Effective communication interactions are essential if people are to participate in society, with their families, and in their medical care. Effective communication is the successful joint establishment of meaning wherein speakers and their communication partners exchange information. To be truly effective, communication requires a two-way process (expressive and receptive) in which messages are negotiated until the information is correctly understood by both parties (The Joint Commission, 2010). When an individual has a communication disorder sufficient to interfere with the accurate exchange of information, communication breakdowns that interfere with community engagement and participation with family, friends, caregivers, and medical providers are common. The concept of supporting communication refers to any intervention program, technology, or strategy that supplements residual speech or language skills to improve how accurately and effectively people communicate (Simmons-Mackie, 2013).
In this special issue, authors have been invited to share their knowledge about communication during medical evaluations and in a range of different medical settings. Three additional articles focus on communication support for people with aphasia, dementia, and motor speech disorders
The first article (Burns, Baylor, Dudgeon, Starks, & Yorkston, 2017) reviews communication accommodations for patients with communication disorders during medical interactions. Based on Communication Accommodation Theory, the authors describe the SEGUE and FRAME strategies to organize communication interactions during medical encounters. For each strategy, they provide examples of underaccommodation, overaccommodation, and appropriate accommodation for people with aphasia and dysarthria. The authors also provide guidelines for including family or caregivers in medical interactions.
In the second article, Nordness and Beukelman (2017) discuss patient-provider communication strategies and policies across medical settings. Medical errors are now the third leading cause of death in the United States (Makary & Daniel, 2016), and many errors are precipitated by communication failures between patients and providers during medical care (Blackstone, Beukelman, & Yorkston, 2015; The Joint Commission, 2010). Communication failures can occur during personal care and medical encounters for people who are communication vulnerable due to communication disorders, language barriers, lack of medical knowledge, or a combination of these factors. The need for policy and accountability addressing patient-provider communication within medical settings is emphasized, so that these communication support services are not solely dependent on a staff advocate who may leave the setting because of retirement, promotion within the organization, or acceptance of a position in another setting.
The third article (King & Simmons-Mackie, 2017) focuses on communication supports for individuals with aphasia, such that they can interact effectively with medical and care providers as well as family members through the stages of their recovery. Speech-language pathologists and other health care providers can ensure success by incorporating augmentative and alternative communication strategies into all aspects of care and intervention. The goal of this article is to explain the evidence for and benefits of communication support being included as an integral component of all aphasia interventions, with the aim of providing best practices for each person with aphasia.
The fourth article (Lanzi, Burshnic, & Bourgeois, 2017) highlights the need for appropriate, person-centered and meaningful communication supports to ensure the best quality of life for people with cognitive-communication challenges for adults with primary progressive aphasia and adults with dementia. As the incidence of dementia increases in the United States and internationally, the need for memory and communication supports that involve the individual in all aspects of care and decision-making also increases.
In the final article, Hanson and Fager (2017) describe communication support options for people with dysarthria with stable, improving, and degenerating neurological conditions. The roles of high-technology as well as low-technology augmentative and alternative options are described for individuals who have no functional speech and those who have some residual speaking ability.
The authors of the special issue discuss the need for effective communication support strategies for adults who are communication vulnerable due to acquired severe speech or language disorders. Authors describe a range of communication support materials and strategies and provide access to many of these materials. Included among these supports are mobile technologies that generate text messages and that can capture, store, caption, and display photographic images. Technological advances undoubtedly will continue and will provide increasing communication support in the future.
-David R. Beukelman, PhD
Issue Editor
Senior Researcher
Institute for Rehabilitation Science and Engineering
Madonna Rehabilitation Hospitals, Lincoln, NE
Emeritus Professor
Department of Special Education and Communication Disorders
University of Nebraska, Lincoln
[email protected]
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