Enhancing Written Communication in Persons With Aphasia

• Writing Score on the Western Aphasia Battery-Revised (WAB-R) from pre-treatment to post-treatment [ Time Frame: Change from baseline to 6 weeks ] [ Designated as safety issue: No ]
  

• Western Aphasia Battery-Revised Aphasia Quotient (WAB-R AQ) [ Time Frame: Change from baseline to 6 weeks ] [ Designated as safety issue: No ]
  
• Written Language Sample Analysis [ Time Frame: Change from baseline to 6 weeks ] [ Designated as safety issue: No ]
  Written responses on the Picture Description task of the Western Aphasia Battery-Revised and on a written picture-sequenced story retelling task will be scored for Correct Information Units
  
  
• Communicative Effectiveness Index (CETI) [ Time Frame: Change from baseline to 6 weeks ] [ Designated as safety issue: No ]
  
• ASHA Quality of Communication Life Scale (QCL) [ Time Frame: Change from baseline to 6 weeks ] [ Designated as safety issue: No ]
  
• Community Integration Questionnaire (CIQ) [ Time Frame: Change from baseline to 6 weeks ] [ Designated as safety issue: No ]
  

Stroke is the third leading cause of death and the most common cause of disability in the United States. According to the American Stroke Association, the prevalence of stroke in the U.S. is approximately 4.8 million with approximately 700,000 additional strokes occurring annually. Approximately 150,000 to 250,000 stroke survivors becoming severely and permanently disabled each year. A common neurological deficit among stroke survivors, and thus a substantial contributor to post-stroke disability, is aphasia. The loss of, or difficulty with language is extremely debilitating.

Adequate written communication skills may be one of the barriers that has prevented individuals with aphasia from returning to work. Writing skills are also important for participation in social roles, such as household management, civic activities, or recreational activities with friends. Individuals with aphasia struggle to compose written documents such as personal letters, memos and reports. Furthermore, society's increased reliance on written forms of communication including email correspondence, instant messaging, texting, Twitter, and social networking sites such as Facebook, exacerbate the challenge that individuals with aphasia have in connecting with others, reestablishing and redefining their social roles and accomplishing their life-participation goals.

Computer-directed treatment offers a practical alternative to one-on-one traditional treatment provided by a clinician and may be a cost-effective way of extending therapy beyond the hospital and clinic to meet the needs of the growing numbers of individuals with chronic aphasia and to help them reintegrate into the community and workforce. This project evaluates the efficacy of a theoretically-motivated writing program that has been integrated with novel computer-based virtual therapy systems and that can be provided intensively to individuals with chronic aphasia.