PREFACE
T
he world is abuzz with mobile technology. We check e-mail on an airplane, Skype with friends across the globe, send photographs while hiking, play word games with distant relatives, and so on. In less than a decade, many of us have become quite attached to, perhaps dependent on, these portable devices that allow us to perform endless social, educational, recreational, and occupational functions, any time and any place we choose. Although it may sound hyperbolic, the authors in this special issue on tablet-based aphasia rehabilitation have referred to mobile technology as having “exploded,” as being “groundbreaking,” as having “the ‘it’ factor,” and as heralding a “cultural shift” in how we interact with personal data and others in the world. At the same time, what is common among the studies in this special issue is a barely restrained excitement about these promising new tools and the tremendous potential they hold for a paradigm shift in providing access to long-term rehabilitation, especially for chronically aphasic individuals. Why the need for restraint? It is there for good reason. We have seen this revolution before, with the advent of the personal computer and computer software for “brain training.” Once again, it may be tempting to try every so-called “aphasia app” that shows up in the App Store. However, as Ramsberger and Messamer note, we must strive to integrate technology into therapy in a manner in which “the treatment plan drives the decisions about which app is used rather than the app driving treatment.”
What is so exciting about this special issue is that it provides a foundation for what will inevitably be a growing, perhaps surging, base of evidence for using mobile technology in aphasia rehabilitation. Szabo and Dittelman ground this evidence base in a description of the daily uses of apps, in particular apps that are native to the iPad and that were not developed for the purpose of aphasia rehabilitation but that support aphasia therapy at the Adler Aphasia Center in Maywood, New Jersey. The article includes both the challenges of implementing a mobile technology program along with stories of individual members’ success. Ramsberger and Messamer provide guidelines for using mobile technology, including apps that are not aphasia-specific, and describe decision-making strategies for app selection in three cases. Hoover and Carney illustrate how iPads were incorporated into an intensive, comprehensive aphasia treatment program at Boston University. IPad apps were integrated into all types of treatment across disciplines. They were used in individual, dyadic, and group treatment settings in the clinic and also in home practice during and following intensive treatment, and like the others, with positive results. Kiran, Des Roches, Balachandran, and Ascenso describe the development of an iPad-delivered impairment-based individualized treatment program, Constant Therapy, which allows clinicians to remotely monitor patient progress and change treatment tasks and stimuli over the Internet in accordance with patients’ progress. They illustrate the flexibility of their app across four cases demonstrating a spectrum of
1
iRehab: Incorporating iPads and Other Tablets in Aphasia Treatment; Guest Editor, Jacquie Kurland, Ph.D., CCC-SLP Semin Speech Lang 2014;35:3–4. Copyright # 2014 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel: +1(212) 584-4662. DOI: http://dx.doi.org/10.1055/s-0033-1362989. ISSN 0734-0478.
Department of Communication Disorders, University of Massachusetts Amherst, Amherst, Massachusetts. Address for correspondence: Jacquie Kurland, Ph.D., CCC-SLP, University of Massachusetts Amherst, Department of Communication Disorders, 358 North Pleasant Street, Amherst, MA 01003-9296 (e-mail: jkurland@ comdis.umass.edu).
Downloaded by: Flinders University of South Australia. Copyrighted material.
iRehab in Aphasia Treatment
3
SEMINARS IN SPEECH AND LANGUAGE/VOLUME 35, NUMBER 1
cognitively and linguistically challenged patients. Finally, Kurland, Wilkins, and Stokes describe a homemade iPad-delivered practice program for maintaining recent gains following intensive language action therapy in five persons with aphasia. These authors discuss participant attributes that may have contributed to their relative success at maintaining treated words and learning new ones over the course of 6 months of home practice. Van de Sandt-Koenderman1 recently noted that computer applications, although increasingly utilized in aphasia rehabilitation, tend to favor either a disorder-oriented treatment approach or a functional treatment approach. Thus, computer-assisted aphasia treatment programs have largely focused on restoring linguistic processing ability, while Augmentative and Alternative Communication (AAC) programs and devices have focused on compensating for linguistic deficits. What is so exciting about the advent of mobile technology is that in addition to apps that offer disorderoriented and functional treatment approaches, many apps also have the potential to make serious contributions toward participation-oriented approaches to aphasia rehabilitation. The reason is simple: mobile technology with its
2014
portable access to the Internet lends itself to social networking. As more social media apps become “aphasia friendly,” the tools themselves may take on the role of a sort of lingua franca between persons with aphasia and the rest of the world. While we call for more research evidence evaluating the impact of these tools on the lives of persons with aphasia, we can barely conceal an enthusiastic endorsement of what we have seen so far. We hope you’ll join us in our restrained enthusiasm for using tablet-based technology in aphasia treatment, including the myriad ways it can help us bring more language and communication within closer reach of people with aphasia. Jacquie Kurland Ph.D., CCC-SLP Guest Editor
REFERENCE 1. van de Sandt-Koenderman WME. Aphasia rehabilitation and the role of computer technology: can we keep up with modern times? Int J Speech-Language Pathol 2011;13(1):21–27
Downloaded by: Flinders University of South Australia. Copyrighted material.
