Traditionally aphasic patients have been entitled to a few months of speech rehabilitation during a brief period of so-called "spontaneous recovery" when the brain physiologically heals itself from injury. But research, using computers to do extended therapy, now indicates that these patients can continue to improve even many years after their stroke or brain trauma. Lingraphicare America, developers of the Lingraphica speech generating device for aphasia, has published results of studies which show significant improvements after use of the device over a period of approximately 20 weeks. Speech generating devices are specialized computers that produce audible speech from words and images.
The Lingraphica uses graphic icons to represent words that a user selects in order to hear them speak. These icons can be combined into phrases or sentences that can then be spoken by the device. Patients use the device to hear and repeat words and phrases for the purpose of practice and therapy, but they also use it to speak for them in order to make their wishes known, for instance to order food or inform a caregiver of a need.
Lingraphicare's data documents that nearly half of the subjects of its study evolved to a less severe diagnostic category of aphasia after use of the device. Over a thousand persons with aphasia were assessed using the standardized assessment instruments, the Western Aphasia Battery (WAB) that measures a patient's level of impairment (for instance how well they can repeat a word or name an object from a line drawing), and the Communication Effectiveness Index (CETI) that measures how well a patient communicates in everyday life out in the community. These assessments were done upon intake and then again at discharge from the study. The patients had mostly been discharged from previous treatment programs after having reached a plateau, and no longer being candidates for further significant gains. Nonetheless, assessments showed that, in the mean, those clients made further significant gains after use of the device, and such gains were found in every diagnostic category of aphasia regardless of severity level or time since the onset of aphasia.
Findings from data analyses have been published in the peer reviewed journals Aphasiology, Stroke, Archives of Physical Medicine and Rehabilitation, and Topics in Geriatric Rehabilitation. (The articles can be printed off of Lingrahicare's website, where charts of the data can also be downloaded.)
The effectiveness of the device can be attributed to several factors. First, as has been documented in stroke rehabilitation research, undamaged parts of the brain will often take over the tasks of damaged areas when a patient engages in daily repeated practice. With a computer, patients can work for hours a day at whatever pace they choose. Second, the Lingraphica uses a technique called projection: when a user clicks on an icon, it quadruples in size. This is designed to put the user in a state of arousal not unlike the fight or flight response caused when a predator approaches, and increases a patient's concentration and involvement. Previous study done by researchers Clifford Nass and Byron Reeves of Stanford have documented the patient's response to this type pf stimulus.