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Welcome to this SpeechPathology.com Live Expert e-Seminar!

Supported Reading Comprehension: A Review and Web-Based Applications

Presented By:

Aimee Dietz, University of Cincinnati

Moderated By:

Amy Hansen, M.A.,CCC-SLP, Managing Editor, SpeechPathology.com

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Supported Reading Comprehension:

A Review of Web-Based Applications

Presented by: Aimee Dietz, PhD, CCC-SLP

Goals for Today1. Discuss why text-based AAC options are

successful for people who have aphasia.

2. Review aphasia friendly text principles.

3. Define and differentiate high- and low-gcontext photographs.

4. Define and differentiate personally-relevant and non-personally-relevant photographs.

5. Discuss applications of supported reading comprehension using web-based communications.

What is AAC?AAC involves attempts to study and when

necessary compensate for temporary or permanent impairments, activity limitations, and participation restrictions of persons with severe disorders of speech-language p g gproduction and/or compensation, including spoken and written modes of communication.

(ASHA, 2005)

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Why AAC & Aphasia?Persistent communication challenges

(Hux, Weissling, & Wallace, 2008;LaPointe, 2005)

“In all but the most transient of aphasia, and h it ild t f th i littlperhaps its mildest forms, there is little reason

to believe that aphasia therapy ‘removes’ the aphasia”

(Holland & Beeson, 1993, p. 582)

Why AAC & Aphasia? (2)• 1 in every 250 people have aphasia

(National Aphasia Association, 2009)

• Over 50% of these people have aphasia for years beyond the strokeyears beyond the stroke

(Laska, Hellblom, Murry, Kaha, Von Arbin, 2001)

• World Health Organization(WHO, 2001)

WHO Model• Impairment

– Loss of function

• Activity

– Ability to perform functional tasks (ADL’s)

P ti i ti• Participation– Involvement in life situation

• (i.e., social, educational, vocational, therapeutic)

(World Health Organization, 2001)

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Purposes of Communication Communication of wants and needs

Information transfer

S i l lSocial closeness

Social etiquette

Communication with self

(Beukelman & Mirenda, 2005; Light, 1988)

Seminal Aphasia & AAC Case Study

Primarily text-basedWord dictionaryAlphabet cardN i f i kNew information pocketClues sectionTips for conversational repairConversational control strategies

(Garrett , Beukelman, & Low-Morrow, 1989)

Written Choice StrategyWHERE ARE YOU FROM:• MICHIGAN

• OHIO

• KENTUCKY

• OTHER• (Garrett & Beukelman, 1995)

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REMANTSObjects ,

photographs, itemsevents/activities

Written topic Setter (heading)(Beukelman & Mirenda, 2005; Garrett & Huth, 2005; Ho, Weiss, Garrett, & Lloyd, 2005) Chewbacca

runs marathon.

Visual Scene Displays (VSDs)Include one or more contextually-

rich images(Dietz, Beukelman, & McKelvey, 2006; Dietz, McKelvey, Beuklelman, Weissling, & Hux, 2006)

Low-contextContextually-Rich

Combine with text, voice output, function buttons, highlighting, and color coding

Allow communication partners to co-construct “the gist” of important life events or experiencesevents or experiences

Bypass reliance on linguistic processing and need for extensive verbalizations

(Dietz, et al., 2006; Dietz, et al.., 2006)

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VSD Example

Available during presentation only.

VSD Example #2

Reading Comprehension & AphasiaRestorative treatmentsORLA, MOR, Attention Training

(Beeson, 1999; Beeson, Hirsch,, & Reweaga, 2002; Beeson, Rising, & Volk, 2003; Orjada & Beeson, 2005; Coelho, 2005; Cherney, Merbitz, & Grip, 1985; Cherney, 1995; 2004, 2007; Mayer & Murray 2002)Mayer & Murray, 2002)

versus

Supported Reading Comprehension Techniques

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Supported Reading Comprehension Techniques

Aphasia Friendly Text PrinciplesLARGE FONT

VISUAL PAUSINGVISUAL PAUSING

Simple syntax

Pictures(Brennan, Worrall, & McKenna, 2005; Howe, Worrall, & Hickson, 2004; Rose, Worrall, & McKenna, 2003)

Supported Reading Comprehension Techniques (2)Purpose of the study:

high-context,

low-context, andlow context, and

no context

on the reading comprehension of narratives by people with chronic aphasia.

