Transcript iTechnology and Communicative Drawing for Individuals with Aphasia

iTechnology and Communicative
Drawing for Individuals with Aphasia
Jennifer A. Ostergren, PhD, CCC-SLP
Jennifer Raminick, B.A.
Welcome
Drawing on an iPad by an individual with aphasia (Ostergren, 2012)
Thank You
• To our clients (our wonderful
teachers)
– Thank you for your inspiration and
willingness to participate in our
research
• To my students (future SLPs)
– Thank you for your help in preparing
this presentation. In particular thank
you Kristen Churney for her guest
appearance in describing the CDP
House Keeping
• A handout for this presentation, including
links to the technology discussed is available
at:
• __________ (insert CD page web address
once loaded)
Agenda
• Multi-Modality Communication and Aphasia
• Correlations with Neuroplasticity
• Drawing and Aphasia
• iTechnologies for Communicative Drawing
– Examples of available iApps
– Features of available iApps
– Recommendations for Selection
• Communicative Drawing and iTechnology in a
Clinical Setting
• New Directions and Future Research
• Questions and Answers
Agenda
• Multi-Modality Communication and Aphasia
• Correlations with Neuroplasticity
• Drawing and Aphasia
• iTechnologies for Communicative Drawing
– Examples of available iApps
– Features of available iApps
– Recommendations for Selection
• Communicative Drawing and iTechnology in a
Clinical Setting
• New Directions and Future Research
• Questions and Answers
What is Multimodality
Communication?
• Using different modes of communication to
meet the needs of the individual and to allow
them the opportunity to participate in their
communities (ASHA, 2004)
– Writing
– Gesturing
– Drawing
– AND Speech
Total Communication Use in PWA (Rautakoski, 2011)
• Many people with aphasia (PWA) use nonverbal
methods of communication spontaneously,
including:
•
•
•
•
•
•
Pointing
Gesturing
Facial expressions
Pantomime
Drawing
Concrete signs
• Some PWA also use low-tech devices
• Not used as much as the spontaneous nonverbal
communication
• Some PWA need special training in use of total
communication
Key Elements to
Multimodality Communication
(Beukelman & Mirenda, 2012)
• Co-Construction
• Partner Training
• Varied Approaches Given:
– Partner Dependent Communicators
– Partner Independent Communications
• Direct training and generalization to realworld settings is KEY!
AS: Example of Multimodality Communication
• What did you do
yesterday?
–
–
–
–
Drew a hamburger
Said, “Hamburger. Big”
Put up four fingers
Wrote : UCLA, DDS, 2
Viet, 1 Japan, and 2 white
The client had gone out to eat hamburgers with four of
his friends from dental school at UCLA; two friends were
Vietnamese and two were Caucasian, and the “1 Japan” was
referring to himself.
Neuroplasticity
• Rich body of research on neuroplasticity
in the past decade (Saur & Hartwigsen, 2012)
• Neuroplasticity is defined as,
“ ... functional reorganization/
compensation within residual neural
tissue, mediated by changes in neural
circuitry” (Gonzalez Rothi, Musson, Rosenbeck, & Sapienza, 2008)
Educating Clients about Neuroplasticity
• Empowering Individuals with Aphasia with
Neuroplastic Principles: From Theory to
Practice.
– Birtler, E., Hayes, M., Kim, J., Sibby, K., Weltz, K., Navarro, A., &
Ostergren, J. (2012). California Speech and Hearing Association (CSHA)
Magazine, 42 (1), July 2012.
Explaining Neuroplasticity to PWA
• WHAT YOUR BRAIN IS DOING FOR YOU….
Researchers have identified four strategies your brain uses to
compensate for damaged areas:
1. Homologous area adaptation
2. Cross-modal reassignment
3. Map expansion
4. Compensatory masquerade
No matter how long since your stroke, your brain is still
working to get the job done!
