Using Virtual Technology to Promote Functional Communication in Aphasia: Preliminary Evidence From Interactive Dialogues With Human and Virtual Clinicians

Abstract

Purpose: We investigated the feasibility of using a virtual clinician (VC) to promote functional communication abilities of persons with aphasia (PWAs). We aimed to determine whether the quantity and quality of verbal output in dialogues with a VC would be the same or greater than those with a human clinician (HC). Method: Four PWAs practiced dialogues for 2 sessions each with a HC and VC. Dialogues from before and after practice were transcribed and analyzed for content. We compared measures taken before and after practice in the VC and HC conditions. Results: Results were mixed. Participants either produced more verbal output with the VC or showed no difference on this measure between the VC and HC conditions. Participants also showed some improvement in postpractice narratives. Conclusion: Results provide support for the feasibility and applicability of virtual technology to real-life communication contexts to improve functional communication in PWAs.

“It’s really exciting to think where it could go”: a mixed-method investigation of clinician acceptance, barriers and enablers of virtual reality technology in communication rehabilitation

“…There is also evidence suggesting that communication interventions for people with aphasia can be delivered successfully using a non-immersive VR platform [36]. It has been proposed that virtual reality technology in the rehabilitation of patients with aphasia has the potential to provide treatment efficacy given its capacity to simulate activities of daily living [37]. VR also has the potential to be utilised extensively as a platform for home practice to build communication skills and confidence [38][39][40] within a motivating and engaging virtual environment [41].…”

Technology-Based Rehabilitation to Improve Communication after Acquired Brain Injury

“…Three studies investigated the effectiveness of AphasiaScripts (Cherney and Halper, 2008 ; Manheim et al, 2009 ; Cherney et al, 2014 ) and found gains for performance within the program and on standardized measures [WAB-R, Communicative Effectiveness Index (CETI, Lomas et al, 1989 ), Quality of Communication Life scale (QCL, Paul-Brown et al, 2003 ), and the Communication Difficulty subscale of the Burden of Stroke Scale (BOSS, Doyle et al, 2004 )]. Another study (Kalinyak-Fliszar et al, 2015 ) investigated a different type of script training treatment to improve production and found improvement in production of the trained scripts and some improvement on discourse narratives.…”

“…Of the seven studies that focused treatment on only sentence processing or production (Crerar et al, 1996 ; Linebarger et al, 2007 ; Cherney and Halper, 2008 ; Manheim et al, 2009 ; Thompson et al, 2010 ; Cherney et al, 2014 ; Kalinyak-Fliszar et al, 2015 ), five studies tested and found within task improvement, three studies looked for and found within task generalization, four studies examined and found gains on impairment-based measures while two studies tested and found functional/QOL measurement improvement. Three studies looked for and found maintenance of within task improvement or maintenance of treatment-induced gains on standardized measures.…”

“…Reviewing these studies allows us to examine to what extent studies deliver standardized treatment or tailor the treatment program for individual patients. For instance, ten of the studies (Bruce and Howard, 1987 ; Loverso et al, 1992 ; Crerar et al, 1996 ; Doesborgh et al, 2004 ; Laganaro et al, 2006 ; Fridriksson et al, 2009 ; Cherney, 2010 ; Thompson et al, 2010 ; Corwin et al, 2014 ; Kalinyak-Fliszar et al, 2015 ) required all participants to proceed through the same set of items and/or tasks. Therefore, rehabilitation in these studies was not tailored to individual patients.…”

“…Seventeen studies (Aftonomos et al, 1997 ; Fink et al, 2002 ; Mortley et al, 2004 ; Linebarger et al, 2007 ; Ramsberger and Marie, 2007 ; Cherney and Halper, 2008 ; Fridriksson et al, 2009 ; Manheim et al, 2009 ; Palmer et al, 2012 ; Cherney et al, 2014 ; Hoover and Carney, 2014 ; Kurland et al, 2014 ; Steele et al, 2014 ; Des Roches et al, 2015 ; Choi et al, 2016 ; Stark and Warburton, 2016 ; Woolf et al, 2016 ) prescribed homework in addition to or instead of the treatment sessions. The remaining studies (Seron et al, 1980 ; Bruce and Howard, 1987 ; Katz and Wertz, 1992 , 1997 ; Loverso et al, 1992 ; Crerar et al, 1996 ; Doesborgh et al, 2004 ; Laganaro et al, 2006 ; Raymer et al, 2006 ; Cherney, 2010 ; Thompson et al, 2010 ; Wcislo et al, 2010 ; Corwin et al, 2014 ; Harnish et al, 2014 ; Wenke et al, 2014 ; Kalinyak-Fliszar et al, 2015 ) only provided the computer-based treatment in the clinic when patients made their periodic visits.…”