The Best of Both Worlds: Combining Synchronous and Asynchronous Telepractice in the Treatment of Aphasia

Telepractice is an appropriate model of service delivery for a person with aphasia (PWA). We define telepractice and its two modes of delivery (i.e., synchronous and asynchronous). We detail a technology, web-Oral Reading for Language in Aphasia (web-ORLA™), developed to provide aphasia treatment intensively from a distance and subsequently evaluated during a clinical trial. In this article, we describe our experiences using web-ORLA™, highlighting the role of the speech-language pathologist (SLP) and discussing the advantages and disadvantages of this unique combination of synchronous and asynchronous telepractice. Web-ORLA™ was delivered to PWAs in their homes by a digital agent, or “virtual therapist,” who served as a model and provided instructions similarly to a real therapist. An SLP at a distant geographical location monitored the sessions remotely, either synchronously or asynchronously, provided feedback, made appropriate adjustments to the difficulty level of the stimuli, and conducted weekly pr...

[1]  D. Brennan,et al.  Telerehabilitation Tools for the Provision of Remote Speech-Language Treatment , 2002, Topics in stroke rehabilitation.

[2]  Susan E Palsbo,et al.  Equivalence of functional communication assessment in speech pathology using videoconferencing , 2007, Journal of telemedicine and telecare.

[3]  Denise McCall,et al.  The role of processing support in the remediation of aphasic language production disorders , 2004, Cognitive neuropsychology.

[4]  Pam Enderby,et al.  Superhighway to promoting a client‐therapist partnership? Using the Internet to deliver word‐retrieval computer therapy, monitored remotely with minimal speech and language therapy input , 2004 .

[5]  L. Cherney.  Oral reading for language in aphasia: impact of aphasia severity on cross-modal outcomes in chronic nonfluent aphasia. , 2010, Seminars in speech and language.

[6]  Myrna F. Schwartz,et al.  Computer-based training of language production: An exploratory study , 2001 .

[7]  Annie J. Hill,et al.  The effects of aphasia severity on the ability to assess language disorders via telerehabilitation , 2009 .

[8]  Pam Enderby,et al.  An investigation into the feasibility of remotely monitored computer therapy for people with aphasia , 2003 .

[9]  Robert T. Knight,et al.  Potential of telephonic and television technology for appraising and diagnosing neurogenic communication disorders in remote settings , 1992 .

[10]  Annie J. Hill,et al.  An Internet-based telerehabilitation system for the assessment of motor speech disorders: a pilot study. , 2006, American journal of speech-language pathology.

[11]  Brooke Hatfield,et al.  Management of Communication Disorders Using Family Member Input, Group Treatment, and Telerehabilitation , 2005, Topics in stroke rehabilitation.

[12]  Leora R Cherney,et al.  Oral Reading for Language in Aphasia (ORLA): Evaluating the Efficacy of Computer-Delivered Therapy in Chronic Nonfluent Aphasia , 2010, Topics in stroke rehabilitation.

[13]  G. Ramsberger,et al.  Self-administered cued naming therapy: a single-participant investigation of a computer-based therapy program replicated in four cases. , 2007, American journal of speech-language pathology.

[14]  T. Olsen,et al.  Improvement of oral naming by unsupervised computerised rehabilitation , 2001 .

[15]  Myrna F. Schwartz,et al.  A computer-implemented protocol for treatment of naming disorders: Evaluation of clinician-guided and partially self-guided instruction , 2002 .

[16]  A. Raymer,et al.  Evidence-based systematic review: effects of intensity of treatment and constraint-induced language therapy for individuals with stroke-induced aphasia. , 2008, Journal of speech, language, and hearing research : JSLHR.

[17]  L. Cherney,et al.  Efficacy of oral reading in aphasia treatment outcome. , 1986, Rehabilitation literature.

[18]  L. Cherney.  Efficacy of oral reading in the treatment of two patients with chronic Broca's aphasia. , 1995, Topics in stroke rehabilitation.

[19]  C. Thompson,et al.  Sentactics®: Computer-automated treatment of underlying forms , 2010, Aphasiology.

[20]  Linsey M Barker,et al.  The effect of videoconference-based telerehabilitation on story retelling performance by brain-injured subjects and its implications for remote speech-language therapy. , 2004, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[21]  Deborah Theodoros,et al.  Assessing acquired language disorders in adults via the Internet. , 2008, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[22]  R. Katz,et al.  The efficacy of computer-provided reading treatment for chronic aphasic adults. , 1997, Journal of speech, language, and hearing research : JSLHR.

[23]  A. Aronson,et al.  Telemedicine and the diagnosis of speech and language disorders. , 1997, Mayo Clinic proceedings.

[24]  P. Enderby,et al.  Talk about IT: Views of people with aphasia and their partners on receiving remotely monitored computer‐based word finding therapy , 2003 .

[25]  Linsey M. Barker,et al.  Telerehabilitation and its effect on story retelling by adults with neurogenic communication disorders , 2004 .

[26]  Amanda Brown,et al.  A Role for YouTube in Telerehabilitation , 2010, International journal of telerehabilitation.

[27]  Charles R Doarn,et al.  Overview of telehealth activities in speech-language pathology. , 2008, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[28]  Anne Brady.  MOVING TOWARD THE FUTURE: Providing Speech‐Language Pathology Services via Telehealth , 2007, Home healthcare nurse.