392 Caring to Communicate

A feasibility study to investigate the use of computers to provide additional aphasia therapy on a rehabilitation ward

ALISON GIBSON Frenchay Hospital, Bristol, UK

ABSTRACT This year-long project is based on the rehabilitation ward of Frenchay Hospital. The patients included in the project haue a diagnosis of cerebrovascular accident (CVA). Seueral studies haue already demonstrated the usefulness of the computer as a tool in therapy at the later stages in recoueryfrom stroke. The main aim of the project was to assess the feasibility of prouiding ward-based computer- assisted therapy in the early stages of recovery as a supplement to regular aphasia therapy. Further aims were to assess the acceptability and usage of the computer and to establish the type and number of patients for whom this approach was suitable. All the patients referred to speech and language therapy on the rehabilita- tion ward were screened for suitability. Criteria for acceptance to the project were established. Ouer a period of eight months (at the time of writing), 32 patients were assessed. Ten of these had a speech and language diagonsis of dysarthriddysphagia; three dysphagia; fiue dysarthria; and 14 dysphasia. Of the patients with dysphasia, four failed to meet the acceptance critieria (one was illiterate, one was depressed and two suffered further strokes). The remaining I0 receiued computer-assisted aphasia therapy o n the ward. Sessions were superuised by the speech and language therapist three times a week. The computer was, however; available to the patients at all times. A variety of software was used and exercises were tailor-made to suit the client’s changing needs. Two severely aphasic patients were only able to use the computer with the help of the clinician. They used a trackerball and the concept keyboard as input devices. Progress was minimal. The fiue moderately aphasic patients were able to follow through the exercises alone if the programme was started by ward staff or relatives. They were able to progress to using the keyboard as an input device and, by discharge from hospital, four were able to load the software unaided. The three patients with mild dysphasia were able to use the computer unaided. In these last two groups, progress was clearly reflected in the results that are stored on the disc for analysis. On discharge, a questionnaire was given to participating patients. All reported that they uery much enjoyed this ap- proach and found it uery helpful. Only one had used a computer preuiously. All participants worked on the computer most days whilst on the ward, with one re- porting more use than once a day. A further questionnaire has been deuised for ward and therapy staff to assess their attitudes to this approach. The results of this are not auailable at the time of writing. It seems that patients with a mild or mod- erate dysphasia benefit most from this approach. The results recorded prouide useful information on progress. Most importantly, the computer allows the patient unlimited access to an enjoyable form of intensiue language remediation.