The development and accuracy testing of CommFit™, an iPhone application for individuals with aphasia

Background: There has been an increasing amount of focus on measuring the ICF concept of participation in the rehabilitation of people with aphasia. The amount of time that people with aphasia talk has the potential to be used as an indicator of participation for this population. However, in order to measure talk time, an accurate, portable, and usable biofeedback tool is required. This paper details the development and accuracy testing of the CommFit™ iPhone application, which, paired with a BlueTooth headset, times the talk of the user. Aims: The aim of development of CommFit™ was to maximise the likelihood that the app would be usable by people with stroke and aphasia. Accordingly, aphasia-friendly text principles and other features of accessibility were integrated into the design, which is described in detail in this paper. The purpose of this study was to investigate the accuracy of CommFit™ in quantifying talk time in everyday environments in a small number of healthy adults. Methods & Procedures: Participants were three healthy individuals, who each wore the CommFit™ app with BlueTooth headset and a continuous voice recorder for a total of 10 h in their everyday lives. Talk time registered by the app was compared to the amount of talk time manually calculated from the continuous voice recording to obtain its relative accuracy. Outcomes & Results: CommFit™ measured talk time within ±4% of the actual talk time in an ideal environment with no background noise, and ±13% in everyday environments when a calibration procedure was used. Conclusions: CommFit™ is an app that was developed to be aphasia-friendly and accessible. The accuracy results suggest that the app with headset is a usable and valid indicator of talking time for people with aphasia. Testing will be carried out with the target population to further confirm the usability of the app and its role as an indicator of participation.

[1]  Benjamin Peter Milner,et al.  Speech recognition in adverse environments , 1994 .

[2]  D. Ingram,et al.  Digital data collection and analysis: application for clinical practice. , 2004, Language, speech, and hearing services in schools.

[3]  J. Pennebaker,et al.  The Electronically Activated Recorder (EAR): A device for sampling naturalistic daily activities and conversations , 2001, Behavior research methods, instruments, & computers : a journal of the Psychonomic Society, Inc.

[4]  Keni Ren,et al.  Comparison of two methods of voice activity detection in field studies. , 2009, Journal of speech, language, and hearing research : JSLHR.

[5]  Scott E Crouter,et al.  Validity of 10 electronic pedometers for measuring steps, distance, and energy cost. , 2003, Medicine and science in sports and exercise.

[6]  Juris Terauds,et al.  Science in Sports , 1979 .

[7]  Mi Zhang,et al.  Human Daily Activity Recognition With Sparse Representation Using Wearable Sensors , 2013, IEEE Journal of Biomedical and Health Informatics.

[8]  J. Marshall,et al.  Public knowledge about aphasia: A survey with comparative data , 2009 .

[9]  Ronald J. Baken,et al.  Clinical measurement of speech and voice , 1987 .

[10]  Mika Raento,et al.  Smartphones , 2009 .

[11]  B E Ainsworth,et al.  Accuracy of five electronic pedometers for measuring distance walked. , 1996, Medicine and science in sports and exercise.

[12]  P. Schulz,et al.  Mapping mHealth Research: A Decade of Evolution , 2013, Journal of medical Internet research.

[13]  Maria M. Klawe,et al.  The participatory design of a sound and image enhanced daily planner for people with aphasia , 2004, CHI.

[14]  D G Jamieson,et al.  Effects of microphone type on acoustic measures of voice. , 2001, Journal of voice : official journal of the Voice Foundation.

[15]  Audrey L Holland,et al.  How to use apps clinically in the treatment of aphasia. , 2012, Seminars in speech and language.

[16]  Steven K. Feiner.  The importance of being mobile: some social consequences of wearable augmented reality systems , 1999, Proceedings 2nd IEEE and ACM International Workshop on Augmented Reality (IWAR'99).

[17]  José B. Mariño,et al.  Speech recognition in a noisy car environment based on LP of the one-sided autocorrelation sequence and robust similarity measuring techniques , 1997, Speech Commun..

[18]  Robert E Hillman,et al.  Development and testing of a portable vocal accumulator. , 2003, Journal of speech, language, and hearing research : JSLHR.

[19]  E. Hargittai,et al.  The disability divide in internet access and use , 2006 .

[20]  Karyn Moffatt,et al.  Designing technology for and with special populations : and exploration of participatory design with people with aphasia , 2004 .

[21]  Anthony S Leicht,et al.  Pedometer accuracy during walking over different surfaces. , 2007, Medicine and science in sports and exercise.

[22]  Jacquie Kurland,et al.  iPractice: Piloting the Effectiveness of a Tablet-Based Home Practice Program in Aphasia Treatment , 2014, Seminars in Speech and Language.

[23]  Mika Raento,et al.  ContextPhone: a prototyping platform for context-aware mobile applications , 2005, IEEE Pervasive Computing.

[24]  Maurizio Omologo,et al.  Environmental conditions and acoustic transduction in hands-free speech recognition , 1998, Speech Commun..

[25]  C. Code.  The quantity of life for people with chronic aphasia , 2003, Neuropsychological rehabilitation.

[26]  Robert E Hillman,et al.  Ambulatory Monitoring of Disordered Voices , 2006, The Annals of otology, rhinology, and laryngology.

[27]  Ingo R Titze,et al.  Adaptation of a Pocket PC for use as a wearable voice dosimeter. , 2005, Journal of speech, language, and hearing research : JSLHR.

[28]  Swathi Kiran,et al.  Development of an Impairment-Based Individualized Treatment Workflow Using an iPad-Based Software Platform , 2014, Seminars in Speech and Language.

[29]  Robert E. Hillman,et al.  Mobile Voice Health Monitoring Using a Wearable Accelerometer Sensor and a Smartphone Platform , 2012, IEEE Transactions on Biomedical Engineering.

[30]  N. Simmons-Mackie,et al.  What is aphasia? Results of an international survey , 2002 .

[31]  G. Fairbanks.  Voice and articulation drillbook , 1960 .

[32]  David A. Copland,et al.  Mobile computing technology and aphasia: An integrated review of accessibility and potential uses , 2013 .