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UBC Theses and Dissertations

Self-directed tablet-based naming therapy in chronic aphasia Rowe, Jacob


Background: The recent interest in the use of mobile devices (like iPads and their application programs; apps) in aphasia therapy has been motivated in part by a belief that they could facilitate self-directed home practice with minimal therapist supervision. Such practice in turn could allow people with aphasia to receive more therapy, without taxing current clinical resources even further. However, it is unknown whether mobile technology can feasibly facilitate self-directed practice. Furthermore, it is unclear whether this kind of therapy can improve outcomes, and there are doubts about the quality of the therapy process when therapy is provided without the expertise of a therapist. Aims: This study aimed to explore the feasibility, therapeutic effect, and therapy process of a naming therapy using an iPad-based therapy app for minimally-supervised self-directed home practice in chronic post-stroke aphasia. Method: A single-subject experiment using a multiple baseline design was replicated across three participants with chronic aphasia, who independently used an iPad-based therapy app to practice naming pictures with the support of cues. Outcome measures included extensive usage and accuracy data unobtrusively collected using the app’s internal logging system, pre- and post-therapy language measures, and qualitative semi-structured interviews to explore participants’ experiences of therapy and perceptions of therapy effects. Results: Therapy was found to be accessible and acceptable for participants with aphasia; however, problems were identified with the therapist’s administrative role in developing and managing word sets, and monitoring therapy progress. Participants demonstrated medium to large naming accuracy gains for practiced words, but minimal gains for unpracticed words. Enabling participants to direct their own therapy process led them to spontaneously enact therapy in ways generally similar to how a therapist might. Conclusion: Despite limitations, self-directed practice using mobile technology may have the potential to improve outcomes by making ongoing long-term gains feasible, and to foster greater collaboration and shared expertise between therapists and people with aphasia. Findings were discussed in terms of suggestions for future research and therapy app development that could allow mobile technology to deliver on this potential.

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