Disclaimer: this resource is intended for speech and language therapists and students of this profession. If you require therapy for aphasia please contact a speech and language therapist.
Reciprocal Scaffolding Treatment (RST)
Summary: Reciprocal Scaffolding Treatment (RST) is a life participation approach which holds that communicative ability and quality of life can improved by supporting individuals with aphasia to share their knowledge and skills with novices. RST reverses the dynamic found in many aphasia therapies by placing the person with aphasia in the role of expert. It is reciprocal in that, while the individual with aphasia teaches novices a skill, the novices provide the individual with aphasia opportunities to practise communication in purposeful, real-life interactions (Avent & Austermann, 2003).
Example: The therapist works with the client to identify a skill or topic they are motivated to pass on to others. Prior to the session or sessions in which this is to take place, the therapist may work with the client to:
If appropriate, it may be helpful for the therapist to prime the novices with some simple supportive strategies that may support the person with aphasia to communicate their expertise more effectively (see strategies detailed in Supported Conversation for Adults with Aphasia entry).
Examples of skills passed on by individuals with aphasia in studies of RST are:
- Facilitate retrieval of relevant vocabulary
- Practising use of a Total Communication approach (see link at bottom of page).
- Role-playing interactions likely to take place during the sessions
If appropriate, it may be helpful for the therapist to prime the novices with some simple supportive strategies that may support the person with aphasia to communicate their expertise more effectively (see strategies detailed in Supported Conversation for Adults with Aphasia entry).
Examples of skills passed on by individuals with aphasia in studies of RST are:
- Teaching science to 4-5 year-olds (Avent & Austermann, 2003)
- Training novices in facilitative communication techniques to support individuals with aphasia (Avent et al., 2009)
Evidence Base: Avent & Austermann (2003) carried out a descriptive case study comparing RST with a peer discourse group treatment for a participant with moderate anomic aphasia. The participant, a former physicist and university professor, taught science to 4-5 year-olds twice-weekly over 6 weeks. Improved word retrieval was noted in the RST sessions as well as improvements in quality of life, as measured by the participant’s journal entries.
Avent et al. (2009) also report on a case study into the effect of RST on word retrieval and discourse ability for a participant with anomic aphasia. Following 7 weeks of twice-weekly RST sessions, in which the participant taught graduate student clinicians supportive communication strategies, improvements were noted in word fluency, correct information units (CIUs) and type-token ratio (i.e. more varied vocabulary).
Avent et al. (2009) also report on a case study into the effect of RST on word retrieval and discourse ability for a participant with anomic aphasia. Following 7 weeks of twice-weekly RST sessions, in which the participant taught graduate student clinicians supportive communication strategies, improvements were noted in word fluency, correct information units (CIUs) and type-token ratio (i.e. more varied vocabulary).
References
Avent, J. & Austermann, S., 2003. Reciprocal Scaffolding: A context for communication treatment in aphasia. Aphasiology, 17(4), 397-404
Avent, J., Patterson, J., Lu, A., & Small, K., 2009. Reciprocal scaffolding treatment: A person with aphasia as a clinical teacher. Aphasiology, 23(1), 110-119
Avent, J. & Austermann, S., 2003. Reciprocal Scaffolding: A context for communication treatment in aphasia. Aphasiology, 17(4), 397-404
Avent, J., Patterson, J., Lu, A., & Small, K., 2009. Reciprocal scaffolding treatment: A person with aphasia as a clinical teacher. Aphasiology, 23(1), 110-119