Computer gesture therapy for adults with severe aphasia

Aphasia intervention has made increasing use of technology in recent years. The evidence base, which is largely limited to the investigation of spoken language outcomes, indicates positive treatment effects for people with mild to moderate levels of aphasia. Outcomes for those with severe aphasia however, are less well documented and - where reported - present less consistent gains for measures of spoken output. In light of this issue for existing approaches, and due to the fact that non-speech focused interventions might therefore be more suitable, the current thesis explores the use of computer gesture therapy for people with severe aphasia. An initial review of gesture therapy is presented, followed by a systematic review of current computer therapy literature. A pseudo-randomised, wait-list control study of twenty participants with severe aphasia forms the experimental body of the thesis. The study investigates the effects of two purpose-built gesture therapy technologies: GeST and PowerGeST. The latter of these was developed for the purposes of the thesis. Following completion of a range of candidacy measures examining gesture comprehension, language, cognition and praxis, participants undertook a five-week intervention period comprising practice with GeST and PowerGeST. Primary outcomes were assessed using a measure of gesture production in isolation. Secondary outcome measures included an assessment of naming production, a novel assessment of interactive gesture abilities and an accessible computer use and confidence measure. These two latter measures were developed for the purposes of the thesis. Study outcomes show significant improvement in gesture production abilities for adults with severe aphasia following computer intervention. They indicate no transfer of effects into naming gains or interactive gesture. Findings reveal comparatively low levels of access to everyday technologies for this group. Outcomes therefore, indicate the positive effects of a purpose built computer-delivered therapy for a population who commonly experience challenges with access to everyday technology. Insights gained within this thesis offer encouraging results for computer therapy methods within this hitherto under-researched population and propose a case for further development of the evidence base in this field