Supported Conversations for Adults with Aphasia (SCA)

Overview

Supported Conversations for Adults with Aphasia is a treatment approach that was developed by the Aphasia Institute. This approach targets both receptive and expressive language. The goal of this intervention approach is to help encourage both communication partners and individuals with aphasia to use multiple communication modalities during conversations (Aphasia Institute, n.d.). This intervention approach has shown to have a positive impact on the social abilities of individuals with mild to severe aphasia, even when only the communication partners were given training (Kagan et al., 2001; Aphasia Institute, n.d.). This method is helpful for bringing a sense of normalcy and autonomy back to conversations for persons with aphasia (Aphasia Institute, n.d.; Lingraphica, 2020).

How to Implement Supported Conversations for Adults with Aphasia

One of the key things to remember when have a conversation with an individual with aphasia is to be as natural as possible (Aphasia Institute, n.d.). Clinicans should begin by including a small amount of visual cues, such as gestures, and increasing the number of prompts and cues as needed until they are at a level that complements the skills of the client (Aphasia Institute, n.d.). Clinicans and communication partners may wish to use gestures, written modalities, drawings, or verbal prompts in order to facilitate conversation (Aphasia Institute, n.d.; Lingraphica, 2020). As both communication partners become more familiar with the technique, cues can be changed depending on what is observed to work best (Aphasia Institute, n.d.; Lingraphica, 2020). Below are considerations for clinicians when implementing SCA:

Whenever possible, both the client and their regular communication partners should receive training
Speak in a natural tone of voice
Ask yes/no questions
Affirm when you have understood the person with aphasia
Summarizing the communication from the person with aphasia to confirm their message
For severe communication deficits, focus on using gestures/words/drawings to identify one word at a time

(Aphasia Institute, n.d.; Lingraphica, 2020)

https://www.aptus-slt.com/post/aphasia-tips

https://nrtimes.co.uk/gestures-can-improve-communication-in-aphasia-ststory/

Materials

Gestures
Blank paper, markers, pencils, and erasers
Flashcards
Preprinted pictures with frequently discussed objects
Low-tech AAC board

(Aphasia Institute, n.d.)

https://www.keeponsolutions.com/products/abcde-english-alphabet-board

Copy of Data Collection Sheet with Cues.docx

Prompting and Data Collection

Like other modalities of receptive language therapy, visual and verbal cues are built into this intervention method. Clinicians and communication partners should begin with a low level of prompting and cueing and raise the number until they are at a level that promotes functional communication (Aphasia Institute, n.d.). As both communication partners become more fluid in conversation and as the client's receptive skills progress, cues should be reduced accordingly. The clinician should set short term objectives with varying levels of cues to track progress, and use these objectives to track data and adjust cueing. An example data tracking sheet like the one to the right may be used to track goals, successful attempts, and prompts/cues.

Example Goal

In six months, Client will independently utilize a visual or gestural support to participate in a conversation with 80% accuracy across three consecutive sessions, as measured by clinician data.

References

Aphasia Institute. (n.d.) Communication Tools: Communicative Access & Supported Conversation for Adults with Aphasia (SCA™). Aphasia Institute. https://www.aphasia.ca/communication-tools-communicative-access-sca/.

Kagan A, Black SE, Duchan FJ, Simmons-Mackie N, Square P. Training volunteers as conversation partners using "Supported Conversation for Adults with Aphasia" (SCA): a controlled trial. J Speech Lang Hear Res. 2001 Jun;44(3):624-38. doi: 10.1044/1092-4388(2001/051). PMID: 11407567.

Lingraphica. (2020). Supported Conversation for Adults with Aphasia (SCA™). Lingraphica. https://www.aphasia.com/aphasia-resource-library/aphasia-treatments/supported-conversation-for-adults-with-aphasia-sca/.

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