregivers.OntarioNeurotrauma Foundation.

    Togher,L.,AdvancedPerspectivesonCommunication,ABIandEvidence BasedPractice,BrainstormingBrainInjuryConferenceDr.MarkYlvisaker HonoraryLecture.May2011

    TogherL.,PowerE.,TateR.,MacDonaldSk..&Rietdijk R.,(2010)Measuringthesocialinteractionsofpeoplewithtraumaticbraininjuryandtheircommunicationpartners:TheadaptedKagan scales,Aphasiology,24:68,914927,DOI:10.1080/02687030903422478

    Togher,L.,MacDonald,Sk.,Code,C.,&Grant,S.,(2004)Trainingcommunicationpartnersofpeoplewithtraumaticbraininjury:Arandomisedcontroltrial,Aphasiology,18:4,313335,DOI:10.1080/02687030344000535