Grafman (2000). Conceptualizing Neuroplasticity
Explaining Neuroplasticity to PWA
WHAT YOU CAN DO FOR YOUR BRAIN….
• Repeat, Repeat, Repeat
o Why does your clinician make you keep repeating
the same thing over and over?
Raymer et. al (2008). Translational research in aphasia
Explaining Neuroplasticity to PWA
Raymer et. al (2008). Translational research in aphasia
Explaining Neuroplasticity to PWA
Pulvermüller & Berthier (2008). Aphasia therapy on a neuroscience basis
Outcome of Education
• Clients and family members are very receptive to
information about neuroplasticity
• Visual aids and reducing jargon critical
• Qualitative changes were noted immediately:
–
–
–
–
Increased motivation/participation
More attempts to verbalize
More willingness to try alternative modalities
Seeking areas of change in their own environments
EDUCATING CLIENTS ABOUT DRAWING, as part of
multimodality communication, is critical!
Agenda
• Multi-Modality Communication and Aphasia
• Correlations with Neuroplasticity
• Drawing and Aphasia
• iTechnologies for Communicative Drawing
– Examples of available iApps
– Features of available iApps
– Recommendations for Selection
• Communicative Drawing and iTechnology in a
Clinical Setting
• New Directions and Future Research
• Questions and Answers
Effects of Brain Damage
on Drawing
Left hemisphere lesions
• May have difficulty
depicting internal details
of a target picture, but
little difficulty depicting
external shape
• Some are unable to
generate a mental image
of the target items
• Some may have difficulty
choosing the correct color
for images
Right hemisphere lesions
• May retain ability to
produce internal details but
fail to correct spatial
relations or relative size
• May omit all or the left half
of external configuration
• May interfere with ability to
discriminate between
colors
(Helm-Estabrooks & Albert, 2004)
Left or Right Hemisphere Lesion?
Right hemisphere
?
Left hemisphere
?
(Helm-Estabrooks & Albert, 2004)
History of Drawing
and Aphasia
• Long history in the research literature (Lyons, 1995)
• Two primary areas of emphasis in the research:
– Realm of AAC and improving functional
communication (Beeson & Ramage, 2000; Sacchett, 2002; Sacchett
& Lindsay, 2007; Helm-Estabrook & Albert, 2004)
– For its impacts on verbal output as a source of deblocking and semantic access (Davis, Farias, Baynes, 2005;
Farias, Davis, Harrington, 2006)
Drawing and AAC
• Drawing can be used to compensate when a PWA is
not able to use written or verbal language (Lyons, 1995)
• Advantage - no limitations caused by deficits in
short-term memory and/or sequential ability (Sacchett,
2002)
• A move toward interactive (Sacchett, 2002)
• Supplementing Language
– Communication is enhanced by the drawings, so the
emphasis is on the exchange of information and ideas
• Substituting Language
– Drawings are the communication, so emphasis is on
producing recognizable content units.
De-blocking, Semantic
Access, and Drawing
• Drawing vs. writing as a cue for
verbal expression
– Drawing more effective in increasing
verbal naming (Davis, Farias, Baynes, 2005; Farias,
Davis, Harrington, 2006)
– Quality of the drawings has no impact
on the ability to access the semantic
features of a word (Farias, Davis, Harrington, 2006)
Possible
Explanation?
Communicative Drawing Program (CDP)
“The functional goal of the CDP is for
patients with aphasia who are unable to
convey desired messages through speech
or writing to communicate instead
through drawing.”
