An investigation into the impact of computer therapy on people with aphasia.

Use of computers by the general population continues to increase and computers are now an integral part of communication, leisure activities and work. The majority of research into use of computers by people with aphasia has focussed narrowly on evaluating effects of computer therapy on specific language impairments. Little is known about the broader impacts of computer use by people with aphasia, in terms of levels of social activity and social participation and little is known of the views of people with aphasia on using computers.
The research in this thesis investigates the outcome of computer therapy from the perspective of people living with aphasia. Outcome was evaluated using the framework of the World Health Organisation International Classification of Functioning, Disability and Health (WHO ICF 2001) to investigate impact not just in terms of impairment but on activity and participation as well. The ICF also provided a framework for investigating contextual factors (environmental and personal) which might effect outcome. The investigation took the form of two complementary but contrasting case series studies: an investigation into the outcome of using computers to target word finding abilities (treatment targeting impairment only); and an investigation into the outcome of training to use voice recognition software as a writing aid (treatment aiming to overcome activity limitations but not targeting impairment itself). Both studies comprised a qualitative investigation of the views of participants on the outcome and process of therapy. Both studies supplemented this qualitative data with complementary quantitative evaluations seeking to quantify key aspects of outcome.
Study one findings indicated that all six participants perceived benefits to levels of activity, participation and confidence in addition to benefits to language impairment. Although some of this benefit was attributed to improved language skill, benefits were also attributed to increased confidence associated with acquiring skills. Study two found benefits to levels of activity and participation and confidence for all participants. Benefits were perceived even where there was no measured change to language impairment or quality or quantity of language used.
Computer use by people with aphasia can therefore bring much broader benefits than just to language impairment. Benefits include increases in leisure and social activity, social participation and confidence. Previous computer experience is not necessary and benefits can be shown many years post stroke. These broader benefits should be borne in mind when selecting who may be appropriate for computer therapy.