Communication

Departments Wards Charities

Speech and Language Therapists (SaLTs) are highly trained allied health professionals. In this Trust our Adult SaLT service specialises in the assessment and treatment of adults who have acquired communication difficulties as either in- or outpatients.

These communication difficulties with speech and/or language could arise as a result of a Stroke or other acquired neurological disorders such as Parkinson’s disease, Motor Neurone Disease, Brain Injury, Multiple Sclerosis, and Dementia.

A brief summary on the most commonly occurring types of acquired communication disorders has been outlined below:

Aphasia

What is it?

Aphasia is an acquired language disorder which means it may affect a person’s ability to talk, write, understand spoken information and written information (reading).

Aphasia is a long-term and life-changing condition that can make every day activities very challenging. It requires the individual as well as their family and friends to adapt to support their communication.

Why does it occur?

It often occurs due to damage to areas of the brain responsible for language. Most commonly this is due to a stroke or focal brain injury.

Key organisations:

Aphasia alliance – group of organisations working on aphasia.
Aphasia now – social initiative by people living with aphasia.
The Tavistock Trust For Aphasia – trust aimed at improving quality of life for people with aphasia.
The Stroke Association – a national charity that works to prevent and support those affected by Stroke. There are also local branches including one within the Salisbury area.

Useful resources:

Aphasia software finder
Tactus therapy – what is aphasia?
Aphasia therapy online
Words of the Week sign up – this is a flexible resource that gives sets of 10 current news stories which are simplified into 1 or 2 sentences and a related picture. The resource can be used in many ways e.g. for supported conversation practice or word retrieval therapy

Apraxia of Speech (AoS)

What is it?

AoS is a motor speech disorder that refers to a difficulty in planning, sequencing and coordinating movements needed for speech.

It may result in difficulty producing any speech at all, or may have a less severe impact on parts of speech such as articulatory movement, fluency, or inconsistencies with producing longer or more complex words (such as words with several syllables).

Why does it occur?

It’s caused by damage to the brain, resulting in a disruption to the ‘blueprint’ for programming the speech muscles and so deliberate control of the speech muscles is affected. Therefore, some automatic speech (such as counting) may be less affected by AoS.

Useful resources:

Tactus therapy – apraxia of speech info sheet

Dysarthria

What is it?

Dysarthria is the umbrella term used to describe a group of motor speech disorders, which affect intelligibility of speech.

It may cause speech to be completely unintelligible or present as more subtle changes such as reduced volume, reduced clarity with mildly slurred speech, changes to usual pitch or intonation patterns.

Why does it occur?

It is caused by damage to the central or peripheral nervous system and can be developmental (occurring pre/during birth) or acquired (following a period of ‘typical’ speech development). In adults with acquired dysarthria, it is often caused by Parkinson’s disease, Motor Neurone Disease, and sometimes in Stroke.

Useful resources:

National aphasia association – dysarthria info sheet

Cognitive communication disorder (CCD)

What is it?

CCD is an acquired communication disorder where an individual’s communication is affected but speech and language often remains a relative strength, in comparison to other cognitive domains such as memory.

Why does it occur?

It is caused by damage to the brain impacting on cognition, most commonly due to a stroke, traumatic brain injury or progressive condition.

Useful resources:

Tactus therapy – CCD info sheet

General advice for conversation partners

Communication is a two-way process. Therefore, a conversation partners’ role is essential in order to facilitate conversation and maximise the potential of the person with a communication difficulty.

Below are some general considerations that you may find useful as a conversation partner:

Think about the ENVIRONMENT:

Try to minimise background noise and reduce distractions
Give the person your full attention
Have access to pen and paper, communication aids and any ‘ramps’ these are items that facilitate individuals during discussions (e.g. calendar, TV guide, photographs, maps etc)

Think about YOUR COMMUNICATION:

Use short sentences and keep language simple.
Write down key words.
Don’t rush – Allow plenty of time to process information and to respond.
Repeat and rephrase information as needed to ensure full understanding.
Use closed questions (yes / no) and provide options for them to choose between (these can be verbal, written or objects).
Start off with broad topics and then narrow this down further (e.g. “Would you like a drink?” - “Would you like a hot or cold drink?” - “Would you like a cup of tea or coffee?”).

Think about how to help them with their EXPRESSION:

Clarify and rephrase what you have understood to check that it is correct.
Check the broad topic that you are talking about to ensure that you are both talking about the same area.
Ask targeted questions relevant to the topic (e.g. “What does it look like?”).
Be aware of non-verbal communication (e.g. facial expression, gesture) and encourage the use of total communication, such as miming, pointing, and drawing.

It is also important to be aware of variability in communication as it can be impacted by many factors such as: tiredness, emotion (e.g. being upset, angry or frustrated) and illness, particularly for individuals with communication difficulties.

If you or the person you are communicating with start getting frustrated, it can be helpful to agree to stop and re-try the conversation / topic later when it might be more successful.

For more information and training opportunities, please look at the communication training tab or liaise directly with your Speech and Language Therapist.

Useful information/signposting

Communication difficulties following Brain Injury
Communication difficulties after Stroke:
Speech and Communication difficulties in Parkinson’s Disease
Dementia – Communicating and language
The Contented Dementia Trust
Motor Neurone Disease – Speech and Communication
Progressive Supranuclear Palsy (PSP) - Speech and communication
Speech problems in Multiple Sclerosis (MS)

Communication training

Communication access training– This training is aimed both individuals and business, in order to provide skills and confidence to be able to facilitate people with communication difficulties during interactions.
Become a Dementia friend – This training provides useful information on Dementia and ways to support those with the condition from raising awareness to facilitating conversations.
Better Conversations with Aphasia – This is a flexible and free e-learning course that focuses on improving access and understanding of conversation therapy.

Resources

Words of the Week sign up – this is a flexible resource that gives sets of 10 current news stories which are simplified into 1 or 2 sentences and a related picture. The resource can be used in many ways e.g. for supported conversation, word finding therapy and speech practice.
Stroke association ‘communication tools’
Aphasia friendly resources
Pictographic resources for facilitating conversations
Alphabet charts
Symbol charts
Brain injury ID card
Picture communication tool – to aid conversations about healthcare

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