Initial evaluation of the TALES (technology and literacy engagement after stroke) programme targeting functional literacy and social engagement in people with aphasia after stroke

Abstract

ABSTRACT Background and aims Literacy skills are typically affected in people with stroke aphasia, leading to reduced engagement in functional everyday reading/writing tasks, such as email/messaging via social media. The aim of this study was to investigate the outcomes of the TALES (Technology And Literacy Engagement after Stroke) programme, a group-based online literacy-focused programme for people with aphasia after stroke. This first evaluation of this programme aimed to examine outcomes related to feasibility, changes in language, literacy and self-ratings of communication skills. Methods Five participants with aphasia were assessed on a range of outcome measures relating to language and self-perception of communication skills. These were: the Western Aphasia Battery-Revised (WAB-R; (Kertesz, 2007)), literacy subtests from the Psycholinguistic Assessment of Language Processing in Aphasia (PALPA; (Kay et al., 1996)) and the Communication Outcomes after Stroke (COAST; (Long et al., 2008)). TALES consisted of a weekly group online session, 1:1 supported telehealth reading/writing practice and regular messaging via email. Results and main contribution From a descriptive statistics perspective, the mean gains across the cohort were 7.94 (from 84.24 to 92.18) on the WAB AQ (aphasia quotient), 8.92 (from 81.18 to 90.10) on the WAB LQ (language quotient). Additionally, there was a change in the mean scores for PALPA subtests (31, 37 and 40) observed between the pre-treatment assessment and post-treatment assessment. Finally, the mean score increased by 8.8 (from 49.40 to 58.20) on the COAST (max score = 80). Results indicated gains in literacy and communication measures as well as changes to self-rating of communication reflecting changes in communication confidence. Conclusions Mindful of the threats to the internal validity inherent in the study design, the reported online therapy can overcome barriers such as distance and mobility limitations and may provide greater accessibility to therapy for individuals with aphasia. TALES was a low-therapist-input yet reasonably intensive treatment approach which embedded language practice immediately in functional use through the social group format and personally-relevant written communication. Implications The TALES programme meets many neuroscience principles of neurorehabilitation including “use it or lose it”, salience and transference. Future research may usefully investigate the contribution of the group format versus the functional literacy components towards these potentially promising early data.