Supporting communication for patients with neurodegenerative disease

Group intervention for individuals with primary progressive aphasia and their spouses: Who comes first?

Primary progressive aphasia (PPA) is a neurodegenerative dementia in which language impairment is the first and most dominant symptom. There is a considerable dearth of interventions for PPA although language rehabilitation has made headway in managing the disorder. Thus far, no comprehensive services have been proposed for PPA clients and/or their spouses. This paper describes the first structured group intervention program designated exclusively for people with PPA and their caregivers. This pilot project originates from a clinical service and presents supporting evidence for initiation of a larger study to establish an evidence-based intervention for PPA. A 10-week intervention program comprised working on language activities, learning communication strategies, counselling and education. Outcome measures administered to participants and their spouses before and after the intervention were compared showed improvements in quality of communication and coping skills in the PPA group compared to controls. Qualitative comments from all 10 participants in the active treatment group highlighted the necessity of intervention that is tailored specifically to the PPA population and addresses the needs of both individuals with PPA and their caregivers. All participants in the intervention group contributed to the study and are also co-authors of this paper.

Telephone talk: effects of two access methods on phone call success

The slower and unnatural timing of speech inherent to speech-generating devices (SGDs) can be a barrier to successful aided telephone calls. The timing of message delivery when using an SGD may vary depending on the type of access method used. We measured the difference in the success rate of telephone calls made with an SGD either using switch scanning or direct selection with eye gaze. The scripted calls, asking for directions, were placed to 100 randomly selected businesses. Analysis showed a statistically significant difference in the success rate between the two conditions, with eye gaze access resulting in more successful calls. Findings from this study suggest that people who use SGDs for phone calls may improve the timing of message delivery by using eye gaze access compared to switch scanning.

SOLICITING BCI USER EXPERIENCE FEEDBACK FROM PEOPLE WITH SEVERE SPEECH AND PHYSICAL IMPAIRMENTS

Brain-computer interface (BCI) researchers have shown increasing interest in soliciting user experience (UX) feedback, but the severe speech and physical impairments (SSPI) of potential users create barriers to effective implementation with existing feedback instruments. This article describes augmentative and alternative communication (AAC)-based techniques for obtaining feedback from this population, and presents results from administration of a modified questionnaire to 12 individuals with SSPI after trials with a BCI spelling system. The proposed techniques facilitated successful questionnaire completion and provision of narrative feedback for all participants. Questionnaire administration required less than five minutes and minimal effort from participants. Results indicated that individual users may have very different reactions to the same system, and that ratings of workload and comfort provide important information not available through objective performance measures. People with SSPI are critical stakeholders in the future development of BCI, and appropriate adaptation of feedback questionnaires and administration techniques allows them to participate in shaping this assistive technology.