Communication Partner Training (CPT) for Adult Speech Therapy

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You know that communication partner training is an important part of treatment for your patients—but it can be hard to know which strategies to use.

That’s why, in this post, we did the research for you! You’ll find time-saving summaries of evidence-based communication partner training programs for aphasia, TBI, and dementia. Plus, lots of helpful links and treatment tips to put into practice today.

For pre-made communication partner handouts, see the bestselling Adult Speech Therapy Starter Pack!

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Table Of Contents
  1. Communication Partner Training For Aphasia
  2. Communication Partner Training For TBI
  3. Communication Partner Training For Dementia
  4. More Speech Therapy Materials
  5. References

Communication Partner Training For Aphasia

Communication partner training for aphasia aims to teach loved ones and caregivers how to communicate better with the person with aphasia.

You can absolutely teach this on your own with handouts and instructions. But if you’re looking for more guidance and structure, there are pre-made protocols. Keeping scrolling to learn more!

1. Supported Conversation for Adults with Aphasia (SCA™)

supported conversation for adults with aphasia

SCA was developed by the Aphasia Institute to “help people with aphasia re-join life’s conversations.” The goals of this approach are to 1) acknowledge the competence of the person with aphasia and 2) help the person with aphasia reveal their competence.

Treatment focuses on the communication partner, not the patient.

How It Works:

You teach the conversation partner how to:

  • Acknowledge competence (of the person with aphasia)
  • Get their message IN (be understood by the person with aphasia)
  • Get the person with aphasia’s message OUT (understand the person with aphasia)

How to Acknowledge Competence:

  • Use a natural tone of voice
  • Choose adult/complex topics of conversation
  • Express that you know that the patient knows more than they can communicate
  • Attribute communication breakdowns to your own limitations as a communicator
  • Be open when you have to turn to someone else to get information

How to Reveal Competence:

  • Use short, simple sentences and visual information, such as gestures, written keywords, and pictures.
  • Reduce distractions
  • Observe the patient’s non-verbal social cues to help understand their level of comprehension.
  • Summarize what you believe the message to be and ask for clarification
  • Ask yes/no questions
  • Ask one question at a time
  • Ask specific questions. For example, “For lunch, I can make a sandwich or soup. Which one do you want?” (versus “What do you want for lunch?” which is too open-ended.)
  • Request more information by asking the patient to gesture, point, write, etc.
  • Give the patient plenty of time to respond

How to Verify the Message:

Summarize the patient’s message by asking, “Let me make sure I understand” and by:

  • Repeating the message and/or
  • Adding gestures or writing down key-words and/or
  • Expanding what you think they were trying to say and/or
  • Giving a brief summary of longer conversations

Learn More About SCA

  1. SCA Trainings
  2. SCA Webinars
  3. FREE SCA introduction course

2. Better Conversations With Aphasia

better conversations with aphasia

Better Conversations with Aphasia is a FREE online program for speech therapy professionals, people with aphasia, and their communication partners.

The ‘look’ of the materials is uninspiring, but they do teach useful conversation strategies.

How Does It Work?

  • First make an account (it’s free)
  • There are 8 lessons organized into 3 modules
  • Each lesson is comprised of printable Session Plans and patient/communication partner Handouts
better conversations with aphasia
Screenshot from University College London

Topics covered include:

  • Conversation and agrammatism
  • Turns, sequences, and actions
  • Practicing conversation strategies

Communication Partner Training For TBI

communication partner training TBI

Communication partner training for TBI aims to teach conversation partners how to create the best communication environment for the person with a TBI.

Research shows that it works! Likely because they give the person with TBI lots of opportunities for supportive and positive communication.

TBI Communication Partner Tips

Adapted from the INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part IV: Cognitive-Communication and Social Cognition Disorders

  • Use positive question-asking strategies (ask questions about their feelings and opinions)
  • Give the person with TBI the floor
  • Use scaffolding strategies such as jointly produced narratives (aka help the person with a TBI tell a story)
  • Provide background information on a given topic to help the person with TBI engage more easily in a conversation (cognitive supports)
  • Approach conversations with a positive, interested attitude

1. TBIconneCT

TBIconneCT is an evidence-based communication partner training program for TBI. It was developed by speech pathologists at the University of Sydney.

How Does TBIconneCT Work?

First, purchase the TBIconneCT Clinical Manual. The PDF version costs ~ $95 USD.

  • The manual walks you through how to teach a 10-week program to both the communication partner(s) and the patient
  • Each session takes 1.5 hours per week
  • It can be done in-person or via telehealth

What Does TBIconneCT Teach?

The lessons are organized into 10 modules. They include:

  • TBI & Communication. How TBI affects the skills needed to have successful conversations
  • Playing our Role. How to change their communication, depending on the situation
  • Effective Speaking & Listening. Strategies that can help the patient with TBI be more successful
  • Collaboration. Working together as a team to have positive conversations
  • Elaboration. Using strategies to keep the conversation going and on track
  • Asking Questions. Using questions to create positive conversations

Free TBIconneCT Resources

Communication Partner Training For Dementia

Communication partner training for dementia aims to improve communication by modifying their environment and how the partner delivers and receives messages.

1. MESSAGE Communication Strategy in Dementia

The MESSAGE Communication Strategies in Dementia was developed by The University of Queensland in Australia. Click here for their free PDF.

It’s an evidence-based approach to training caregivers of patients with dementia. If you’re interested in learning more, the university provides lots of free support materials online.

