Effects of training student volunteers to use multi-modality communication in conversations with nursing home residents with aphasia

The purpose of this study was to examine the effects of training student volunteers (SVs) to use multi-modality communication with nursing home residents with aphasia (RAs). The SVs were four undergraduate Communication Disorders majors who had experience in interacting with elders, but not with individuals with aphasia. The RAs were two individuals with moderate-severe Broca's aphasia with minimal ability to communicate verbally. One RAs' expression consisted primarily of a verbal sterotypy, while the other RAs' expression consisted primarily of head nods and facial expressions. Each RA interacted with two SVs. The training program included five components: general education, identification of modalities in videotaped conversations, videotape review and self-evaluation, and conversational practice of multi-modality communication with and without on-line feedback. An ABA multiple baseline across subjects (SVs) and communication partners (RAs) design was employed to examine changes in the SVs' use of multi-modality communication and the resulting effects on the RAs' participation in 10-minute analog conversations. The specific modalities used by all participants and the comprehensibility of the RAs' participation during each phase were examined. The SVs demonstrated marked increases in use of nonverbal modalities. The RAs did not demonstrate changes in modalities used. However, the comprehensibility of the RAs' participation increased. Sequential analyses revealed that RAs' comprehensible responses were more likely to follow SVs' multi-modality utterances during all phases, with this effect becoming stronger after training. Other measures of treatment effects included types and frequencies of questions produced by SVs and balance of conversations. The overall frequency of question productions decreased across phases, but the proportions of question types did not change. The balance of the conversations also did not change across phases, but differences were noted across dyads. Participant satisfaction and social validation were measured using both quantitative and qualitative measures. These measures revealed that the changes in the conversational interactions in were clinically significant. Furthermore, this training program proved to be a useful intergenerational service-learning program. The SVs gained valuable skills and increased their interest in gerontology. The RAs gained opportunities for social interaction in which they were able to reveal their communicative competence.