Effects of a Tablet-Based Home Practice Program With Telepractice on Treatment Outcomes in Chronic Aphasia Purpose The aim of this study was to determine if a tablet-based home practice program with weekly telepractice support could enable long-term maintenance of recent treatment gains and foster new language gains in poststroke aphasia. Method In a pre–post group study of home practice outcomes, 21 individuals with ... Research Article
Research Article  |   May 17, 2018
Effects of a Tablet-Based Home Practice Program With Telepractice on Treatment Outcomes in Chronic Aphasia
 
Author Affiliations & Notes
  • Jacquie Kurland
    Department of Communication Disorders, University of Massachusetts Amherst
  • Anna Liu
    Department of Mathematics and Statistics, University of Massachusetts Amherst
  • Polly Stokes
    Department of Communication Disorders, University of Massachusetts Amherst
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication.×
  • Correspondence to Jacquie Kurland: jkurland@comdis.umass.edu
  • Editor-in-Chief: Sean Redmond
    Editor-in-Chief: Sean Redmond×
  • Editor: Charles Ellis
    Editor: Charles Ellis×
Article Information
Telepractice & Computer-Based Approaches / Language Disorders / Aphasia / Language / Research Articles
Research Article   |   May 17, 2018
Effects of a Tablet-Based Home Practice Program With Telepractice on Treatment Outcomes in Chronic Aphasia
Journal of Speech, Language, and Hearing Research, May 2018, Vol. 61, 1140-1156. doi:10.1044/2018_JSLHR-L-17-0277
History: Received July 21, 2017 , Revised November 10, 2017 , Accepted December 19, 2017
 
Journal of Speech, Language, and Hearing Research, May 2018, Vol. 61, 1140-1156. doi:10.1044/2018_JSLHR-L-17-0277
History: Received July 21, 2017; Revised November 10, 2017; Accepted December 19, 2017

Purpose The aim of this study was to determine if a tablet-based home practice program with weekly telepractice support could enable long-term maintenance of recent treatment gains and foster new language gains in poststroke aphasia.

Method In a pre–post group study of home practice outcomes, 21 individuals with chronic aphasia were examined before and after a 6-month home practice phase and again at follow-up 4 months later. The main outcome measure studied was change in naming previously treated or untreated, practiced or unpracticed pictures of objects and actions. Individualized home practice programs were created in iBooks Author with semantic, phonemic, and orthographic cueing in pictures, words, and videos in order to facilitate naming of previously treated or untreated pictures.

Results Home practice was effective for all participants with severity moderating treatment effects, such that individuals with the most severe aphasia made and maintained fewer gains. There was a negative relationship between the amount of training required for iPad proficiency and improvements on practiced and unpracticed pictures and a positive relationship between practice compliance and same improvements.

Conclusion Unsupervised home practice with weekly video teleconferencing support is effective. This study demonstrates that even individuals with chronic severe aphasia, including those with no prior smart device or even computer experience, can attain independent proficiency to continue practicing and improving their language skills beyond therapy discharge. This could represent a low-cost therapy option for individuals without insurance coverage and/or those for whom mobility is an obstacle to obtaining traditional aphasia therapy.

Acknowledgments
This work was supported by funding from the National Institute on Deafness and Other Communication Disorders of the National Institutes of Health (Grant R01DC011526 to Jacquie Kurland). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would like to thank Kylee Osowski, Alisson Reber, Kristen Stem, and Abigail Wilkins for their assistance in creating the iBooks, Mary Andrianopoulos for her evaluation of AOS, Nicole Kurland for her assistance with graphics, and the individuals with aphasia and their families for participating in this study.
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