M – Maximize Attention

  • Attract Attention
    • Address the person by name
    • Move to their eye level
    • Maintain eye contact
  • Avoid Distraction
    • Limit external distractions by turning off the TV or radio or moving to a quieter place
  • One At A Time
    • Try to make sure that only person talks at a time
    • Try not to hold other conversations when talking to a person with dementia

E – Expression and Body Language

  • Relaxed and Calm
    • Be aware of your facial expression, tone of voice, and body language when talking to a person with dementia
    • Try to appear as relaxed and calm as possible
  • Show Interest
    • Use your body language to show that you are interested
    • Face the person, lean forward, and nod your head when appropriate

S – Keep it Simple

  • Short, Simple, and Familiar
    • Use short, simple, and direct sentences
    • Use familiar words
    • Use nouns and names, rather than pronouns (Say Maria, the chair, etc. instead of he, she, it)
    • (You can use simple language without talking down to someone)
  • Clear Choices
    • Help the person express needs or wants by offering clear choices
    • Use questions with yes or no answers
    • Suggest choices (“Would you like water or tea?”)
    • In the later stages, you may need to limit questions to one choice with a yes or no answer (“Would you like chicken?”)

S – Support Their Conversation

  • Give Them Time
    • Communication is harder if a person is feeling rushed, so give them extra time
    • A good rule is to wait 5 seconds after you’ve finished speaking before you expect a response
  • Find the Word
    • There are several ways you can help the person find the right word:
      • Suggest a word
      • Repeat the unfinished sentence with a suitable word in place
      • Ask, “Do you mean ___?”
  • Repeat then Rephrase
    • If the person doesn’t seem to understand what you said:
      • First, try repeating your sentence
      • If that doesn’t work, say the sentence in a different way
  • Reminders of the topic
    • Clearly state the topic of your conversation
    • Repeat the topic throughout the conversation
    • Make it clear when you are changing the topic. Do this by stating the topic change or leaving time between topics

A – Assist with Visual Aids

  • Gesture & Action
    • Use gestures (pointing and actions) when speaking to help clarify what you are saying
  • Objects & Pictures
    • Use visuals as well as speech, by showing:
      • The object you are talking about
      • A picture of the object or topic
      • Written words

* Use visuals instead of speaking, when words are hard to understand. Familiar objects or actions can trigger understanding.

G – Get Their Message

  • Listen, Watch, & Work Out
    • Pay attention to words and non-verbal clues. You may need to use both to understand the person’s message
  • Behavior & Non-verbal Messages
    • The person may communicate through their behavior:
    • Facial expressions or where the person is looking can give you information
    • Be familiar with the person’s life, likes, dislikes, interest, and routines. This may help you decipher their message

E – Encourage & Engage in Communication

  • Interesting & Familiar Topics
    • Encourage conversation about familiar and interesting things such as:
    • Photos (see our post on how to make a memory book)
    • Memorabilia
  • Family & Friends
    • Encourage conversation whenever you get the chance. Encourage friends and family to do the same
    • Don’t ask test questions
    • Don’t argue if the person seems confused about reality. Instead, acknowledge their feelings, give assurances as needed, and try to move on gently to another topic

More Speech Therapy Materials

Visit our shop for print-and-go communication partner handouts—and much more!

References

  1. Aphasia Institute. (n.d.). Communication Tools: Communicative Access & Supported Conversation for Adults With Aphasia (SCA™). Aphasia Institute. Retrieved March 23, 2023, from https://www.aphasia.ca/communication-tools-communicative-access-sca/
  2. Beeke S, Sirman N, Beckley F, Maxim J, Edwards S, Swinburn K, Best W. 2013. Better Conversations with Aphasia: an e-learning resource. Available at: https://extend.ucl.ac.uk/ 
  3. Cicerone, K. et al.(2019). ACRM Cognitive Rehabilitation Manual & Textbook Second Edition. American Congress of Rehabilitation Medicine. https://acrm.org/meetings/cognitive-rehab-training-second-edition/
  4. Kagan, A., Black, S. E., Duchan, F. J., Simmons-Mackie, N., & Square, P. (2001). Training volunteers as conversation partners using “Supported Conversation for Adults with Aphasia” (SCA): a controlled trial. Journal of speech, language, and hearing research : JSLHR, 44(3), 624–638. https://doi.org/10.1044/1092-4388(2001/051)
  5. Rietdijk, R., Power, E., Brunner, M., & Togher, L. (2018). A single case experimental design study on improving social communication skills after traumatic brain injury using communication partner telehealth training. Brain Injury, 1-11. https://doi.org/10.1080/02699052.2018.1531313
  6. The University of Queensland. (2009). MESSAGE communication in cementia and RECAPS memory strategies in dementia. https://static.cambridge.org/content/id/urn:cambridge.org:id:article:S1041610210001845/resource/name/S1041610210001845sup001.pdf
  7. Togher, L., McDonald, S., Tate, R., Power, E., & Rietdijk, R. (2013). Training communication partners of people with severe traumatic brain injury improves everyday conversations: a multicenter single blind clinical trial. Journal of Rehabilitation Medicine, 45(7), 637-645. https://doi.org/10.2340/16501977-1173
  8. Togher, L., McDonald, S., Tate, R., Rietdijk, R., & Power, E. (2016). The effectiveness of social communication partner training for adults with severe chronic TBI and their families using a measure of perceived communication ability. NeuroRehabilitation, 38(3), 243-255. https://doi.org/10.3233/NRE-151316
  9. Togher, L., Douglas, J., Turkstra, L. S., Welch-West, P., Janzen, S., Harnett, A., Kennedy, M., Kua, A., Patsakos, E., Ponsford, J., Teasell, R., Bayley, M. T., & Wiseman-Hakes, C. (2023). INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part IV: Cognitive-Communication and Social Cognition Disorders. The Journal of head trauma rehabilitation, 38(1), 65–82. https://doi.org/10.1097/HTR.0000000000000835
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