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VIDEOTELEPHONY IN INTERVENTION WITH PEOPLE WITH SPEECH AND LANGUAGE DISABILITIES

Irene Johansson, University College of Karlstad, professor
e-mail: Irene@swipnet.se
Magnus Magnusson, University College of Karlstad, speech pathologist
e-mail: Magnus.Magnusson@hks.se
Eva Wallin, University College of Karlstad, speech pathologist
e-mail: Eva.Wallin@hks.se

Web Posted on: December 12, 1997


Introduction

During the last decades questions about language competence and language deficiencies have been thoroughly discussed. There is a strong consensus on language as a matter of vital importance of quality of life in a society similar to that of Sweden.

Usually, these discussions were concentrated upon children. During recent years, however, there has been a growing interest in adults with severe language deficiencies as well.

There is a political ambition to offer language deficient adults qualified rehabilitation. However, there is a minority of adults with mental retardation who actually participate in an intervention program. The situation is about the same for adults with aphasia. The reasons for this situation are shortcomings of resources and lack of knowledge. There are e.g. not an adequate number of people, who are qualified as supervisors in language intervention.


Aim

The aim of this study is to experimentally establish the effectivity of videotelephony in language intervention in adults with severe language deficiencies.


Subjects

The study concentrates on two groups, one group of people with Aphasia and one group of people with mental retardation. The group with Aphasia consists of 26 participants between the ages 26 and 82, 12 persons were born before 1931 and were in other words retired. The rest were born between 1931 and 1954 and one participant was born in 1960. 16 are men and 10 women. Three participants have global Aphasia, 12 have the Broca-type and the rest have the Wernicke-type of Aphasia. All of the participants except the ones with global Aphasia use spoken language. A control group has also been chosen.

The group of people with mental retardation consisted of 26 persons between the ages 26 and 64.19 persons were born after 1950.Half of the group is male and the other half is female.18 of the participants use spoken language , some of them in combination with signs. Three persons mainly use signs and one uses BLISS-symbols. A control group has also been chosen and interviewed.


Method

Desktop video systems were used in the study, running over a 2x64 kb/s network. In the Aphasia group the standard system Vistium was used, based on a Pentium 75 mhz computer with special language training software. Two trial sites were used, at one site a speech therapist was leading the sessions and at the other site 300 kilometers (= 180 miles) away, the participants went regularly, once every fortnight. Every participant has been offered 20 sessions, every session lasting between 45 minutes and one hour.

In the group of mentally retarded a similar system was used with specially developed software for Pictogram communication, using a concept keyboard and a document camera for still-picture communication.

The whole study is divided into the following stages

  • inventory of related work
  • interviews with spouses or staff
  • assessment of participants
  • assessment of control group
  • development of training plans
  • performing the training series
  • evaluation

A specially developed basic language test has been used to study the language capacity of every participant . Individual plans for treatment have been developed after the assessment phase. The initial and final Aphasia sessions are documented on video and for the rest of the sessions a written diary is kept.


Some preliminary results

The inventory has shown that very little work has been done in this field. For the Aphasia group field trials with remote language therapy has been done in Norway (Holland, 1991) and in Germany (Peters, 1996). A presentation of the possibilities using telematics in clinical work in the Aphasia field has been done in the US (Wertz, 1992).

Interviewing the staff and the spouses has already been reported at a few Swedish conferences.

In the Aphasia group a total of 300 training sessions have been performed during one year. The first two sessions for every participant consisted of testing and creating the basic individual plans. Due to sickness and two deaths, there have been difficulties in keeping a regular pace in the sessions. This means that two thirds of the group have participated in 12 - 15 sessions and the rest have participated 3 - 7 times. All of the participants and their spouses have been very positive to the training and experience the project as meaningful to them. All of the participants have access to computer based language training in their homes or at local training centers.

In the mental retardation group about 125 sessions have been performed and the participants show a very positive towards the project and the sessions. However, there have been some technical difficulties.

The individual training plans for the participants in the Aphasia group cover a wide span. They can be divided into a few main groups:

  • reading and writing
  • learning about Windows
  • perception
  • fluent and interactive conversation
  • word finding strategies
  • basic AAC-strategies

All of the participants are interested in working with reading and writing. A few of them want to train conversation and all of them have some interest in the basics of the computer system.


Conclusion

The project will run for another one and a half year and will result in several reports about the result of the use of videotelephony.


References

U. Holland (1991) Use of Graphic Communication in Distance Training of Patients with Aphasia Brussels, In: "Issues in Telecommunication and Disability", COST 219, pp 289-95

W. Peters (1996) Bildtelefone fsr Aphasiker In: ComputerunterstŸtzte Sprachtherapieprogramme und Kommunikationshilfen fsr Aphasiker, WŸrzburg, 13 September 1996

R.T. Wertz & al (1992) Potential of Television and Telephonic Technology for Appraising and Diagnosing Neurogenic Communication Disorders in Remote Settings Aphasiology, 6(1992)2, pp 195-202