## Supporting Communication for Adults with Acute and Chronic Aphasia edited by **Nina Simmons-Mackie, Ph.D., BC-ANCDS** Southeastern Louisiana University **Julia M. King, Ph.D.** University of Wisconsin–Stevens Point and **David R. Beukelman, Ph.D.** University of Nebraska–Lincoln ## Contents 1. Supporting Communication: Improving the Experience of Living with Aphasia *Julia M. King, Nina Simmons-Mackie, and David R. Beukelman.* ... 1 2. Frameworks for Managing Communication Support for People with Aphasia *Nina Simmons-Mackie.* ... 11 3. Communication Supports *Julia M. King.* ... 51 4. Supporting Communication with Technology *Julia M. King.* ... 73 5. Staging Communication Supports Across the Health Care Continuum *Nina Simmons-Mackie.* ... 99 6. Assess for Success: Evidence for Therapeutic Assessment *Deborah Hersh, Linda Worrall, Robyn O’Halloran, Kyla Brown, Brooke Grohn, and Amy D. Rodriguez.* ... 145 7. Integrating Communication Supports into Aphasia Intervention in Inpatient and Outpatient Rehabilitation *Kristy S.E. Weissling and Judy Harvey.* ... 165 8. Integrating Communication Support into Aphasia Group Treatment *Roberta J. Elman and Elizabeth Hoover.* ... 189 9. Communication Support for Everyday Life Situations *Nina Simmons-Mackie and Julia M. King.* ... 221 10. Supporting Communication with Partner Training *Jacqueline J. Hinckley, Natalie M. Douglas, Rachel A. Goff, and Erline V. Nakano.* ... 245 11. Ongoing Management and Maintaining Communication Support *Nancy B. Alarcon.* ... 275 12. Communication Access, Rights, and Policies *Jennifer Horner.* ... 303 ## About the Editors ### Nina Simmons-Mackie, Ph.D., BC-ANCDS Professor and Scholar in Residence, Department of Communication Sciences and Disorders, Southeastern Louisiana University. ### Julia M. King, Ph.D. Professor, School of Communicative Disorders, University of Wisconsin–Stevens Point. ### David R. Beukelman, Ph.D. Professor, Department of Special Education and Communication Disorders, University of Nebraska–Lincoln. ## Communication Support for Everyday Life Situations Nina Simmons-Mackie and Julia M. King Everyday life situations typically involve communication. Whether it is communication with oneself or with other people, the importance of successful communication cannot be underestimated. Communication is the essence of human life (United States Society for Augmentative and Alternative Communication, 2009). Each individual’s essence or nature develops from daily interactions in the world. In fact, engaging in life situations (i.e., doing things), connecting with other people, and feeling optimistic and hopeful for the future are key components of "living successfully" with aphasia (Brown, Worrall, Davidson, & Howe, 2010; Grohn, Worrall, Simmons-Mackie, & Brown, 2012). Daily communication experiences vary and are as unique as each individual. ### DEFINING EVERYDAY SITUATIONS Everyday situations are those activities that people perform in the course of daily life, such as chatting on the phone with a friend, ordering at a café, reading the morning newspaper, or managing household finances. Everyday situations can be relatively specific tasks (e.g., making a grocery list) or major elements of life participation (e.g., being a mother). The World Health Organization International Classification of Functioning, Disability and Health (WHO ICF, 2001) classifies life situations into nine categories: - Communication (e.g., speaking, conversing, producing nonverbal messages) - Interpersonal interactions and relationships (e.g., family, friends, strangers, intimacy) - Major life areas (e.g., education, employment, managing finances) - Learning and applying knowledge (e.g., learning to read, learning to use email) - General tasks and demands (e.g., performing required tasks) - Mobility (e.g., walking, driving, using transportation) - Self-care (e.g., washing, dressing, eating, toileting) - Domestic life (e.g., preparing meals, shopping) - Community, social, and civic life (e.g., recreation, religion, political life) ### FUNCTIONAL COMMUNICATION AND EVERYDAY SITUATIONS Many, if not most, everyday situations require language and communication. The type of communication employed in everyday situations is often referred to as functional communication. For people with aphasia, communication support is an important consideration in facilitating functional communication and participation in everyday situations. ### ASSESSING SUPPORT FOR EVERYDAY SITUATIONS The characteristics of the person with aphasia, the target situation or activity, and aspects of the environment are traditionally considered during an assessment. A novel approach to assessment was presented, advocating for a therapeutic assessment approach. ### EVERYDAY SITUATIONS AND THE ENVIRONMENT Aspects of the environment in which everyday situations occur will impact the opportunities available and the participation level of the person with aphasia. Environmental factors classified by WHO ICF include: - Products and technology (e.g., building design, electronic devices) - Natural environment and human-made changes to environment (e.g., lighting, sound) - Support and relationships (e.g., family, friends) - Attitudes (e.g., individual attitudes, social norms) - Services, systems, and policies (e.g., communication systems) ### BOX 9.1: Supporting Doris’s Choice of Leisure Activities Doris and her husband completed a questionnaire that asked for information about her life prior to aphasia. This informed subsequent discussions about her preferences and activities she wanted to pursue. ### BOX 9.2: Kinsey’s Participation in a Cooking Club Kinsey, a woman with moderately severe aphasia, found it difficult to read recipes and follow printed instructions. A "cooking club" comprised of family and friends helped her with cooking tasks and encouraged her participation. ### SUPPORTING EVERYDAY SITUATIONS Implementing supports for everyday circumstances will depend on each person’s life situation. The life situation categories from the WHO ICF provide a framework for discussion to begin the process of supporting participation in everyday situations.