Authors: Hough M, Johnson RK
Title: Use of AAC to enhance linguistic communication skills in an adult with chronic severe aphasia
Source: Aphasiology 2009 23(7-8): 965-976
Year: 2009
Research Design: Single Case Design

BACKGROUND: Individuals with non-fluent aphasia (NA) exhibit sparse verbal output and impaired word-finding skills. For some, traditional speech-language therapy aids in regaining verbal communication. For other aphasic individuals these techniques are unsuccessful. Augmentative and alternative communication (AAC) provides a means of communicating through devices/techniques when spoken skills are not adequate. Individuals with chronic NA can use AAC to communicate; however, many investigations do not include strategies to facilitate communication or caregiver participation. Also, variables influencing treatment efficiency (length, intensity) have not been sufficiently evaluated. AIMS: The current study expanded on Johnson, Hough, King, Vos, and Jeffs (2008), investigating if a gentleman with severe, chronic NA could learn to use an AAC device, monitoring communication skill improvement periodically throughout treatment. METHODS and PROCEDURES: TE, a 56-year-old left-handed, Caucasian male with severe NA and apraxia of speech resulting from left CVA participated. The Western Aphasia Battery-Revised and ASHA FACS were administered pre-treatment, at 1 and 2 months, and post-treatment. The American Speech-Language Hearing Association Quality of Communication Life Scale and Communicative Effectiveness Index were administered pre- and post-treatment. The AAC device used was Dialect by Zygo with Speaking Dynamically Pro. The treatment protocol was similar to Koul, Corwin, and Hayes (2005) and Johnson et al. (2008). Treatment was 1 hour, 4 days weekly, over 3 months. The first stage, four-level symbol identification, organised a hierarchical structure in which TE was to identify each symbol on the display. The second stage involved navigation to category, choosing a symbol requested by the clinician, which evolved into scenario role-play; TE was asked questions about life situations and daily schedules. The next phase, sentences, involved answering questions about everyday activities/interests with short phrases using symbols. The spouse received training that included overview on navigating symbol levels, hierarchy structure used with symbols, facilitation strategies, and cues/prompts to incorporate device use outside therapy. OUTCOMES and RESULTS: Results revealed that TE performed all stages of the treatment programme, allowing progression to each phase of treatment. He completed the programme in 40 therapy sessions. WAB scores (AQ, CQ) showed that performance continually improved on both scores throughout the entire protocol, with most increases in the last month. ASHA FACS scale ratings also yielded continuous increases throughout the regimen for all communication scales. CONCLUSIONS: Findings support previous research indicating that individuals with chronic NA can learn symbol-meaning association using AAC. Implementation of a device should be a viable consideration for chronic, severe NA.

Access: Paywall