(Helm-Estabrooks & Albert, 2004, pg. 273)
CDP Candidate Profile (Helm-Estabrooks & Albert, 2004)
Inability to communicate information through speech or writing
Ability to use a medium-point felt-tip pen to copy one dimensional shapes
Relatively intact visual memory
Good visual attention skills
Alert, cooperative, and willing to pursue a drawing program to improve
functional communication
Pre-morbid artistic skills are not required, nor it is necessary to draw with the
dominant hand
Overview of Steps
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Basic semantic-conceptual knowledge
Knowledge of object color properties
Outlining pictures of objects with distinct shape properties
Copying geometric shapes
Completing drawings with missing internal and external features
Drawing objects with characteristic shapes from memory
Drawing objects to command from stored representations
Drawing objects within superordinate categories
Generative drawing- animals and modes of transportation
Drawing cartooned scenes
(Helm-Estabrooks & Albert, 2004)
Step 1
Basic Semantic-Conceptual Knowledge
“Circle the objects that belong together.”
Criterion: 100% identification of the 5 items in 5 different
superordinate categories
Step 2
Knowledge of Object Color Properties
“Select the correct color (from 12 colored markers)
and color that item.”
Criterion: Correct color choices for all nine items.
Step 2
Knowledge of Object Color Properties
“Select the correct color (from 12 colored markers)
and color that item.”
Criterion: Correct color choices for all nine items.
Step 3
Outlining Pictures of Objects with Distinct Shape Properties
“Take this pen and draw an outline around each object
without touching the lines of the pictures”
Criterion: Each object outline conforms to shape and does not
touch or trace the lines of printed stimuli
Step 4
Copying Geometric Shapes
“Take this pen and copy each figure. Your drawings should not
touch the examples.”
Criterion: For each shape, all lines are present, in correct
proportion and in proper relation to one another
Step 5
Completing Drawings with Missing
External and Internal Features
“Show me what is missing in this picture…Okay, now take this
pen and fill in the missing part.”
Criterion: All completions are successfully rendered,
complete, and conceptually reasonable
Step 6
Drawing Objects with Characteristic Shapes from Memory
“Look at this object. (Present single card.) Remember what it looks
like, because I’m going to ask you to draw it. Okay, are you
ready? Take this pen and draw the object here.”
Criterion: For each shape, all lines are present, in correct
proportion and in proper relation to one another
Step 7
Drawing Objects to Command from Stored
Representations
“Look at this word. It says____ Can you draw____right here?”
ice cream
Criterion: Drawings of each object can be correctly identified by a
naïve judge who is not shown the target words
Step 8
Drawing Objects Within Superordinate Categories
“See this word? It says ___. I want you to think of a _____ and draw
it right here.”
tool
Criterion: All responses belong to the named superordinate
category and can be identified correctly by a naïve judge not
provided with the target words.
Step 9
Generative Drawing:
Animals and Modes of Transporting People
“On this page, I want you to draw as many types of animals/modes of
transportation as you can. Make your drawings clear enough so that
anyone could name the animals/modes of transportation that you draw.”
Criterion: All responses are correct exemplars of the superordinate
categories and are correctly identified by a naïve judge.
Step 10
Drawing Cartooned Scenes
“Show me what is funny about this picture…Now study the picture well
because I’m going to ask you to draw it from memory.”
Criterion: Each panel should be accurate enough for a naïve judge to
identify all elements necessary for understanding and stating the
message (joke) of each cartoon.
CDP: Case Study (A.S)
•
•
•
•
•
45-yr-old male
Status post left basal ganglia intracranial hemorrhagic CVA 10/03/2008
Dentist
Bilingual in English (primary) and Japanese
Mixed , non-fluent aphasia
- Verbal expression characterized by:
- 1-word utterances
- verbal apraxia
- decreased loudness and pitch range
- confrontational naming relatively intact
- Written expression characterized by 1-word phrases
- Severe auditory and reading comprehension deficits
(1-2 word phrases)
- Used writing and gestures to supplement verbal expression
Sample CDP Goals (A.S.)
Goal: To improve multimodality communication, the client will draw three-panel
drawings from memory with enough detail so that a naive judge can identify
the message.
