Full Goal

Across structured SCA training sessions (4-6 sessions per partner) and during natural conversation with the PWA (person with aphasia), with a structured partner-skills observation tool, partner will demonstrate SCA techniques: acknowledging competence (verbal and nonverbal), revealing competence (using key words, written choice, drawing, gesture), and verifying understanding (recap, fixed-choice, yes/no verification) with each technique demonstrated at fidelity criterion across 3 consecutive 10-minute observed conversations, and partner self-rated confidence ≥7/10; AND PWA self-rated communicative success ≥7/10 in conversations with the trained partner, as measured by SLP structured observation using the Measure of Skill in Supported Conversation (MSC) or equivalent, partner self-assessment, and PWA self-report.

Why a Partner-Side Aphasia Goal

The Simmons-Mackie et al. (2010, 2016) systematic reviews are unambiguous: communication partner training produces measurable improvements in conversation quality, partner skill, and patient-reported outcomes in aphasia. Partner training has stronger evidence than many impairment-level interventions for functional communication outcomes.

Yet partner training is often informal, off-the-clock, or absent in standard aphasia care. Goals that target partner behavior put it on equal footing with patient-side work — which the evidence supports.

SCA (Kagan, 1998) is the most-replicated specific partner-training program. The “competence” framing is central: partners learn to acknowledge that the PWA is a competent adult whose communication is impaired but whose thinking, opinions, and identity are intact, and to use specific techniques to reveal that competence in conversation.

Individualization Guidance

Before using this goal, verify:

• Partner selection. Family members, professional caregivers, healthcare staff, and volunteers all benefit from SCA training. Goal-setting should specify who is being trained.
• SCA training format. Kagan’s published materials and Aphasia Institute training are the gold-standard sources. The training typically uses video examples, role-play, structured practice with the PWA, and feedback. Train this approach or partner with a colleague who has.
• MSC (Measure of Skill in Supported Conversation) for observation. The MSC has two scales: skill in acknowledging competence, and skill in revealing competence. Use it (or an equivalent structured tool) for observation. Don’t rely on global judgment.
• PWA self-report is part of the measurement. This is the outcome that matters most: does the PWA experience the trained partner as a better communicator? The patient’s voice must be in the data.
• Multiple partners, cascade training. If the PWA has multiple key partners, each needs training, or a structured cascade (train spouse → spouse trains adult children) needs to be planned. Document the cascade.
• Healthcare staff training is high-leverage. Hospital staff trained in SCA reduce miscommunication, frustration, and adverse events for PWA. Inpatient settings particularly benefit from systematic staff training.
• Cultural and linguistic responsiveness. SCA materials and training should be culturally and linguistically responsive to the PWA’s identity, language(s), and family context.
• Maintenance. Partner skills can decay without practice. Plan for follow-up observations and refresher sessions.

Clinical Notes

The dual criterion (partner skill demonstrated AND PWA confirms communicative success) keeps both sides of the conversation in the data. A partner who scores well on the MSC but with whom the PWA reports poor experience is not actually skilled — something the MSC missed. A PWA who reports positive experience with a partner who scores low on MSC may be reporting on warmth rather than skill, which is also useful data but a different signal.

The 4-6 session training dose matches the published evidence base. Shorter doses produce limited gains; longer doses are often unnecessary for trained partners with regular practice.

The “across 3 consecutive 10-minute observed conversations” condition ensures the partner skill is demonstrated repeatedly under varied conversational topics, not just on a single video clip.

SCA pairs naturally with script training (the partner supports script deployment), SFA (the partner reinforces word retrieval), and LPAA participation goals (the partner is a key enabler of life participation). A complete chronic-aphasia program rarely lacks partner training.

For CMS skilled-service documentation: partner training as a related service or caregiver education is reimbursable under Medicare and many other payers. Cite Simmons-Mackie systematic reviews and Kagan’s RCT when justifying coverage. Document partner skill data alongside patient-side data.

This goal is appropriate as:

• A primary goal in chronic aphasia where partner-supported communication is the realistic functional target.
• An adjunct goal alongside impairment-level work.
• A discharge-preparation goal in inpatient settings (caregiver education before discharge).
• A team-training goal in SNF or assisted-living settings.

Related Goals

• Script Training for Functional Communication in Aphasia — PWA-side functional communication goal
• Semantic Feature Analysis for Word Retrieval — Chronic Aphasia — impairment-level companion goal
• LPAA-Aligned Life Participation Goal — broader life-participation framing