Introduction to the Technique

Promoting Aphasics' Communicative Effectiveness (PACE) is a multimodal therapy approach that helps individuals with aphasia communicate more effectively. It encourages the use of any form of communication—whether speech, writing, gestures, or augmentative communication devices. This method supports the exchange of messages regardless of the patient's expressive language abilities, focusing on enhancing their communicative confidence and success through various adaptive methods.
 

Patient Population

PACE is suitable for individuals with severe expressive aphasia, as well as those with mild to moderate aphasia, including those facing word retrieval difficulties and challenges in forming sentences.
 

Pre-requisites or Contraindications

PACE may not be appropriate for individuals with severe receptive aphasia (e.g., Wernicke’s aphasia), where comprehension of spoken or written messages is severely impaired.

key learning point

 PACE is a multimodal approach that encourages various communication methods like speech, gestures, writing, and drawing. It focuses on communication success rather than perfection, boosting patients' confidence. The technique adapts to individual needs, using cues like pictures and written words to help with word retrieval and expressive language. It promotes active participation from both the patient and communication partner, aiming to improve communicative effectiveness and reduce stress.

approach procedure 

In the approach procedure ,intervention can be conducted at both the word level and sentence level and sentence level .
  Set the communication context by selecting appropriate materials that represent common scenarios or messages. The materials should be meaningful and suited to the patient’s abilities.
  The patient selects a communication material and uses any available method to express the message, such as drawing.
  The communication partner interprets the message and responds in a supportive, non-judgmental manner
  If the message is unclear, encourage repetition, rephrasing, or the use of alternative methods.
  Praise successful communication efforts to build the patient’s confidence. Adapt communication methods based on the patient’s strengths, such as preferences for drawing.
  Offer constructive feedback, emphasizing what worked well in the communication. Encourage the patient to reflect on the process
 
 
Material with Illustrated Examples

• Word Cards: A set of word card representing everyday scenarios (daily using things) can be used for prompting communication.                              
  

  
  

  
  
  
  

                        

• Drawing/Sketching Materials: A simple sketching pad for patients to draw objects or ideas to convey messages.

 Images and visual examples of such materials would be integrated within the blog for better clarity

 
 Brief Description of the Steps Involved in the Technique

Step 1: Set the Communication Context
Select appropriate materials (word cards) that represent common scenarios. These items serve as cues for communication.

Step 2: Sender Communicates the Message
The patient (sender) uses any method (gesture & drawing) to convey their message. The communication partner (receiver) interprets and responds supportively.

Step 3: Encourage Use of Alternative Methods
If the message is unclear, encourage use of different communication methods (e.g., gestures or Drawing) for clarity.

Step 4: Reinforce Communication and Adapt Strategies
Praise successful communication attempts and adapt methods based on the patient’s strengths, such as focusing on writing or gestures when speech is difficult.

Step 5: Provide Feedback and Reflect
Offer constructive feedback, helping the patient reflect on what worked well and how they can improve communication methods for future exchanges.

video demonstration

 
 

Sample outcome recording sheet 

Item	Turn as sender	Communication methods used	Responded/ Not Responded	Response mode	Comments on support
Scissor	D	Gesture	Responded	Verbal
Watch	R	Gesture	Responded	Verbal
Telephone	D	Gesture and Writing	Responded	Verbal
House	R	Gesture	Responded	Verbal
Fan	D	Gesture and Writing	Responded	Verbal

 
 
 
  Picture Communication

• Use pictures of everyday objects, activities, or scenarios.

• Ask the patient to point to or describe the pictures using words, gestures, or writing.

          

Home bases activities

  Daily Life Scenarios

• Create simple communication tasks based on daily activities (e.g., grocery shopping, cooking, or weather conditions).

 

• Encourage the patient to express themselves using preferred methods (speech, drawing, or writing).

  Word Retrieval Exercises

• Provide the patient with a list of words or phrases related to a specific theme.

• Ask the patient to communicate these words through gestures, writing, or drawing.

  Sentence Completion

• Provide incomplete sentences (e.g., "I want to go to the __") and ask the patient to complete them using any communication method they prefer.