Huntington’s Disease (HD) is a progressive degenerative neurological condition which usually leads to speech and communication difficulties. People with HD often develop a reduction in cognitive abilities, with language elements such as a lack of communication initiation, reduced sentence complexity and word-finding problems as well as difficulties in speech production. The ability to understand spoken language is also likely to be affected but there is less research into this than into the effects on expressive language.
In the later stages of the condition communication can be very difficult but there are few published studies looking into the effectiveness of communication interventions for people with HD.
Talking Mats (TM) is a low-tech augmentative and alternative (AAC) technique that has been used successfully to support the communication of people with a variety of progressive and non-progressive conditions. It is used alongside peoples usual communication systems to help those with communication difficulties express their views.
What did the authors do?
The authors investigated whether TM is suitable for people who have advanced HD. They compared communicative effectiveness using TM with structured and unstructured communication interactions.
Five people with HD participated in the study.
Researchers examined communication about three topics: interests and activities, personal information and communication. Each participant was visited three times, the first to demonstrate TM and then to undertake the communication activities. One visit focussed on structured and unstructured communication, the other on TM. The topics covered in the structured and TM sessions were the same, differing only in the provision of mats and pictures related to each topic when TM were used.
What did they find?
They looked at the participants understanding of the options presented, engagement with the interviewer and task and ability to keep on task and the interviewers understanding of the participants views.
The results were analysed using the Effectiveness Framework of Functional Communication (EFFC). Each topic was rated separately as well as in a total score for each participant. A descriptive analysis was also completed.
The results indicated that structured communication was more successful than unstructured, and communicative effectiveness was significantly higher when TM were used than without. This was the case for all participants though only two of them achieved ‘acceptable communicative effectiveness’ as rated by the EFFC.
Communication with TM led to increased time spent communicating.
This was a small sample group and therefore the results cannot be generalised to all people with HD. There might have been factors other than TM alone that influenced the results, e.g. the structured presentation of topics with visual support, communication partners slowing their rate of speech and the number of words used.
All participants seemed to enjoy using TM so increasing their motivation to communicate. TM also supported the people with HD’s communication partners, making it easier to follow lines of reasoning and giving a joint focus of attention leading to more balanced interaction patterns than the other formats.
People with HD can find their communicative effectiveness is improved by the use of TM and also by structured approaches to communication interactions rather than unstructured. TM is particularly recommended when more abstract or difficult topics are being discussed.
The use of TM could increase participation in life-planning for people with HD but is dependent on good support from trained communication partners.
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Added to site May 2015