. A comparison of remote therapy, face to face therapy and an attention control intervention for people with aphasia: A quasi-randomised controlled feasibility study. Clinical Rehabilitation, 30(4), pp. 359-373. doi: 10.1177/0269215515582074 This is the accepted version of the paper.This version of the publication may differ from the final published version. Outcome measures: Feasibility was assessed by recruitment and attrition rates, participant observations and interviews, and treatment fidelity checking. Effects of therapy on word retrieval Permanentwere assessed by tests of picture naming and naming in conversation.Results: Twenty-one participants were recruited over 17 months, with one lost at baseline.Compliance and satisfaction with the intervention was good. Treatment fidelity was high for both remote and face to face delivery (1251/1421 therapist behaviours were compliant with the protocol). Participants who received therapy improved on picture naming significantly more than controls (mean numerical gains: 20.2 (remote from University); 41 (remote from clinical site); 30.8 (face to face); 5.8 (attention control); p <.001). There were no significant differences between groups in the assessment of conversation. Conclusions:Word finding therapy can be delivered via mainstream internet video conferencing.Therapy improved picture naming, but not naming in conversation.3

Rekindling the love of books-a pilot project exploring whether e-readers help people to read again after a stroke. Aphasiology, 30(2-3), pp. 290-319.

No abstract

This is the unspecified version of the paper.This version of the publication may differ from the final published version. Permanent repository link AbstractPurpose: This study investigated whether a group of people with severe aphasia could learn a vocabulary of pantomime gestures through therapy, and compared their learning of gestures with their learning of words. It also examined whether gesture therapy cued word production and whether naming therapy cued gestures.Method: Fourteen people with severe aphasia received 15 hours of gesture and naming treatment. Evaluations comprised repeated measures of gesture and word production, comparing treated and untreated items.Results: Baseline measures were stable, but improved significantly following therapy. Across the group, improvements in naming were greater than improvements in gesture. This trend was evident in most individuals' results, although three made better progress in gesture. Gains were item specific and there was no evidence of cross modality cuing. Items that received gesture therapy did not improve in naming, and items that received naming therapy did not improve in gesture. Conclusions:Results show that people with severe aphasia can respond to gesture and naming therapy. Given the unequal gains, naming may be a more productive therapy target than gesture for many (although not all) individuals with severe aphasia.The communicative benefits of therapy were not examined, but are addressed in a follow up paper.3

This study showed that 21 people with dysgraphia improved on a functional writing measure following therapy using assistive technology. The results suggest that treatment compensated for, rather than remediated, the impairment, given that unassisted writing did not change. Further studies of technology-enhanced writing therapy are warranted.

About a third of strokes cause aphasia, or language loss, with profound consequences for the person's social participation and quality of life. These problems may be mitigated by group social support. But this intervention is not available to all individuals. This study investigated whether it is feasible to deliver group social support to people with aphasia via a multiuser , virtual reality platform. It also explored the indicative effects of intervention and the costs. Intervention aimed to promote wellbeing and communicative success. It enabled participants to form new social connections and share experiences of living with aphasia. It comprised 14 sessions delivered over 6 months and was led by community based coordinators and volunteers. Feasibility measures comprised: recruitment and retention rates, compliance with intervention and assessment of treatment fidelity. Effects of intervention were explored using a waitlist randomised controlled design, with outcome measures of wellbeing, communication, social connectedness and quality of life. Two intervention groups were randomised to an immediate condition and two were randomised to a delayed condition. The main analysis explored scores on the measures between two time points, between which those in the immediate condition had received intervention, but those in the delayed group had not (yet). A comprehensive approach to economic data collection ensured that all costs of treatment delivery were recorded. Feasibility findings showed that the recruitment target was met (N = 34) and 85.3% (29/34) of participants completed intervention. All groups ran the 14 sessions as planned, and participants attended a mean of 11.4 sessions (s.d. 2.8), which was 81.6% of the intended dose. Fidelity checking showed minimal drift from the manualised intervention. No significant change was observed on any of the outcome measures, although the study was not powered to detect these. Costs varied across the four groups, from £7,483-£12,562 British Pounds Sterling ($10,972-$18,419 US dollars), depending on travel costs, the relative contributions of volunteers and the number of hardware loans that were needed. The results suggest that a larger trial of remote group support,