4
T
he world is abuzz with mobile technology. We check e-mail on an airplane, Skype with friends across the globe, send photographs while hiking, play word games with distant relatives, and so on. In less than a decade, many of us have become quite attached to, perhaps dependent on, these portable devices that allow us to perform endless social, educational, recreational, and occupational functions, any time and any place we choose. Although it may sound hyperbolic, the authors in this special issue on tablet-based aphasia rehabilitation have referred to mobile technology as having “exploded,” as being “groundbreaking,” as having “the ‘it’ factor,” and as heralding a “cultural shift” in how we interact with personal data and others in the world. At the same time, what is common among the studies in this special issue is a barely restrained excitement about these promising new tools and the tremendous potential they hold for a paradigm shift in providing access to long-term rehabilitation, especially for chronically aphasic individuals. Why the need for restraint? It is there for good reason. We have seen this revolution before, with the advent of the personal computer and computer software for “brain training.” Once again, it may be tempting to try every so-called “aphasia app” that shows up in the App Store. However, as Ramsberger and Messamer note, we must strive to integrate technology into therapy in a manner in which “the treatment plan drives the decisions about which app is used rather than the app driving treatment.”
What is so exciting about this special issue is that it provides a foundation for what will inevitably be a growing, perhaps surging, base of evidence for using mobile technology in aphasia rehabilitation. Szabo and Dittelman ground this evidence base in a description of the daily uses of apps, in particular apps that are native to the iPad and that were not developed for the purpose of aphasia rehabilitation but that support aphasia therapy at the Adler Aphasia Center in Maywood, New Jersey. The article includes both the challenges of implementing a mobile technology program along with stories of individual members’ success. Ramsberger and Messamer provide guidelines for using mobile technology, including apps that are not aphasia-specific, and describe decision-making strategies for app selection in three cases. Hoover and Carney illustrate how iPads were incorporated into an intensive, comprehensive aphasia treatment program at Boston University. IPad apps were integrated into all types of treatment across disciplines. They were used in individual, dyadic, and group treatment settings in the clinic and also in home practice during and following intensive treatment, and like the others, with positive results. Kiran, Des Roches, Balachandran, and Ascenso describe the development of an iPad-delivered impairment-based individualized treatment program, Constant Therapy, which allows clinicians to remotely monitor patient progress and change treatment tasks and stimuli over the Internet in accordance with patients’ progress. They illustrate the flexibility of their app across four cases demonstrating a spectrum of
1
iRehab: Incorporating iPads and Other Tablets in Aphasia Treatment; Guest Editor, Jacquie Kurland, Ph.D., CCC-SLP Semin Speech Lang 2014;35:3–4. Copyright # 2014 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel: +1(212) 584-4662. DOI: http://dx.doi.org/10.1055/s-0033-1362989. ISSN 0734-0478.
Department of Communication Disorders, University of Massachusetts Amherst, Amherst, Massachusetts. Address for correspondence: Jacquie Kurland, Ph.D., CCC-SLP, University of Massachusetts Amherst, Department of Communication Disorders, 358 North Pleasant Street, Amherst, MA 01003-9296 (e-mail: jkurland@ comdis.umass.edu).
Downloaded by: Flinders University of South Australia. Copyrighted material.
iRehab in Aphasia Treatment
3
SEMINARS IN SPEECH AND LANGUAGE/VOLUME 35, NUMBER 1
cognitively and linguistically challenged patients. Finally, Kurland, Wilkins, and Stokes describe a homemade iPad-delivered practice program for maintaining recent gains following intensive language action therapy in five persons with aphasia. These authors discuss participant attributes that may have contributed to their relative success at maintaining treated words and learning new ones over the course of 6 months of home practice. Van de Sandt-Koenderman1 recently noted that computer applications, although increasingly utilized in aphasia rehabilitation, tend to favor either a disorder-oriented treatment approach or a functional treatment approach. Thus, computer-assisted aphasia treatment programs have largely focused on restoring linguistic processing ability, while Augmentative and Alternative Communication (AAC) programs and devices have focused on compensating for linguistic deficits. What is so exciting about the advent of mobile technology is that in addition to apps that offer disorderoriented and functional treatment approaches, many apps also have the potential to make serious contributions toward participation-oriented approaches to aphasia rehabilitation. The reason is simple: mobile technology with its
2014
portable access to the Internet lends itself to social networking. As more social media apps become “aphasia friendly,” the tools themselves may take on the role of a sort of lingua franca between persons with aphasia and the rest of the world. While we call for more research evidence evaluating the impact of these tools on the lives of persons with aphasia, we can barely conceal an enthusiastic endorsement of what we have seen so far. We hope you’ll join us in our restrained enthusiasm for using tablet-based technology in aphasia treatment, including the myriad ways it can help us bring more language and communication within closer reach of people with aphasia. Jacquie Kurland Ph.D., CCC-SLP Guest Editor
REFERENCE 1. van de Sandt-Koenderman WME. Aphasia rehabilitation and the role of computer technology: can we keep up with modern times? Int J Speech-Language Pathol 2011;13(1):21–27
Downloaded by: Flinders University of South Australia. Copyrighted material.
4
