Canadian researchers from universities and rehabilitation institutes in Toronto and Ottawa have collaborated to study a therapeutic, internet-based application for persons with aphasia (PWA) who have naming challenges. The primary aim of the study was to assess the usability – for treating clinicians and intervention recipients both – of an application built to deliver the Phonological Components Analysis Treatment for anomia. A secondary aim was to probe the experiences and satisfaction levels of those who were using the application.
Participants in the study comprised six PWA as intervention recipients, and two speech-language pathologists as treating clinicians. Intervention recipients were all person with chronic aphasia, their mean time post-onset being 5.8 years. Impairment severity ranged from mild anomia (AQ = 95) to moderate-severe Broca’s aphasia (AQ = 35). None had previous experience with online therapy. Both clinicians were proficient users of computers generally, but had no prior familiarity with this particular application. Following a 1-hour introductory training, all participants received approximately 6 hours of treatment using the application. During treatment, the clinician displayed pictures of nouns (e.g., ‘cat’), surrounded by phonology-based questions regarding that word (e.g., ‘starts with _’, ‘ends with _’, ‘rhymes with _’), for responses from the PWA. Clinicians and PWA could communicate with each other in real time, using distance conferencing capabilities. An independent observer monitored the treatment sessions to capture observations regarding the effectiveness and efficiency of treatment, as well as those regarding user satisfaction. Effectiveness was defined as ability to complete a task without reminders or prompts, and was measured using a 4-point scale. Efficiency was assessed by counting number of operational errors during use, and was also measured using a 4-point scale. At the end, satisfaction was gauged by having users complete 5-point Likert ratings for items on the System Usability Scale.
Results of data analysis showed that PWA completed application operational tasks with high levels of both efficiency and effectiveness over the treatment hours, and registered a mean satisfaction score of 83.1% (SD = 12.2%). Clinician satisfaction ratings were 16 points lower, at 67.5%. Clinicians expressed concerns about difficulty establishing satisfactory clinical rapport on-line. In this study, the clinical effectiveness of this treatment for the participating PWA was not assessed. The authors call for further research to address this and other issues with larger numbers of study subjects.
For further reading: T. Simic, C. Leonard, L. Laird et al., 2016, A Usability Study of Internet-Based Therapy for Naming Deficits in Aphasia. American Journal of Speech-Language Pathology, 25(4): 642–653, https://doi.org/10.1044/2016_AJSLP-15-0030