COMPUTER-ASSISTED SPEECH-LANGUAGE THERAPY: SNAKE OIL OR PANACEA? Terri Nichols, MS, CCC-SLP, Providence Portland Medical Center This white paper was prepared for the 1999 WSHA and ASHA conferences. [Free trials are available for all the programs described in this article. Click here to download them..]
INTRODUCING COMPUTERIZED THERAPY FOR THE FIRST TIME
Let's face it… Computers can be intimidating, even if you haven't had a stroke or brain injury. Here are a few tips on making that first experience a positive and rewarding one, for all involved.
CASE STUDY: APHASIA SOFTWARE Patient is a 39 year old male, s/p left CVA 3/26/97, with severe aphasia crossing all modalities. He had no motoric deficits from the CVA, so was discharged directly from acute care to home with his parents. Pre-morbidly, he was a computer programmer. Initial eval data: AUDITORY COMPREHENSION Single word comprehension/picture identification: 75% Yes/No questions: 65% 1-step instructions: 0% VERBAL EXPRESSION: Spontaneous Naming: 0% Sentence Completion: 0% Word repetition: 90% READING COMPREHENSION: Picture-word matching: 96% Sentence Comprehension: 70% WRITTEN LANGUAGE: Single word naming: 0% Copying: 100% Signature: functional Outpatient treatment commenced at a frequency of twice per week, for 1-hour sessions, on 5/1/97. Because the patient was computer literate, and was still able to install software and use familiar Windows-based programs, focus in the clinic was on verbal expression and auditory comprehension, and the patient independently targeted written naming and reading skills at home. He used Aphasia Tutor 1 and Aphasia Tutor 2 from Bungalow Software. He brought printouts of his performance data to each treatment session, which were used to determine when he should progress to the next level. He was encouraged to proceed quickly to the fill-in levels, and resort to multiple choice only after 2 failed attempts at typing the words. During a re-evaluation 7/26/97 (after 20 treatment sessions, and 2 months of home computer practice with aphasia software), the patient indicated with gesture and verbalization that he noticed that writing words he had practiced on the computer was far easier than words he had not practiced. Overall, he had made the following progress:
AUDITORY COMPREHENSION INITIAL PROGRESS Single word comprehension: 75% 100% Yes/No questions: 65% 80% 1-step instructions: 0% 90% VERBAL EXPRESSION: Spontaneous Naming: 0% 40% Sentence Completion: 0% 70% Word repetition: 90% 90% READING COMPREHENSION: Picture-word matching: 96% 100% Sentence Comprehension: 70% 100% WRITTEN LANGUAGE: INITIAL PROGRESS PROGRESS UNPRACTICED COMPUTER-PRACTICED Single words: nouns: 0% 40% 100% Single words: verbs 0% 25% 80% Written sentence completion: 0% 20% 100% The Written Language testing was done with pencil and paper, rather than typing on the computer. The patient continued to receive therapy services for 15 months, at decreasing frequency, for a total of 54 visits. He currently converses primarily in single words and phrases, and occasional sentences. He is reading novels, and has learned a new programming language. He was re-hired by his former employer as a contract programmer for 3 months, and vocational rehabilitation paid for a consultation visit to his employer for recommendations to maximize communication.
SETUP FOR SUCCESS – PROGRAM OPTIONS APHASIA TUTOR 1 & 2 To change the hint options, select: Options Hints ® No hints Show hint button (default) Always give Hint (first letter of word) To change the Hint placeholder, select: Options Change hint placeholder
APHASIA TUTOR 3 & 4:
SIGHTS AND SOUNDS Set the program to work on:
To set the specific prompts to display, choose: Automatically Display… Sound (play model)Playback model Text Picture
DIRECTION FOLLOWING PLUS
CATEGORIZATION AND WORD RELATIONSHIPS Works on:
TRAFFIC SIGN TUTOR Works on:
FREEFORM
SPEECH PACER
Open File Select the file you have saved with the .txt extension
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