Facilitating Independent Communication for an Adult with Severe, Nonfluent Aphasia Using a Voice Output Communication Aid

• Main Author: Stayer, Jane Mary
• Format: Others
• Published: PDXScholar 1994
• Subjects: Communication devices for people with disabilities; Aphasic persons; Communication; Speech and Rhetorical Studies
• Online Access: https://pdxscholar.library.pdx.edu/open_access_etds/4790; https://pdxscholar.library.pdx.edu/cgi/viewcontent.cgi?article=5862&context=open_access_etds

Aphasia is an acquired general impairment of the language processes resulting from brain damage that is frequently caused by cerebrovascular accidents (CVAs). Persons with aphasia have a history of retaining important communication competencies that have the potential for helping them succeed in using augmented communication systems. Using augmentative and alternative communication (AAC) systems by adults with aphasia has been studied, but few studies have reported successfully using AAC systems in rehabilitating adults with aphasia. New advanced technologies including the availability of devices that talk, store a lot of information, and are relatively small can give AAC the potential to affect a greater change in functional communication skills for more persons with aphasia, particularly as experience with AAC rehabilitation grows. The purpose of the present study was to determine whether an adult with severe, nonfluent aphasia could communicate independently by adding a voice output communication aid (VOCA) to his natural communication repertoire. This study also sought to answer the following question: Does the addition of a VOCA to natural expression facilitate independent communication in an adult with severe, nonfluent aphasia? One subject was drawn from the out-patient members of a recreationoriented communication treatment group which is conducted at the Portland Veterans' Affairs Medical Center. The subject had been diagnosed with severe, nonfluent aphasia by a certified Speech/Language Pathologist. This study used a single-subject, component assessment research design to explore the relative effectiveness of components in an aphasia and AAC treatment package. It compared the relative effectiveness of Promoting Aphasics' Communicative Effectiveness (PACE) only treatment using natural communication strategies with that of PACE treatment for natural strategies plus a VOCA component. The subject's attempts to convey information were videotaped and analyzed using mean scores and a split-middle method of trend estimation to determine whether performance differences existed under two treatment conditions. The data for the number of conversational turns show an increase in the number of conversational turns which confirms an overall decrease in efficiency of communication for a severely aphasic person in this structured task in the augmented condition. Second, although the data for the number of communication breakdowns, the number of repair turns, and the repair turns as a percentage of total turns show a decline which would confirm an overall increase in effectiveness, this study does not conclusively demonstrate that the use of a VOCA enhances communication in this setting for this person compared to PACE only treatment. Lastly, the data for the number of messages conveyed correctly show little change which confirms by the measure used in this study, no difference in accuracy of communication for this activity in the augmented condition.