•
Objective 1: In the clinical setting, when given the name of an object with
distinct visual features (i.e., ice cream cone, palm tree, etc), the client will
draw the object with enough detail so that a naive judge can identify the
object with 100% accuracy in a minimum of 10 trials.
•
Objective 2: In the clinical setting, when given a superordinate category
(e.g., tool, animals, vehicle, etc.) and no prompts, the client will draw at
least one object within the specified category with enough detail so
that a naive judge can identify the object with 100% accuracy in a minimum
of 10 trials.
•
Objective 3: In the clinical setting, when given a three-panel cartooned
story, the client will draw the story from memory with enough detail so
that a naive judge can identify the message of the cartoon in 2 out of 3
trials.
CDP Training/Tasks (A.S.)
• Began with Step 3 of the CDP
• During Step 7
1. Modeled adding more detail to unrecognizable drawings
2. Client began to spontaneously add more detail
3. Clinician provided the client with a puzzled look
whenever his drawings were not recognizable
• Homework given for Steps 8-9
• CDP supplemented by multimodality communication
– Barrier tasks encouraged all modalities
CDP Outcome Measure
The client will draw one-, two-, and
three-panel cartooned stories from
memory.
– Panel should be accurate enough for a
naïve judge to identify all elements
necessary for understanding and stating the
message (joke) of each cartoon.
(Helm-Estabrooks & Albert, 2004)
1-Panel Model
Copyright 2003. Helm-Estabrooks, N. Communicative Drawing Program Cartoons
Pre-Therapy
Post-Therapy
2-Panel Model
Copyright 2003. Helm-Estabrooks, N. Communicative Drawing Program Cartoons
Pre-Therapy
Post-Therapy
3-Panel Model
Copyright 2003. Helm-Estabrooks, N. Communicative Drawing Program Cartoons
Pre-Therapy
Post-Therapy
Maintenance/Generalization Data
Copyright 2003. Helm-Estabrooks, N. Communicative Drawing Program Cartoons
Maintenance/Generalization Data
2
1
3
Caregiver interview and the Communicative Effectiveness Index (CETI) indicate that
A.S. primarily communicates via verbal and written expression and drawing
Potential Supplemental Practice Game Apps
• Draw Something
– Social drawing and
guessing game
• Whiteboard
– Collaborative drawing
app
Agenda
• Multi-Modality Communication and Aphasia
• Correlations with Neuroplasticity
• Drawing and Aphasia
• iTechnologies for Communicative Drawing
– Examples of available iApps
– Features of available iApps
– Recommendations for Selection
• Communicative Drawing and iTechnology in a
Clinical Setting
• New Directions and Future Research
• Questions and Answers
New Frontier
• The role of new technologies in multimodal
communication, including drawing.
• More questions than answers
– Is new technology applicable for drawing
purposes?
– What technology is best?
– Any hidden pitfalls?
– Any potential advantages?
– Where to begin??????
Technology for PWA
• Most often technology is used in speech
therapy for: stimulus material, data tracking,
and AAC (ASHA, 2011)
• Technology-aided therapy effective, due to the
increased intensity of treatment (van de SandtKoenderman, 2011)
– Likely due to potential for use with multiple
communication partners and use across multiple
settings
What is a Smartphone?
• “Smartphone is a mobile phone that includes
software that a user is able to modify and
update. The user controlled software must be
able to transfer information to and from
external systems” (Toyysy & Helenius, 2006, p. 110).
Smartphone Options
Windows Phone
$400-$500
Android
Blackberry
$300-$400
$250-$500
iPhone
HP Palm
Nokia
$400-$600
$400-$600
$400-$600
Alternate Formats - Tablets
iPad
$500 - $750
Android Tablet
$480-$750
Alternate Formats – iPod Touch
$299-$399
What is an App?
• “Apps” is an abbreviation for application
• Piece of software that can run on the Internet,
on a computer, on a phone or other electronic
devices
• Variety of available on different smartphones
• Some require internet connectivity, while others
do run off-line
What is iTechnology?