(Dietz, Hux, & Beukelman, 2009)

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Implications Contextually-rich visuographic information

positively affects the reading comprehension of a people with moderate reading comprehension deficits associated with chronic aphasia Increased accuracy with high- or low-context photos vs.

none

Reported task to be EASIER when pictures present

Low- and high-context images yielded significantly longer response times compared to no-context

(Dietz et al., 2009)

The 21st Century & Communication

Who is using the Internet?

oE-mail

oFacebook

oInstant Messaging

oSkypeoBlogs

oTwitter

(Aphasia Hope Foundation, 2009; Christenson, 2004; NAA, 2010; Dietz, Ball, & Griffith, 2010;Golashesky, 2008; Komen, 2009; Facebook, 2009; Twitter, 2009)

Text & Web-Based Communication

E-mailAphasia friendly text principles

Embed contextually-rich imagesEmbed contextually rich images

Scan remnants

(Dietz et al., 2010; Golashesky, 2008)

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Facebook

Tagged photos

Text & Web-Based Communication (2)

(Dietz et al., 2010)

Facebook© ExampleFriending rulesHiding posts

(Dietz et al., 2010)

Text & Web-Based Communication (3)

Instant Messaging (IM)Aphasia Friendly Text Principles

Key for Texting abbreviations

Written ChoiceWritten Choice

Visual Pausing

Use of Emoticons

(Dietz et al., 2010)

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Instant Messaging Example

Text & Web-Based Communication (4)Skype

Multimodality Input

Written Choice Method

(Dietz et al., 2010)

SkypeTM Example

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Text & Web-Based Communication (5)

Blogs

Twitter

Aphasia Friendly Text Principles

(Dietz et al., 2010)

TwitterTM Example

Text & Web-Based Communication (6)

Closed Captioning

Upload your personal videos

(Dietz & Griffith, 2010)

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YouTubeTM Example

Text & E-books Amazon Kindle©

Large textText to speech featureBlack and white

A l iP d©Apple iPad©

iBook ApplicationColor

No text to speech(Dietz & Griffith, 2010)

Amazon Kindle©

Apple iPad© Examples

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Summary• Information Age

– Attention Age?

• What does this mean for people with aphasia?– Supported web-based communication– Traditional assessment

• Needs assessment

– How can we use on-line communication partners?

• Navigational & communication support

(Dietz et al., 2010)

Final thoughts….

• SLPs are uniquely qualified to help people with aphasia “…cross the digital divide.”

(Elman, 2001)

• “The power of the Web is in its universalityThe power of the Web is in its universality. Access by everyone regardless of disability is an essential aspect.”

– Tim Berners-Lee (W3C, 2010)

References• Aphasia hope foundation: forums. (2009). Retrieved from

http://www.aphasiahope.org/forums

• American Speech-Language-Hearing Association (2005). Roles and Responsibilities of Speech-Language Pathologists With Respect to Augmentative and Alternative Communication: Position Statement [Position Statement]. Retrieved from www.asha.org/policy.

• Beeson, PM. (1999). Treating acquired writing impairment: strengthening graphemic representations Aphasiology 13(9-11)strengthening graphemic representations. Aphasiology, 13(9-11), 767-785.

• Beeson, PM, Hirsch, F, & Rewega, M. (2002). Successful single-word writing treatment: experimental . Aphasiology, 16, 473-491.

• Beeson, PM, Rising, K, & Volk, J. (2003). Writing treatment for severe aphasia: Who Benefits? Journal of Speech, Language and Hearing, 46, 1038-1160.

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• Beukelman, DR, Dietz, A, Hux, K, McKelvey, M, Wallace, S, & Weissling, K. (n.d.). What is a contextually-relevant scene? Retrieved from http://aac.unl.edu/reference/ASHA_VSDTrain.pdf.

• Beukelman, DR, & Mirenda, P. (2005) Augmentative Alternative Communication: Supporting Children and Adults with Complex Communication Needs (3 ed.). Baltimore: Paul H Brookes Publishing Co.

• Brennan, A, Worrall, L, & McKenna, K. (2005). The relationship between specific features of aphasia- friendly written material and comprehension of written material for people with aphasia: An exploratory study. Aphasiology, 19, 693-711.

• Cherney, LR. (1995). Efficacy of pral reading in the treatment of two y, ( ) y p gpatients with chronic broca’s aphasia. Topics in Stroke Literature, 2(1),57-67.

• Cherney, LR. (2004). Aphasia, alexia and oral reading. Topics in Stroke Rehabilitation, 11(1), 22-36.

• Cherney, LR. (2007). Aphasia treatment; an update for the practicing clinician. Nebraska Speech-Language and Hearing Annual Convention, Kearney, NE.

• Cherney, LR, Merbitz, CT, & Grip, T. (1986). Efficacy of oral reading in aphasia treatment outcome. Rehabilitation Literature, 47, 112-117.

• Christensen C. (2004). Relationship between orthographic-motor integration and computer use for the production of creative and well structured written text. British Journal of Education of Psychology, 74(4), 551-564.

