| Abstract: |
Background: Speech pathologists face the clinical obstacle of providing an intensive service for individuals with aphasia. Computer therapy potentially offers a solution to the dilemma of increasing therapy frequency while maintaining or reducing the load on therapists' resources. Aims: This systematic review of the literature aimed to determine the effect of computer therapy both in comparison to no therapy and in comparison to clinician-delivered therapy in individuals with aphasia. Seventeen terms encompassing three main concepts (aphasia, technology, and rehabilitation) were used to search four electronic databases. Two reviewers independently screened titles and abstracts against inclusion/exclusion criteria. Data extraction for included studies was completed by one reviewer and confirmed by the second reviewer. Main Contribution: Seven studies were included, with six studies suitable for determining the effectiveness of computer therapy in comparison to no therapy, and three studies suitable for determining the effectiveness of computer therapy in comparison to clinician-delivered therapy. Two studies were suitable for answering both questions. The studies ranged in quality and were analysed descriptively. Meta-analysis was unable to be completed due to heterogeneity in methods, study types, computer programs, and outcome measures. All six studies investigating computer therapy in comparison to no therapy reported statistically significant improvements within the computer group. Five out of six studies reported statistically significant differences in language outcomes between the computer therapy and control group. All three studies comparing computer- and clinician-delivered therapy reported improvements in both the clinician and computer-delivered interventions with no statistically significant differences in language outcomes between the two treatment groups. One study reported no statistically significant differences in number of sessions needed to reach therapy criterion, whereas another reported an observed increase in the number of computer-delivered sessions over clinician-delivered sessions required to reach the therapy criterion for several treatment levels. Conclusions: This review provides evidence that computer therapy is effective when compared to no therapy and provides preliminary evidence that computer-delivered therapy may be as effective as clinician-delivered therapy for a specific population of individuals with aphasia. However, the quality of the evidence is low due to the small number of studies included. This review highlights the need for further research investigating the effectiveness of computer therapy in comparison to clinician-delivered therapy in a larger sample to enable the exploration of factors such as the type of aphasia and severity and the role of feedback and cueing hierarchies on treatment success. |
