Investigating communication support strategies as ‘micro-interventions’: A conceptual-methodological framework applying realist evaluation and relevance theory

Communication Partner Training is widely applied in speech and language therapy practice, premised on the idea that communication support strategies can optimise conversations involving persons with communication disabilities. The pragmatic mechanisms by which these communication support strategies work in the moment of the conversation, remain under-theorised. We present a conceptual-methodological framework applying realist evaluation and using relevance theory as the 'theory engine' of the evaluation. This paper situates communication support strategies as 'micro-interventions', that is, interventions that occur in the complex social reality of conversation and affect the outcome of the unfolding conversation between a person with a communication disability and their communication partner, and the cognitive environment of both interlocutors. The theory-driven approach proposed provides a robust means through which to postulate the mechanisms by which communication support strategies work (that is how and why they work) within and across conversational contexts. A relevance-driven realist evaluation has the potential to generate explanatory accounts of communication support strategies which are both comparable across clinical populations and, crucially, empirically testable. What is already known on this subject Communication Partner Training (CPT) is widely applied in speech and language therapy practice, premised on the idea that communication support strategies can optimise conversations involving persons with communication disabilities. What this study adds to existing knowledge This paper situates communication support strategies as 'micro-interventions', and proposes an approach to study how and why these strategies influence pragmatic processing in different contexts. The approach outlined involved realist evaluation and relevance theory. What are the potential or actual clinical implications of this work? Understanding how and why communication supports strategies influence pragmatic processing opens up the opportunity to identify universal principles across different clinical groups. [Abstract copyright: © 2026 The Author(s). International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.]