The use of computer-assisted therapy in anomia rehabilitation: A single-case report

Background: Research has shown there are three different recognised levels of processing involved in spoken word production: the semantic level, the lexical level, and the phonological level. All of these influence the naming performance of anomic patients. However, there is disagreement regarding the most appropriate strategies for the treatment of anomic problems (repetition, lexical-phonological cueing, semantic cueing, or a combination of all three). The use of computers seems to offer considerable advantages for the daily work of speech therapists, however there is still discussion as to whether or not computers can help patients achieve goals in therapy, and whether computers really can assist therapists in helping their patients to reach their full potential. Aims: This report describes the Computer-assisted Anomia Rehabilitation Program (CARP) designed to be used by a speech therapist working with anomic patients. The program uses semantic, phonological, written, and semantic/phonological cueing procedures to promote the naming of objects and actions. A single-case study is described in an attempt to demonstrate the effectiveness of the program. We hoped to increase naming ability and help the patient internalise these strategies and apply them to untreated items in order to demonstrate the effectiveness of the treatment. Methods & Procedures: This is a single-case report using ABA design, in which a pre-treatment naming baseline was obtained followed by a computer-assisted intervention procedure over a 12-day period. Post-treatment evaluation was conducted a month later to determine the extent of the improvement in the subject's denomination performance. We compare the results to control measurements (PALPA Oral Picture Naming test, Raven's Progressive Matrices, and Yesavage Geriatric Scale). Outcomes & Results: Comparison of pre- vs post-treatment results of the practised words indicated improvement in target naming from 53% to 70% correct responses, when tested 30 days after the end of treatment. In addition, significant improvement was also found in an untrained PALPA Oral Picture Naming test (pre: 13/40; post: 26/40). Results in the generalisation group of stimuli can be related to the patient's internalisation of strategies provided during treatment and its application to untreated items. On the other hand, no significant gains were observed in other areas of cognition taken as control (IQ measured by the Raven's Matrices). Conclusions: This report shows the effectiveness of the Computer-assisted Anomia Rehabilitation Program (CARP) in this single case. It suggests that computer-based programmes can be valid in the treatment of anomic disorders, and proposes further study and development of these systems in clinical practice.