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.
Supported Conversation for Adults with Aphasia (SCA)
Summary: Kagan argues that aphasia can mask communicative ‘competence normally revealed through conversation’ (1995). Supported Conversation for Adults with Aphasia (SCA™) (Kagan, 1995) focuses on revealing this communicative competence of clients with aphasia by training their conversation partners. The trained conversation partner is viewed as a ‘communication ramp’ to support the individual with aphasia’s wider communication. This functional approach is intended to reduce the psychosocial effects of aphasia, create opportunities for meaningful interaction, promote autonomy, and increase participation (Kagan, 2010).
For additional therapy approaches that include conversation partner training see Creating Aphasia-Friendly Environments & Conversational Coaching / Conversation Therapies (see links at bottom of page).
For additional therapy approaches that include conversation partner training see Creating Aphasia-Friendly Environments & Conversational Coaching / Conversation Therapies (see links at bottom of page).
Example: The following are examples of skills and strategies taught to conversation partners in SCA™ training:
1) Acknowledging the client’s competence, e.g. speaking at normal volume in an adult manner, acknowledging the client’s frustration and potential embarrassment (e.g. “I know you know the word”)
2) Revealing the client’s competence by:
(Search online for The Aphasia Institute’s online SCA™ module for further information).
1) Acknowledging the client’s competence, e.g. speaking at normal volume in an adult manner, acknowledging the client’s frustration and potential embarrassment (e.g. “I know you know the word”)
2) Revealing the client’s competence by:
- Supporting their comprehension, e.g. use of short, simple sentences, gestures, write down key words, use pictures to support understanding
- Supporting the client’s expression, e.g. giving the patient plenty of time to respond, asking yes/no or closed questions, prompting the patient to use any modality to respond (gestures, writing, printed pictures or drawing)
(Search online for The Aphasia Institute’s online SCA™ module for further information).
Evidence Base: While no research has been carried out into the effectiveness of training family members in SCA™, several studies have demonstrated positive effects from training volunteers and medical students.
In a randomised controlled trial Kagan et al. (2001) assessed and compared the interactions of 20 volunteers who attended a one day SCA™ workshop with those of 20 volunteers who watched a video about and interacted with individuals with aphasia for the same length of time. Kagan et al’s own outcome measure tool, the Measure of Supported Conversation for Adults with Aphasia, was used. Volunteers who received SCA™ training were rated significantly higher in their acknowledgement of communicative competence and ability to reveal communicative competence than those who were simply exposed to individuals with aphasia. Ratings of the communicative skills of the individuals with aphasia also improved, despite the fact that they did not themselves receive training.
Legg, Young, & Bryer (2005) investigated the effects of SCA™ on the ability of medical students to build rapport with and gather a case history from an individual with aphasia. 10 medical students were taught about aphasia theory, roughly in line with factual information on aphasia received during medical training, while 11 medical students received SCA™ training (including videos of interactions, familiarisation with SCA™ techniques, role playing, reflection, and informal feedback on performance as a communicative facilitator). The medical students who received SCA™ training improved significantly in their ability to initiate sessions, gather a case history, and build rapport when working with individuals with aphasia, whereas those students in the control group did not. Likewise, there was an improvement in the perceptions of the interaction amongst both medical students and individuals with aphasia following the SCA™ training.
In a randomised controlled trial Kagan et al. (2001) assessed and compared the interactions of 20 volunteers who attended a one day SCA™ workshop with those of 20 volunteers who watched a video about and interacted with individuals with aphasia for the same length of time. Kagan et al’s own outcome measure tool, the Measure of Supported Conversation for Adults with Aphasia, was used. Volunteers who received SCA™ training were rated significantly higher in their acknowledgement of communicative competence and ability to reveal communicative competence than those who were simply exposed to individuals with aphasia. Ratings of the communicative skills of the individuals with aphasia also improved, despite the fact that they did not themselves receive training.
Legg, Young, & Bryer (2005) investigated the effects of SCA™ on the ability of medical students to build rapport with and gather a case history from an individual with aphasia. 10 medical students were taught about aphasia theory, roughly in line with factual information on aphasia received during medical training, while 11 medical students received SCA™ training (including videos of interactions, familiarisation with SCA™ techniques, role playing, reflection, and informal feedback on performance as a communicative facilitator). The medical students who received SCA™ training improved significantly in their ability to initiate sessions, gather a case history, and build rapport when working with individuals with aphasia, whereas those students in the control group did not. Likewise, there was an improvement in the perceptions of the interaction amongst both medical students and individuals with aphasia following the SCA™ training.
References
Kagan, A., 1995. Revealing the competence of aphasic adults through conversation: A challenge to health professionals. Topics in Stroke Rehabilitation, 2, 15-28
Kagan, A., Shumway, E., & Podolsky, L., 2010. “Supported Conversation for Adults with Aphasia”: Why and how? - Selected slides. ASHA Convention 2010. [online] Available at: <www.asha.org/Events/convention/handouts/2010/1674-Kagan-Aura> [Accessed 19/06/2016]
Kagan, A., Black, S., Duchan, J. F., Simmons‐Mackie, N., & Square, P., 2001. Training volunteers as conversation partners using 'Supported conversation for adults with aphasia': A controlled trial. Journal of Speech, Language and Hearing Research, 44(3), 624‐638
Legg, C., Young, L., & Bryer, A., 2005. Training sixth-year medical students in obtaining case-history information from adults with aphasia. Aphasiology, 19(6), 559-575
Kagan, A., 1995. Revealing the competence of aphasic adults through conversation: A challenge to health professionals. Topics in Stroke Rehabilitation, 2, 15-28
Kagan, A., Shumway, E., & Podolsky, L., 2010. “Supported Conversation for Adults with Aphasia”: Why and how? - Selected slides. ASHA Convention 2010. [online] Available at: <www.asha.org/Events/convention/handouts/2010/1674-Kagan-Aura> [Accessed 19/06/2016]
Kagan, A., Black, S., Duchan, J. F., Simmons‐Mackie, N., & Square, P., 2001. Training volunteers as conversation partners using 'Supported conversation for adults with aphasia': A controlled trial. Journal of Speech, Language and Hearing Research, 44(3), 624‐638
Legg, C., Young, L., & Bryer, A., 2005. Training sixth-year medical students in obtaining case-history information from adults with aphasia. Aphasiology, 19(6), 559-575
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