The Lingraphica Blog

Supported Conversations for Adults with Aphasia: It Takes Two to Tango

Aug 08, 2017 | by Abigail Presti

Supported Conversations for Adults with Aphasia is ainternationally-recognized and trusted method of communication between two individuals. Read on to learn how success comes when caregivers share responsibility in conversation.

Supported Conversations for Adults with Aphasia (SCA) is a method fostered by The Aphasia Institute that emphasizes two goals: 1) acknowledging the competence of the adult with aphasia, and 2) helping to reveal the competence of the adult with aphasia. 

The method focuses on conversation-assisting techniques including spoken and written keywords, body language, hand drawings, and detailed pictographs. These techniques help the communication partner successfully communicate his/her message to the adult with aphasia, as well as help the adult with aphasia express his/her own messages. The Aphasia Institute, based in Toronto, hosts training courses for Speech-Language Pathologists (SLPs) to become certified to teach SCA techniques to others—communication partners, colleagues, and other healthcare professionals—and implement it into their own practices. One of Lingraphica's Clinical Consultants who attended these training courses, Brianne Kosch, M.A., CCC-SLP, ATP, explained the significance of SCA.

"The reason behind the success of SCA," Brianne said, "is that SCA acknowledges that conversations with adults with aphasia are a two-way street. Instead of putting all of the responsibility of the conversation on the person with aphasia, SCA takes the onus off solely the person with aphasia and puts it on both people having the conversation." 

SCA techniques require communication partners to meet those with aphasia halfway—asking "yes or no" questions instead of open-ended questions, using keywords, writing things down, and drawing pictures to fully communicate their message. Brianne stressed that when people who struggle with communicating do not have anyone to support their efforts, they can often appear to others as incompetent. However, we know that aphasia is a loss of language, not intellect. SCA works to reveal the true competency of these individuals. SCA tools help communication partners see adults with aphasia "come alive," demonstrating their ability to communicate and fully get their message across.

The beauty of SCA is in its utilization of natural tools. Many of the techniques emphasized require only our hands for gestures, our voices for asking simple, yes/no questions, and a pencil and paper for writing keywords or drawing. They can be used in any setting! For many SLPs, these techniques come naturally in their practice, but SCA combines these techniques into an explicit and organized method that can be taught to communication partners. This differs from other communication methods that focus on improving the communication skills of persons with aphasia, instead of improving the skills of communication partners. 

Brianne spoke of a two-part video presented during one of her SCA courses that really highlighted the efficacy of SCA in revealing the competency of individuals with aphasia. The first video depicted a doctor, who had not been trained in SCA, trying to gather patient information from a gentleman with severe aphasia. The doctor asked many open-ended questions and did not use any support materials or techniques. The gentleman with aphasia appeared confused, as if he did not understand anything the doctor said and could not communicate at all. The second video took place after the doctor participated in SCA training. By using the SCA strategies in this second session, the doctor was able to successfully collect the information he needed, and the patient was confident and communicative. Interestingly, the patient and his aphasia did not change at all. The only thing that changed was the doctor's use of SCA techniques and how he approached communicating with a person with aphasia.

"That's the cool part," Brianne mentioned, "to see how it actually work with communication partners and teach them this. They see that their loved ones and clients are competent, that they can still be part of the conversation." 

Simply put, SCA's effectiveness is evident in its results. As Brianne stated, "it's remarkable when you see it."

For more information about SCA, visit the Aphasia Institute's SCA webpage or download the self-directed learning module.