OUTCOME IMPROVEMENTS IN PERSONS WITH CHRONIC GLOBAL APHASIA FOLLOWING THE USE OF A SPEECH-GENERATING DEVICE
Journal Title: Acta Neuropsychologica - Year 2010, Vol 8, Issue 4
Abstract
Advanced computer-based interventions have demonstrated effectiveness in aphasia rehabilitation even in the chronic stage, and outcome studies using standardised assessment instruments reveal previously unstudied patterns of improvement and associated improvement magnitudes. Here we analyze persons with chronic global aphasia. Twenty subjects were assessed at intake and at discharge, at the impairment and functional communication levels, using standardized assessment instruments. During intervention, the subjects used a speechgenerating device, therapeutically and communicatively, in the clinic and at home. Matched t-tests were used to measure the significance of overall improvements after intervention; and WAB assignments to same or different aphasia diagnostic category at discharge established subject subgroups, with one-way ANOVA employed to measure the significance of differences. Mean subject time post-onset was 2.7 years, and mean duration of intervention was 20.6 weeks. Following intervention, the subject means improved significantly on 3 of 5 impairment-level items, and on 15 of 17 functional-level items. Eight of the 20 subjects (40%) were recategorized to Broca’s aphasia at discharge, while the others significantly improved within global aphasia. Overall, the Gl:Br subgroup scored significantly higher – among other items – in Auditory Verbal Comprehension, and at discharge in “having a spontaneous conversation”. By contrast, the Gl:Gl subgroup improved much more during intervention than the Gl:Br subgroup in “getting someone’s attention” and “communicating anything (including ‘yes’ or ‘no’) without words”. Advanced computer-based interventions can improve mean rehabilitation outcomes in chronic global aphasia at the impairment and functional communication levels. Some may be reassigned to Broca’s aphasia, while others improve greatly in basic functional communication tasks that improve quality of life.
Authors and Affiliations
Richard Steele, Lefkos Aftonomos, Rajinder Koul
Keywords
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