Affiliation:
1. Department of Clinical Health Sciences, Texas A&M University–Kingsville
2. Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
3. Lingraphica, Princeton, NJ
Abstract
Purpose
Current computer technologies permit independent practice for people with cognitive–communicative disorders. Previous research has investigated compliance rates and outcome changes but not treatment fidelity per se during practice. Our aim was to examine adherence to procedures (treatment fidelity) and accuracy while persons with aphasia independently practiced word production using interactive, multimodal, user-controlled, word-level icons on computers.
Method
Four persons with aphasia independently practiced single-word production after stimulation via user-initiated interactions in 3 conditions: (I) auditory stimulus with static representational drawing; (II) auditory stimulus with synchronized articulation video; and (III) users' choice between the 2 prior conditions. Sessions were video-recorded for subsequent analysis, which established emergently refined behavioral taxonomies using an iterative, mixed-methods approach.
Results
In independent practice, users only sometimes adhere to modeled behaviors, other times improvising novel behaviors. The latter sometimes co-occurred with successful productions. Differences in success rates were noted between Conditions I and II across behaviors with Condition II generally favored. In Condition III, participants tended to choose the stimulus that resulted in highest success rates.
Conclusions
During independent practice with technology, persons with aphasia do not necessarily comply with clinicians' practice instructions, and treatment fidelity does not determine success. Autonomy and choice in practice may reveal unanticipated dimensions for computerized aphasia treatment.
Publisher
American Speech Language Hearing Association
Subject
Speech and Hearing,Linguistics and Language,Developmental and Educational Psychology,Otorhinolaryngology
Cited by
9 articles.
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