The Impact of Exposure With No Training: Implications for Future Partner Training Research Purpose This research note reports on an unexpected negative finding related to behavior change in a controlled trial designed to test whether partner training improves the conversational skills of volunteers. Method The clinical trial involving training in “Supported Conversation for Adults with Aphasia” utilized a single-blind, randomized, controlled, ... Research Note
Research Note  |   September 19, 2018
The Impact of Exposure With No Training: Implications for Future Partner Training Research
 
Author Affiliations & Notes
  • Aura Kagan
    Aphasia Institute, Toronto, Canada
  • Nina Simmons-Mackie
    Health & Human Sciences, Southeastern Louisiana University, Hammond
  • J. Charles Victor
    University of Toronto, Canada
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Aura Kagan: akagan@aphasia.ca
  • Editor-in-Chief: Sean Redmond
    Editor-in-Chief: Sean Redmond×
  • Editor: Carl Coelho
    Editor: Carl Coelho×
Article Information
Normal Language Processing / Language Disorders / Aphasia / Language / Research Notes
Research Note   |   September 19, 2018
The Impact of Exposure With No Training: Implications for Future Partner Training Research
Journal of Speech, Language, and Hearing Research, September 2018, Vol. 61, 2347-2352. doi:10.1044/2018_JSLHR-L-17-0413
History: Received November 6, 2017 , Revised February 27, 2018 , Accepted May 18, 2018
 
Journal of Speech, Language, and Hearing Research, September 2018, Vol. 61, 2347-2352. doi:10.1044/2018_JSLHR-L-17-0413
History: Received November 6, 2017; Revised February 27, 2018; Accepted May 18, 2018

Purpose This research note reports on an unexpected negative finding related to behavior change in a controlled trial designed to test whether partner training improves the conversational skills of volunteers.

Method The clinical trial involving training in “Supported Conversation for Adults with Aphasia” utilized a single-blind, randomized, controlled, pre–post design. Eighty participants making up 40 dyads of a volunteer conversation partner and an adult with aphasia were randomly allocated to either an experimental or control group of 20 dyads each. Descriptive statistics including exact 95% confidence intervals were calculated for the percentage of control group participants who got worse after exposure to individuals with aphasia.

Results Positive outcomes of training in Supported Conversation for Adults with Aphasia for both the trained volunteers and their partners with aphasia were reported by Kagan, Black, Felson Duchan, Simmons-Mackie, and Square in 2001 . However, post hoc data analysis revealed that almost one third of untrained control participants had a negative outcome rather than the anticipated neutral or slightly positive outcome.

Conclusions If the results of this small study are in any way representative of what happens in real life, communication partner training in aphasia becomes even more important than indicated from the positive results of training studies. That is, it is possible that mere exposure to a communication disability such as aphasia could have negative impacts on communication and social interaction. This may be akin to what is known as a “nocebo” effect—something for partner training studies in aphasia to take into account.

Acknowledgments
The original study acknowledged a grant from Health Canada (Project no. 4687-06-93/250), awarded to the Aphasia Institute, that partially supported the development of Supported Conversation for Adults with Aphasia. The authors also thank Melodie Chan and Lisa Chan for their help in preparation of the article.
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