| Summary: | 碩士 === 國立臺灣師範大學 === 復健諮商研究所 === 103 === Background: Computerized augmentative and alternative communication (AAC) is increasingly applied in clinical aphasia rehabilitation because it has been proven effective at enhancing the communication skills and efficiency of people with aphasia. Effective use of AAC requires a strong cognitive ability and prolonged training, which is aimed at training people with aphasia to generate communicative sentences through the use of AAC device. This study attempts to determine whether people who developed non-fluent aphasia after a stroke can effectively use AAC device to independently communicate in different communication situations after becoming familiar with operating such device.
Objective: To support the clinical application of AAC in treating people with non-fluent aphasia after a stroke, this study explored the effectiveness of training people who developed non-fluent aphasia after a stroke to use the AAC application software developed in Taiwan, the Voice Symbol for iPad. Subsequently, the accurately completed percentage of communicative sentences and the generalization outcomes of the AAC device were investigated under different communication situations.
Method: This study adopted a multiple probe across-subjects design to investigate the effectiveness of training three people who developed non-fluent aphasia after a stroke to use the Voice Symbol for iPad. Three phases were explored in this study, namely the baseline, intervention, and maintenance phases. The following data were collected: the accurately completed percentage of communicative sentences during each phase under the tested communication situation; and the accurately completed percentage of communicative sentences during the maintenance phase under a generalized communication situation. The collected data were illustrated and analyzed using visual analysis, supplemented with the C statistical test. Before and after the research was conducted, a Mandarin version of communicative effectiveness index was employed to assess the perception of primary caregivers regarding the ability of the participants to communicate independently. After the research was conducted, the social validity and user satisfaction with the AAC were investigated.
Results: After the participants used the Voice Symbol for iPad installed in the AAC, the following results were obtained: (1) the three participants exhibited significant improvement in the accurately completed percentage of communicative sentences, and the training effectiveness was significantly maintained; (2) the three participants exhibited good generalization effect, and better cognitive function resulted in better generalization effect; (3) the participants and primary caregivers were satisfied with using the AAC; (4) regarding the social validity, the therapists identified with the effect of the AAC device more than the primary caregivers did; and (5) the perception of primary caregivers regarding the ability of the participants to communicate independently, except that one participant showed slightly unsatisfactory performance, the other two exhibited substantially improved independent communication skills.
Conclusion: In a clinical therapeutic setting, the Voice Symbol for iPad installed in the AAC can help people who developed non-fluent aphasia after a stroke to express communicative sentences. The training effectiveness of using the Voice Symbol for iPad was influenced by individual cognitive function and personal traits, and the generalization outcomes obtained under different communication situations were affected by cognitive function.
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