Technology manufactured by
Apple, collectively referred to
as: iTechnology or iDevices
For example:
• iPads
• iPod Touch
• iPhones
Potential Benefits of Drawing Apps
• Unlimited numbers of pages accessible without erasing
• Save and organize drawings created for future
access/modification
• Enhance drawings with colors, stored symbols, and
backgrounds.
• Incorporate real photographs
– Possibility? GPS Picture Prediction (e.g., Locabulary for
picture)
• Export and send drawings via email
• Some apps include keyboard function to augment
drawing with typed letters, words, or phrases.
– Possibility? Text-to-speech
– Possibility? Interactive Alphabet Board/Phoneme cue
iTechnology: A Pilot Study
Ostergren, J., & Raminick, J. (n.d.) Drawing and iTechnology: A pilot
study in the use of a drawing iApp by individuals with aphasia (n.d.).
Unpublished manuscript.
• Methods
– 4 PWA
• Ages 20 – 80 years old
• Non-fluent forms of aphasia
– Participants were evaluated on their ability to:
• Access and navigate within a drawing app (NotesPlus)
• Intelligibility of their drawings (as compared to traditional
paper and pencil methods)
CDP Cartoon
Copyright 2003. Helm-Estabrooks, N. Communicative Drawing Program Cartoons
Paper/Pencil vs. iPad
One-Panel
Two-Panel
Three-Panel
One-Panel
Two-Panel
Three-Panel
One-Panel
Two-Panel
Three-Panel
One-Panel
Two-Panel
Three-Panel
Intelligible to a naive judge
using pen and paper
PT1HPR
Yes
Yes
No
PT2
Yes
No
No
PT3
No
Yes
Yes
PT4HPL
No
Yes
Yes
Intelligible to a naive judge
using the iPad
Yes
Yes
No
Yes
No
No
No
Yes
Yes
No
No
No
Example (PT 1): Paper/Pencil vs. iPad
App Use: Ease of Use After Training
Program Functions
3
2
Opening the program
Retreiving the program
Opening a new page
Erasing
1
0
Participant 1 Participant 2 Participant 3 Participant 4
PT 4: Words of Caution
• Still obstacles to over-come
– Non-dominant hand use/Limited control
• Registering drawing contact (false starts)
– No different in stylus vs. finger-tip
– Difficulty and frustration with touch screen use
(with and without stylus)
– No previous touch screen use
– Lower levels of use and confidence with computers
and technology in general
Finding the Right App:
Recommended Feature Analysis -
• ASHA defines feature matching as:
– “…devices are selected based on relationships
between an individual's strengths… capabilities and
communication needs in relation to various
features of a device (ASHA, 2004, page 9).
Best predictor of long-term success with AT is
careful selection of aids to ensure they are wellmatched to the user and the environment
(Scherer et al., 2007)
Which Apps to Use:
App Analysis
• Ostergren, J. & Gastelum, M. (n.d.). An Exploration
iTechnology Drawing Apps for Individuals with Aphasia.
Unpublished manuscript.
• Evaluation of Drawing and Writing apps for
communicative drawing purposes, given:
– Phase 1
– Phase 2
– Phase 3
Phase 1 – App Identification (Part A)
METHODS
• Search Terms: Apps with
“drawing” or “handwriting” in
search terms
• Consumer Ratings: Apps
highly rated by users on the
Apple Market place as a 4 or
higher stars
• Device Mode: Apps that
could be utilized on an iPad.
• Category: “Productivity” apps
RESULTS
• 22 drawing apps
• 112 writing apps identified
TOTAL = 134 apps
Phase 1 – App Identification (Part B)
METHODS
• Line Sizes. Apps with at least 8 line
size options
• Color Choices. Apps with at least 8
color options
• Background Choices. Apps with the
ability to modify the background in
some fashion beyond strictly a
white canvas were selected.