Purpose This study investigated the effects of technology-enhanced reading therapy for people with reading impairments, using mainstream assistive reading technologies alongside reading strategies. Method The study used a quasirandomized waitlist controlled design. Twenty-one people with reading impairments following stroke were randomly assigned to receive 14 hr of therapy immediately or after a 6-week delay. During therapy, participants were trained to use assistive reading technology that offered a range of features to support reading comprehension. They developed skills in using the technology independently and in applying the technology to their personal reading goals. The primary outcome measure assessed reading comprehension, using Gray Oral Reading Test–Fourth Edition (GORT-4). Secondary measures were as follows: Reading Comprehension Battery for Aphasia–Second Edition, Reading Confidence and Emotions Questionnaire, Communication Activities of Daily Living–Second Edition, Visual Analog Mood Scales, and Assessment of Living With Aphasia. Matched texts were used with the GORT-4 to compare technology-assisted and unassisted reading comprehension. Mixed analyses of variance explored change between T1 and T2, when the immediate group had received therapy but the delayed group had not, thus serving as untreated controls. Pretherapy, posttherapy, and follow-up scores on the measures were also examined for all participants. Results GORT-4 results indicated that the immediately treated group improved significantly in technology-assisted reading following therapy, but not in unassisted reading. However, the data were not normally distributed, and secondary nonparametric analysis was not significant. The control group was unstable over the baseline, improving significantly in unassisted reading. The whole-group analysis showed significant gains in assisted (but not unassisted) reading after therapy that were maintained at follow-up. The Reading Confidence and Emotions Questionnaire results improved significantly following therapy, with good maintenance of change. Results on all other secondary measures were not significant. Conclusions Technology-assisted reading comprehension improved following the intervention, with treatment compensating for, rather than remediating, the reading impairment. Participants' confidence and emotions associated with reading also improved. Gains were achieved after 14 therapy sessions, using assistive technologies that are widely available and relatively affordable, meaning that this approach could be implemented in clinical practice.

Background: Aphasia negatively impacts face-to-face social participation and the difficulties that people experience using the phone exacerbate these challenges in staying in touch with family and friends. Videoconferencing enables multimodal communication, and teamed with supported conversation, could facilitate access to conversation and thereby increase social participation for people with chronic aphasia. Aims: This pilot study examined whether supported conversation provided over Skype could improve people's social participation. It reports on preliminary outcomes of this intervention on people's social network, communication confidence, aphasia-related quality of life and mood. Methods & Procedures: 29 participants with chronic aphasia received an initial 2-hour technology training session followed by 16hours of online supported conversation for participation intervention provided by qualified or student speech and language therapists. Intervention was personalised by individualising goals in technology, communication and participation. An observational prospective cohort study design was used with baseline, immediately post-intervention, and 8-week follow-up assessments. Measures of social network and communication confidence (primary outcome measures), and aphasia-related quality of life, life participation, and mood (secondary outcome measures) were undertaken. Shapiro-Wilk tests were conducted to examine normality of distributions of each of the variables. Where data were normally distributed, one-way repeated measures ANOVAs were used to examine the effect of time. Where data were not normally distributed, Wilcoxon Signed Ranks test was used.Outcomes & Results: 27 participants completed the intervention. As a group, participants reported significantly more social contacts, more life participation, and higher aphasia-related quality of life post-intervention, which were maintained. There was a group gain on the measure of communication confidence post-intervention, although this was not maintained. As a group, participants' mood did not significantly change through intervention and follow-up. Individual variability was noted across all outcome measures.Conclusions: These preliminary findings suggest that relatively low dose and non-intensive online supported conversation for participation intervention delivered by qualified or student speech and language therapists improved social participation in some people with aphasia and improved their quality of life. Communication confidence also improved for some, although benefits were short-term. Findings make novel contributions to the existing supported conversation evidence base with positive social participation and quality of life outcomes, likely achieved by the explicit participation focus. Whilst preliminary findings are positive, study limitations need addressing. Further investigations are merited to refine the intervention and outcome measure choice, and capture feasibility data. Finally, a definitive controlled trial is needed to explore clinical e...