Performance in People with Chronic Aphasia Using a Visual Scenes Display

Miechelle McKelvey

Aimee R. Dietz

Karen Hux

Kristy Weissling

David Beukelman

Funded in part by: AAC-RERC, NIDRR, USDE

PURPOSE• Develop a personalized Visual Scenes Display (VSD)

for a person with chronic aphasia (Ron)

• During interaction with unfamiliar partners, document changes: • As Ron became increasingly familiar with the

themes • Before and after intervention

• Investigate generalization with second theme

METHODS

ParticipantsPerson with Aphasia (Ron)– 61-year-old male with chronic aphasia– 8 years post left hemisphere stroke– Lives independently– WAB Aphasia Quotient = 24.2

• Speech Characteristics– Dysfluencies – Word retrieval difficulties– Stereotypic phrases – Paraphasias– Tends to dominate conversations– Inappropriate turn taking– Perseveration on disability

Communication Partners-20 adults without communication challenges

• Age range 21-72• Gender 16 females, 4 males

DEPENDENT MEASURES• Instances of disability talk

– Any utterance Ron makes in an attempt to explain his problem communicating • “Sometimes it is hard to say it.”

• Instances of navigation and organization talk– Any utterance Ron makes to himself, or listener

concerning device navigation.• “Let’s see here.”

• Percentage of inappropriate question and answer exchanges

PROCEDURES• Experimental Design: Multiple Baseline Across

Themes

• Theme Development– Ron and AAC facilitator constructed two themes

• Measurement– Bi-weekly data collection– Videotaped– All utterances, gestures, device navigation, and

device output transcribed

• Instruction– Bi-weekly intervention session

• Analyses– Tallied instances of Disability talk

• Interobserver agreement = 93.7%– Tallied instances of Navigation and

Organization talk• Interobserver agreement = 97.3%

– Tallied number of inappropriate turns following a question

RESULTSDisability Talk

0

5

10

15

20

25

30

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20Session

Insta

nces

Theme 1Pain

Fell/Pain Pain

Fatigued

0

5

10

15

20

25

30

35

40

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20Session

Inst

ance

s

Theme 2

Fell/Pain Fatigued

Fell Broke Arm/No Glasses

Gender Differences in Disability Talk

Navigation & Organization Talk

0

5

10

15

20

25

30

35

40

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20Session

Ins

tan

ce

s

Theme 1

PainPain

Pain

Fatigued

0

5

10

15

20

25

30

35

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20Session

Ins

tan

ce

s

Theme 2

Fell Broke Arm/ No Glasses

Fatigued

Gender Differences in Navigation & Organization Talk

0

5

10

15

20

25

30

35

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Session

Inst

ance

s

Female Listener

Male Listener

Theme 1

Percentage of Inappropriate Turn-Taking following Questions

0102030405060708090

100

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Session

% Q

ue

sti

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s A

ns

we

red

Theme 1

0

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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Session

% Q

ue

sti

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s S

elf

-An

sw

ere

d

Theme 2

Fatigued

Fell Broke Arm/ No Glasses

Pain

DISCUSSION• Generalization to Theme 2 prior to intervention

– Disability Talk– Navigation and Organization Talk– Turn-taking following questions

• Increased efficiency

• Increased reciprocity

• Qualitative interaction differences across genderhttp://aac.unl.edu/