Reciprocal scaffolding: A context for communication treatment in aphasia

Background: The goal of social approaches to aphasia treatment is to improve life quality. This study explored the potential therapeutic value of increasing participation in life through natural language use with communicative partners during shared learning activities. Reciprocal Scaffolding Treatment (RST), based on an apprenticeship model of learning where novices are taught skills by a more skilled partner, was developed to provide an individual with aphasia an opportunity to use pre-stroke knowledge and vocabulary during teaching interactions. Aims: The purposes of the study were to determine whether an individual with aphasia in the role as a teacher would improve language production and whether changes in quality of life were evident as a result of the experience. Methods & Procedures: A descriptive case study approach was used to compare RST and peer discourse group treatment. The participant was a former physicist with moderate aphasia. He was placed in a preschool classroom to teach science to 4- and 5-year-old children. Correct information unit (CIU) analysis and type token ratio (TTR) scores were used to compare language samples. Journal entries were used to document psychosocial and quality of life changes. Outcomes & Results: Results indicated better verbal word retrieval skills within the classroom (RST) as compared to discourse group treatment. While involved in the teaching experience, the participant's lesson plans improved in detail and clarity. Journal entries showed improvements in quality of life. Conclusions: These findings show how the re-application of prestroke vocational skills can enhance quality of life and improve language performance. While these results support a social approach to aphasia treatment, additional research is needed.