• Coelho, C. (2005). Direct attention training as a treatment for reading impairment in mild aphasia. Aphasiology, 19(3), 275-283.

• Dietz, A, Ball, A, & Griffith, J. (submitted). Reading and Writing with Aphasia in the 21st Century: Technological Applications of Supported R di C h i d W itt E iReading Comprehension and Written Expression.

• Dietz, A, McKlevey, M, & Beukelman, DR. (2006). Visual scene display (vsd): new aac interfaces. Perspectives in Augmentative Alternative Communication, 15(1), 13-17.

• Dietz A, Hux, K, McKelvey, ML, Beukelman, DR, & Weissling, K. (2009). Reading comprehension by people with aphasia: A comparison of three levels of visuographic support. Aphasiology, 23(7–8), 1053–1064.

. • Dietz, A, McKelvey, M, Beukelman, D, Weissling, K, & Hux, K. (2006) Integrating Contextually Relevant Visual Scenes into Aphasia Interventions. Seminar presented at the American Speech-Language Hearing Association Annual National Convention, Miami, FL.

• Dietz, A. & Griffith (2010). The role of text in AAC interventions for people with aphasia. Seminar presented at the Ohio Speech-Language & Hearing Association Annual Convention, Columbus , OH.

• Elman, R. (2001). The Internet and Aphasia: Crossing the Digital Divide. Aphasiology, 15(10/11), 895-899.

• Facebook. (2010). Facebook fact sheet. Retrieved at http://www facebook com/press/info php?factsheethttp://www.facebook.com/press/info.php?factsheet.

• Facebook. (2010). Demographics and Statistics Report 2010-145% Growth in one year. Retrieved at http://www.istrategylabs.com/category/social-network-analysis.

• Garrett, LK, & Beukelman, DR. (1995). Changes in interaction patterns of an individual with severe aphasia given three types of partner support. Clinical Aphasiology, 23, 237-251.

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• Garrett, LK, Beukelman, DR, & Low-Morrow, D. (1989). A Comprehensive augmentative communication system for an adult with broca’s aphasia. Augmentative Alternative Commuincation, 5, 55-61.

• Garrett, KL, & Huth, C. (2002). The impact of graphic contextual information and instruction on the conversational behaviors of a person with severe aphasia. Aphasiology,16, 523-536.

• Garrett, K. & Lasker, J. (2005). Adults with severe aphasia. In D. Beukelman & P. Mirenda (Eds.), Augmentative and alternative communication (3rd ed., pp. 467-504). Baltimore, MD: Paul H. Brooks.

• Golashesky, C. (2008). Technology applications at the Adler Aphasia Center. Topics in Stroke Rehabilitation, 15(6), 580-585.p , ( ),

• Ho, KM, Weiss, SJ, Garrett, K, & Lloyd, LL. (2005). The effect of remnant and pictographic books on the communicative interaction of individuals with global aphasia. Augmentative and Alternative Communication, 21, 218-232.

• Howe, TJ, Worrall, LE, & Hickson, MH. (2004). Review: What is an aphasia-friendly environment? Aphasiology, 18(11), 1015-1037.

• Hux, K, Weissling, K, & Wallace, S. (2008). Communication-based interventions: AAC for people with aphasia. In R. Chapey (ed.), Language Intervention Strategies in Adult Aphasia (5th ed,) Baltimore: Williams & Wilkins. L.

• Kagan, A. (1998). Supporting conversation for adults with aphasia Methods and resources for training communication partners. Aphasiology, 12, 816-830

• Mayer, JF, & Murray, LL. (2002). Approaches to the treatment of alexia in chronic aphasia. Aphasiology, 16(7), 727-743.

• Meyer-Johnson. (2006) Boardmaker Software Family (Version 6) {Computer software} Soloma Beach, CA: Meyer-Johnson LLC.

• Orjada, SA & Beeson, PB. (2005). Concurrent treatment for reading and spelling in Aphasia. Aphasiology, 19(3/4), 341-451.

• Rose, TA, Worrall, LE, & McKenna, KT. (2003). The effectiveness of aphasia-friendly principles for printed health education material for people with aphasia following stroke. Aphasiology, 17(10), 947-963.

• Susan G. Komen for the Cure. Share your experience. (2009). Retrieved from http://ww.komen.org/ShareStory.aspx?itc=emoentpnt:4

• Twitter. (2009). Retrieved from http://www.Twitter.com

• The National Aphasia Association. (2009). Aphasia frequently asked questions.

• The National Aphasia Association. (2010). Aphasia Online: Blogs, Groups & Therapy. Retrieved from http://www.aphaisa_community/aphaisaonline.html

• W3C. Retrieved from http://www.w3.org/standards/webdesign/accessibility

• World Health Organization. (2001). International Classification of Functioning, Disability, and Health. Geneva: WHO