Computer-assisted treatment of word retrieval deficits in aphasia

Abstract

Background : There are now numerous experimental studies demonstrating successful treatment of word retrieval deficits in aphasia. Technological advances allow us to implement many of these approaches on the computer and target the underlying impairment (e.g., in phonologically vs semantically based retrieval deficits). These computer-assisted treatments have the potential to facilitate the work of clinicians and, if geared towards independent or volunteer-assisted usage, extend the rehabilitation process beyond the period of formal therapy. Aims : Our aim is to review the benefits and limitations of computer-assisted treatment for word retrieval deficits, focusing on the lessons we have learned from a computerised therapy system, developed in our laboratory, which was designed to be used in the clinical setting, as well as by patients working independently. Contributions : We review relevant single and multiple case studies that use computer-assisted treatment programmes in various clinical and home settings. We then describe an outcome study that used the therapy system developed in our laboratory to deliver a hierarchical, multi-modality cueing protocol under clinician-guided and self-guided instruction. Through the use of mini case studies, we exemplify the system's application in the clinical setting and in home usage. Additionally we present use and satisfaction data which impact on clinical and home use. Conclusions : Theoretically motivated, computer-assisted treatments for naming impairments can be beneficial as an adjunct to one-on-one speech/language therapy, and are an effective way to intensify and continue the rehabilitation process. While many of our patients are capable of working independently or with minimal assistance to achieve their goals, computers still represent an unfamiliar and intimidating technology for the majority of our patients and families; and access in the home remains limited. One way to provide needed support is through a computer lab, staffed by trained volunteers working under the supervision of a speech-language pathologist. Additional research is needed to replicate these findings with a larger and more diverse group of individuals with aphasia and to evaluate the effectiveness of the Multi-modality Matching Module of MossTalk Words® software in the treatment of semantically based anomia. This could potentially provide pilot data for a large-scale clinical trial.