Abstract
We report a 12-week outcome study in which nine persons with long-term chronic aphasia received individual and group speech-language teletherapy services, and also used on-line language exercises to practice from home between therapy sessions. Participants were assessed at study initiation and completion using the Western Aphasia Battery, a portion of the Communicative Effectiveness Index, ASHA National Outcome Measurement System, and RIC Communication Confidence Rating Scale for Aphasia; additionally participants were polled regarding satisfaction at discharge. Pretreatment and post-treatment means were calculated and compared, and matched t-tests were used to determine significance of improvements following treatment, with patterns of independent on-line activity analyzed. Analysis of scores shows that means improved on most measures following treatment, generally significantly: the WAB AQ improved +3.5 (p = .057); the CETI Overall (of items administered) — +17.8 (p = .01), and CCRSA Overall — + 10.4 (p = .0004). Independent work increased with time, and user satisfaction following participation was high.
Highlights
There has long been interest in using distance communication technologies to serve the rehabilitation needs of persons with neurogenic communication disorders such as aphasia
We report a 12-week outcome study in which nine persons with long-term chronic aphasia received individual and group speech-language teletherapy services, and used on-line language exercises to practice from home between therapy sessions
The change in the calculated ‘Aphasia Quotient’ is noteworthy: it showed a modest improvement (+ 3.5, out of 100) that is coupled with a strong trend towards significance (p = .057)
Summary
There has long been interest in using distance communication technologies to serve the rehabilitation needs of persons with neurogenic communication disorders such as aphasia. There is good reason to think that this configuration — remote service delivery by a teleclinician, combined with independent client practice using assigned, high-technology therapy materials – will become an important feature of future service delivery This model permits continued remote engagement with clients who may move away, live distantly, or travel; it reduces travel requirements on the clinician; it supports both 1-on-1 and group therapy sessions; it empowers clients to work independently between clinical sessions with a Speech-Language Pathologist (SLP) in pursuit of benefit from massed practice (Cherney et al, 2008; Pulvermüller et al, 2001); it allows SLPs remotely to review client activity with assigned materials and modify associated treatment plans; and it enables clinicians to adjust the balance of face-to-face therapy vs independent on-line work adaptively to exploit synergies between the two. The authors designed and executed the following study with two complementary, overarching goals: first, to demonstrate the practical feasibility using this model to deliver therapeutic services to persons with chronic aphasia; and second, to establish and begin characterizing the clinical and other benefits of such service delivery
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