Exploring high-technology augmentative and alternative communication interfaces: the effect of age and technology experience

PURPOSE

Many people with aphasia have inadequate language skills for functional communication thereby necessitating well-designed augmentative and alternative communication (AAC) interfaces. Using both a grid and a VSD interface with single word hotspots by neurologically healthy adults, across ages and with different technology experiences, this study examines the utility of these interfaces prior to investigating their use with people with aphasia in future studies.

METHOD

Participants include 18 young adults, 24 older adults with technology experience, and 20 older adults with limited technology experience. The older adult groups were matched for mean age and for sex. Participants described pictures with each interface, and performance was measured based on four dependent variables: (a) the total number of correct information units (CIUs), (b) the percentage of CIUs, (c) CIUs per minute, and (d) preferred interface.

RESULTS

There was a significant difference between older adults and the young adult group for the total number of CIUs (p < 0.001) and CIUs per minute (p < 0.001). Despite the changes in technology experience between the two older groups, there was no significant difference in performance. Additionally, there was no significant difference in performance across the two interfaces in any of the groups.

CONCLUSION

Findings suggest age does impact performance on AAC. However, the difference in technology experience in older adult groups did not affect performance. Furthermore, both interfaces used in the current study were equally beneficial when describing pictures by healthy adults. Implications for RehabilitationAugmentative and alternative communication (AAC) systems involve various interface designs. Consequently, the comparative utility of these interfaces must be examined across populations and communicative functions.Advancement in technology has given rise to numerous high-tech AAC interface designs. However, older adults with acquired language difficulties whose technology experience is limited may become reluctant to use high-tech AAC. Hence, the  influence of technology experience on high-tech AAC performance should be investigated.Prior to examining interfaces with individuals with acquired language difficulties, the current study examined the use of a) grid display and b) visual scene display (VSD) with single word hotspots, by healthy adults of different ages and technology experiences.The study revealed that older adults with limited technology experience were equally competent in using high-tech AAC interfaces, as those with technology experience. Hence, an individual's technology experience should not be considered a deterrent to using high-tech AAC interfaces.Additionally, the study found no differences in performance between the two interfaces, making it essential to consider user's personal preference when adopting AAC interface designs.

AAC apps for aphasia: a pilot study on the role of intuition and learning

PURPOSE

To characterize the untrained performance of people with aphasia (PWA) in finding symbols (single words) on two symbol-based augmentative and alternative communication applications (AAC apps).

METHODS

Nine individuals with aphasia and no previous experience with AAC searched for five symbols on two grid display apps with differing representation systems and vocabulary (Proloquo2Go and Speak for Yourself) following a brief demonstration. Participants were allowed two minutes to locate each symbol on each app (Trial 1), following which the process was repeated with the same symbols (Trial 2) for both apps. Measured variables included total number of symbols found as well as average efficiency score, search time per symbol, and number of cell selections per second for successful trials. Participants were interviewed about their stated app preferences.

RESULTS

In the absence of training, participants performed significantly better using Proloquo2Go for average search time (p < .001), and rate of cell selection (p < .001). No significant differences were found across trials. Seven of the nine participants expressed a preference for Proloquo2Go.

CONCLUSIONS

Participant performance and stated preferences appeared to favour the layout found in Proloquo2Go, possibly suggestive of greater intuitiveness in the absence of training. However, significant learning was not observed across two trials, suggesting the importance of training and increased exposure.Implications for RehabilitationIndividuals who are diagnosed with aphasia may have long-term communication difficulties that require alternative means of communication.There are numerous commercially available augmentative and alternative communication applications (AAC apps) which may be beneficial for this population. However, there is limited research examining their usefulness.This study with a small sample of individuals with aphasia found that in the absence of training some apps may be easier to use than others.Additionally, the study found that learning may not occur in the absence of training highlighting the importance of treatment.

Clinical Feasibility of Combining Transcranial Direct Current Stimulation with Standard Aphasia Therapy

Background

Transcranial direct current stimulation (tDCS) is a safe, portable, and inexpensive form of noninvasive brain stimulation that appears to augment the effects of concurrent therapy. However, several methodological issues in existing studies distance tDCS from current clinical practice. In this study, we offered (and administered) tDCS to individuals seeking typical behavioral aphasia therapy on an outpatient basis.

Methods

We approached clients (n = 10) planning to receive standard aphasia therapy at a university clinic. Following a brief description of tDCS, we offered to provide stimulation during their therapy. Those interested and without contraindications participated in a double-blind, sham-controlled crossover study of tDCS paired with speech-language therapy provided twice weekly. Participants received active (2 mA) or sham tDCS during two eight-week therapy phases (separated by ten weeks) with the anode over Broca's area and the cathode on the contralateral forehead. Stimulation was provided for the first 20 minutes of each one-hour session. Prior to and following each phase, participants were video recorded telling the Cinderella narrative. Recordings were transcribed and analyzed for correct information units (CIUs).

Results

Seven individuals (70%) were interested in and eligible for tDCS. Data from four participants who completed the study indicated a large effect size favoring active over sham tDCS (Cohen's d = 1.32). The participant with the most severe deficits did not benefit from therapy in either condition.

Conclusion

There is potential for tDCS to enhance meaningful communication outcomes in standard clinical practice. Further investigation is needed to replicate findings and determine individual characteristics predictive of treatment response.