• Saving Capacity. Apps with the
ability to save drawings for future
retrieval and easily modification.
• Ability to Email. Apps with an
email function.
RESULTS
• 5 drawing apps
• 9 writing apps identified
TOTAL = 14 apps
Phase 3 – App Evaluation
METHODS
Apps from Phase 2 rated using 5 point scale, as follows
• Ease of Navigation:
1 = Complex navigation………………5 = Minimal/Easy Navigation
• Visual Distraction
1 = Maximal Distraction…....................5 = Minimal Distraction
• Workspace:
1 = Small Icons/Workspace…………..5 = Large Icons/Workspace
• Iconicity:
1 = Opaque Icons……………………………………5 = Transparent Icons
Drawing Apps
SketchTime
Absolute Board
Pen and Paper
Bords
Paint Gallery
Ease of
Visual
Workspace
Navigatio Distraction
Iconicity
4
4
3
3
2
4
4
3
3
4
5
5
3
5
1
4
4
3
4
3
TOTAL
SCORE
(max
20)
17
17
12
15
10
Writing Apps
Ease of
Visual
Workspace
Navigation Distraction
Noteshelf
Jotter
Notes Plus
PhatPad
Duke Pen
Pencilicious
Remarks
Mighty Note
UPAD
4
3
3
3
3
3
3
2
2
5
5
5
4
3
3
3
3
4
5
5
4
4
4
3
4
4
3
Iconicity TOTAL
SCORE
(max
20)
4
18
4
17
3
16
3
14
3
13
4
13
2
12
3
12
2
11
Looking Deeper:
Additional Trends Uncovered
•
•
•
•
•
Options for setting hand use (right vs. left)
Moveable palm rests
Icon knowledge required
Layers in saving – Less is more
Remote access/additional accounts (e.g.,
EverNote)
• Start position important
• Access knowledge required
– Tapping, swiping, and finger expansion
SketchTime
•
•
•
•
•
•
$1.99
Language: English
Developer:
Hansol Huh
© 2012 Hansol Huh
Rated 4+
Absolute Board
• Free
• Languages:
English, Korean
• Seller:
• Hyeoseong
Hwang
• © ibluegene
Apps
• Rated 4+
Noteshelf
$6.49
Languages: English,
Chinese, Japanese
Seller: Rama Krishna
© 2012 Fluid Touch PTE
LTD
Rated 4+
Jotter
$0.99
Languages: English,
Korean
Seller: groosoft
© 2010 groosoft
Rated 4+
NotesPlus
$8.49
Category: Productivity
Language: English
Seller: Viet Tran
© Viet Tran
Rated 4+
Recent Replication: Pilot Study
• 13 additional PWA
–
–
–
–
Varying forms of aphasia (fluent and non-fluent)
Varying ages
All in chronic stage of recovery from a CVA
All receiving services at CSULB for communication
impairments
• Asked to draw a 1-panel CDP cartoon using paper
and pen and one (1) of the following apps:
–
–
–
–
Sketch Time
Jotter
Absolute Board
Noteshelf
Sketch Time
PT 1
PT 2HPL
PT 3
Intelligible to a
naive judge
using pen/paper
Intelligible to
a naive judge
using the iPad
Yes
No
No
No
No
No
Jotter
PT 1
PT 2HPL
PT 3HPL
Intelligible to a
naive judge
using pen/paper
Intelligible to
a naive judge
using the iPad
No
Yes
No
No
No*
No
Absolute Board
PT 1
PT 2HPR
PT 3HPL
PT 4
Intelligible to a
naive judge
using pen/paper
Intelligible to
a naive judge
using the iPad
Yes
No
No
Yes
No
Yes
No
No
Noteshelf
PT 1HPL
PT 2HPR
PT 3
Intelligible to a
naive judge
using pen/paper
Intelligible to
a naive judge
using the iPad
No
No
No
No
No
No
RESULTS
• 5/17 PWA had intelligible drawings in the
paper and pencil mode (29%)
– Two (2) had equally intelligible app drawings
(Notesplus)
– Three (3) had less intelligible app drawings (Jotter,
Absolute Board, and Sketch-Time)*
Ad Hoc and Qualitative
• Motor control and app use:
– 9/17 individuals had hemiparesis (52%)
• 3 of these individuals had intelligible drawings
in one mode (33%)
– 1 = equally intelligible drawings in both modes
– 1 = less intelligible app drawing
– 1 = less intelligible paper/pencil
• Most individuals in our study with hemiparesis
had unintelligible drawings in both modes (6/9,
67%)
Conclusion
• Interpret with CAUTION – small sample!
