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Purpose This study was designed to compare acquisition and maintenance of scripts under two conditions: High Cue which provided numerous multimodality cues designed to minimize errors, and Low Cue which provided minimal cues. Methods In a randomized controlled cross-over study, eight individuals with chronic aphasia received intensive computer-based script training under two cuing conditions. Each condition lasted three weeks, with a three-week washout period. Trained and untrained scripts were probed for accuracy and rate at baseline, during treatment, immediately post-treatment, and at three and six weeks post-treatment. Significance testing was conducted on gain scores and effect sizes were calculated. Results Training resulted in significant gains in script acquisition with maintenance of skills at three and six weeks post-treatment. Differences between cuing conditions were not significant. When severity of aphasia was considered, there also were no significant differences between conditions, although magnitude of change was greater in the High Cue condition versus the Low Cue condition for those with more severe aphasia. Conclusions Both cuing conditions were effective in acquisition and maintenance of scripts. The High Cue condition may be advantageous for those with more severe aphasia. Findings support the clinical use of script training and importance of considering aphasia severity.

Personally relevant words and phrases were acquired, although not generalized, more successfully than generic words and phrases. Data supports the importance of personalization in script training, but the degree of that importance requires further investigation.

Telepractice is an appropriate model of service delivery for a person with aphasia (PWA). We define telepractice and its two modes of delivery (i.e., synchronous and asynchronous). We detail a technology, web-Oral Reading for Language in Aphasia (web-ORLA™), developed to provide aphasia treatment intensively from a distance and subsequently evaluated during a clinical trial. In this article, we describe our experiences using web-ORLA™, highlighting the role of the speech-language pathologist (SLP) and discussing the advantages and disadvantages of this unique combination of synchronous and asynchronous telepractice. Web-ORLA™ was delivered to PWAs in their homes by a digital agent, or “virtual therapist,” who served as a model and provided instructions similarly to a real therapist. An SLP at a distant geographical location monitored the sessions remotely, either synchronously or asynchronously, provided feedback, made appropriate adjustments to the difficulty level of the stimuli, and conducted weekly probe assessments of the participants' performance. Advantages of web-ORLA™ include increased practice, SLP oversight, guidance by the agent, program simplicity, and a level of autonomy and flexibility afforded to the PWA. Given the rapid advances in technology, current technological problems that were encountered are likely to be mitigated.