ABSTRACT
Background: The use of digital technology is promoted as an efficient route for the delivery of intensive speech and language therapy in aphasia rehabilitation. Research has begun to explore the views of people with aphasia (PwA) in relation to Information and Communication Technology (ICT) usage in the management of aphasia but there is less consideration of the prescribers' views, i.e., speech and language therapists (SLTs). Aim(s): We aimed to explore SLTs' views of ICT use in aphasia management and identify factors that influence their decisions to accept and integrate ICT in aphasia rehabilitation. In addition, we considered the findings in the context of the Unified Theory of Acceptance and Use of Technology (Venkatesh, Morris, Davis & Davis, 2003). Methods & Procedures: Speech and language therapists (n = 15) from a range of clinical and geographical settings in the Republic of Ireland were invited to participate in one of four focus groups. Focus group discussions were facilitated by an SLT researcher and were audio-recorded and transcribed. Analysis was completed following Braun and Clarke's six phases of thematic analysis (Braun and Clarke, 2006). Outcomes & Results: Four key themes were identified;i. Infrastructure, Resources, and Support, ii. SLT beliefs, biases and influencers, iii. Function & Fit, and iv. ICT and Living Successfully with Aphasia. The SLTs discussed a wide range of factors that influence their decisions to introduce ICT in aphasia rehabilitation, which related to the person with aphasia, the SLT, the broad rehabilitation environment, and the ICT programme features. In addition, several barriers and facilitators associated with ICT-delivered aphasia rehabilitation were highlighted. Conclusion(s): This research highlights a range of issues for SLTs in relation to the use of ICT in aphasia rehabilitation within an Irish context. The potential benefits of using ICT devices in rehabilitation and in functional everyday communication were discussed. However, SLTs also identified many barriers that prevent easy implementation of this mode of rehabilitation.Copyright © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
ABSTRACT
Introduction: The COVID-19 pandemic rapidly and drastically required the shift of healthcare services from face-to- face delivery to telepractice modalities. This was a key strategy to maintain and complement healthcare services disrupted by the pandemic, revealing the need for a higher emphasis on telepractice in speech-language- hearing services. We synthesized existing evidence on the effectiveness of speech-language teleinterventions delivered via videoconferencing to users of augmentative and alternative communication (AAC) devices. Patients and methods: A systematic literature search was conducted in ten electronic databases, from inception until August 2021. Included were speech-language teleinterventions delivered by researchers and/or clinicians via videoconferencing to users of AAC systems, without restrictions on chronological age and clinical diagnosis. Quality of the included studies was appraised using the Downs and Brown's checklist, and risk of bias was assessed using the Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I). Results: Six teleinterventions involving 25 participants met inclusion criteria. Five studies used a single-subject design and one was a cohort study. Interventions included active consultation (n = 2), functional communication training (n = 2), brain computer interface (n = 1), and both tele-and on-site intervention (n = 1). All teleinterventions reported an increase in participants' independent use of AAC systems during the training sessions compared to baseline, and an overall high satisfaction and treatment acceptability. Conclusion: Speech-language teleinterventions for users of AAC systems show a great potential of a successful method of service delivery. Future teleintervention studies with larger sample sizes and more robust methodology are strongly encouraged to allow generalization of results across different populations.
ABSTRACT
Background: Communicative rehabilitation can be complex and challenging for children with an acquired brain injury (ABI) who use augmentative and alternative communication (AAC) systems. The development of communicative competence (CC) in children with use AAC systems is in itself complex and multifaceted (Light, 1989, Light and McNaughton, 2014) and it can be challenging for clinicians to target multiple competencies effectively through direct intervention. The Brick-by-Brick™ programme (previously known as LEGObased therapyR) has an evidence base routed in research with verbal young people with Autism Spectrum Condition. The programme is a collaborative play therapy originally designed as a social intervention to target the development of social communication and interaction skills (LeGoff, 2004). Introduction: The presentation aims to explore a use of the Brick-by-Brick™ programme with children with ABI who use AAC to support or replace their verbal communication, as well as the areas of potential clinical need for adaptations to its delivery to increase access for this client group. It will also discuss the theory behind adaptations and the need for evidence to support decision making clinically around this topic. The aims and methods of the presenter's current research will be discussed using Janice Light's framework of communicative competence (Light, 1989;Light and McNaughton, 2012) to discuss areas of competence during the presentation. Methods: The research agenda of an embedded quasiexperimental mixed methods design will be shared, along with considerations for the commencement of data collection in a country still significantly affected by the health, social, and educational repercussions of the Covid-19 pandemic. Clinical adaptations to the programme made by the presenter in her role as highly specialist speech and language therapist will be discussed and linked to her current research. Discussion, Conclusions and Recommendations: Adapting the delivery of the Brick-by-Brick™ programme for use with AAC users with ABI is not without difficulties, but these are not insurmountable. Practical and theoretical recommendations for the adaptation of the programme in both educational and healthcare rehabilitation settings will be shared. Future thoughts on the development of the current research base will also be discussed.