• For some individuals, drawing using an app
was less intelligible, with some apps
• But………
The Devil’s in the Details –
Aim for Total Communication
Pointed to spot
highlighted and said:
“Water” and “Hot”.
Also, gestured drinking.
Big Picture: Lessons Learned
• Aim for communication, not perfection in drawing.
• Incorporate within multimodality system (e.g., speech,
writing, gestures, AND drawing)
• Provide education in neuroplasticity and the positive
impact of drawing on verbal expression
• Consider pre-morbid technology use and comfort
• Increase acceptance by minimizing client frustration
Additional Lessons Learned:
Experiment/Match to Client
• Compare Drawings on Different Apps
• Explore Palm Rest/Hand Use Settings
• Evaluate Stylus vs. Finger-tip
– Individual preference a factor
– Assess with different “pen” settings on the app (fine
vs. large)
• Assess Case
– Withstand pressure from resting palm while drawing
– Adjust to different positions
Additional Lessons Learned:
Therapy Tips
• Incorporate within Multimodality/Total
Communication Training
–
–
–
–
Speaking
Gestures
Drawing
Writing
• Use Barrier Tasks
• Train Partners
• Use CDP to Enhance Details (Internal/External
Features)
• Assess with Referential Communication Tasks
Referential Communication Task
• Based on Purdy and VanDyke (2009)
• CSULB Modifications:
• 15 real color photographs of common everyday
activities
• Unfamiliar listener:
– Instructions: A PWA is going to be describing to you
pictures shown to them. You will not be able to see
these pictures. The PWA may speak, write, draw,
gesture (or use a variety of methods) in describing
these pictures to you. Please write down what you
think the picture represents.
Agenda
• Multi-Modality Communication and Aphasia
• Correlations with Neuroplasticity
• Drawing and Aphasia
• iTechnologies for Communicative Drawing
– Examples of available iApps
– Features of available iApps
– Recommendations for Selection
• Communicative Drawing and iTechnology in a
Clinical Setting
• New Directions and Future Research
• Questions and Answers
Future Research: Information Needed
• Develop and test frameworks for effectively and
efficiently evaluating apps
• Explore communicative drawing and technology
– Influence of technology in communication dynamics
• Collect actual efficacy data
– Just because it is new, doesn’t make it better.
• Move toward dedicate apps for PWA that allow
for fluidity in modalities
– PWA input critical
Agenda
• Multi-Modality Communication and Aphasia
• Correlations with Neuroplasticity
• Drawing and Aphasia
• iTechnologies for Communicative Drawing
– Examples of available iApps
– Features of available iApps
– Recommendations for Selection
• Communicative Drawing and iTechnology in a
Clinical Setting
• New Directions and Future Research
• Questions and Answers
Q&A
For additional information about this
presentation contact:
Dr. Jennifer A. Ostergren
Assistant Professor
California State University, Long Beach
Department of Communicative Disorders
[email protected]
Reference
ASHA. (2004). Roles and responsibilities of speech-language pathologists with
respect to augmentative and alternative communication: technical report
[Technical Report]. Available from www.asha.org/policy
Beeson, P.M., & Ramage, A.E. (2000). Drawing from experience: The
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