Question
I am a certified SLP, and have many patients with expressive aphasia. I have tried various techniques to improve their expressive abilities, but not all return to baseline. Do you have any suggestions or computer programs that may be beneficial?
Answer
There are many computer programs which can help people with expressive aphasia. The specific programs need to be carefully chosen so that they are a good match for the client and set up with the appropriate configurations to maximize progress. Prior to the program selection, you will need to think about the client's independence with getting into and out of programs, their visual perceptual skills, and the ability to benefit from the cues the program gives so that they don't get stuck in a program. You want to be sure that the nature of the task is providing practice toward the client's goals.
I use the computer to both drill and practice as well as compensate for impaired verbal expression. Some of my top picks include Bungalow Software (www.bungalowsoftware.com-Aphasia Tutor 1 and 2 OutLoud, Sights 'n Sounds, and Speech Sounds on Cue) , Parrot Software's online programs (www.parrotsoftware.com), some of the Attainment Software (www.attainmentcompany.com- Looking for Words), Crick Software (www.cricksoftware.com- Clicker 5 and CHAT Software (www.aphasia-therapy.com.) I also like some of the programs which were produced to teach English as a second language. Many more programs are available and described in a book I published recently titled "Technology for Communication and Cognition: The Clinician's Guide" which is available at www.ittsguides.com.
I use text to speech quite a lot. This type of software can be used to help all language modalities. Examples include Universal Reader (www.readingmadeeasy.com), NextUp (www.nextup.com) and Wordq (www.wordq.com). There is variation in cost and features, but the programs can be set to highlight and enlarge words as the computer reads the text aloud. The voice used and rate of speech can be changed as needed. The voices are now much better than they used to be. In my experience, most people with expressive aphasia also need help with other language areas. The software can help with reading because retention and processing improve as the computer reads aloud and the client sees the words highlighted at the same time. It helps with writing because each word can be said aloud as it is typed which improves attention to the task and awareness of errors. Some of these programs also provide word prediction. Text to speech software can also be used to improve verbal expressive skills. Word lists and functional phrases can be typed and then read aloud by the client, and listened to for accuracy. Another way to use the text to speech would be to have the program read the word or sentence aloud first and then the person repeats it.
The Clicker 5 and Sighs 'n Sounds mentioned above have authoring capabilities. Pictures and words selected for each patient can be used during expressive tasks.
I set clients up on their own computers, teach the clients and others (family members and "computer buddies" how to use them. I provide detailed instructions and customize the computer with the appropriate configurations and shortcuts. Clients can then practice on their own for hours a day and really make some decent progress. I continue to support them by updating and revising the independent practice program as needed.
Joan L. Green, M.A., CCC-SLP, is the founder of Innovative Speech Therapy- a private speech pathology practice in the Washington, DC area. She received her undergraduate and graduate level education and training at Northwestern University. Over the past 20 years, she has developed an exciting approach that involves integrating technology and other resources into treatment to help clients, patients and students realize their potential with practical, efficient and affordable solutions. Joan is the founder of two intensive short-term technology oriented programs in Potomac, Maryland- TWIST for Adults and TWIST for parents. She is also the author of "Technology for Communication and Cognitive Treatment: The Clinician's Guide," a revolutionary approach to enhance treatment outcomes for people with speech, language, learning and cognitive disabilities. For more information, visit www.innovativespeech.com or www.ittsguides.com