fkh_po_nl_rz 28.03.2002 9:58 Uhr Seite 1 C M Y CM MY CY CMY K Computer aided aphasia therapy a tele care setting Authors: Rupp Eckart, Seewald Barbara, Schupp Wilfried Patients suffering from speech-communicative functions following acquired brain lesions find it extremely difficult to obtain adequate rehabilitation and after-care services on an outpatient basis. The average duration of treatment in a rehabilitation centre is being reduced continuously. After-care treatment often takes place in a very low weekly frequency. Tele Care Setting The therapists prescribe individual exercises by teleprocessing. The patients can retrieve these exercises from the server at any suitable time. So patients can do their exercises independantly from their therapists. In view of this an IT-media-supported solution is being developed at present at Fachklinik Herzogenaurach. In cooperation with Dr.-Hein GmbH (formerly evosoft Tele Care) speech therapists and doctors develope a special software for computer aided therapy. Statistics Simultaneously, the system software automatically provides the therapist with data relating to the results, to the time at which the training took place and to the duration of the training. On the basis of this statistical documentation the therapists choose the next update exercises. First Experiences Which patients would benefit from computer-aided therapy? Requirements patient In order to guarantee an effective and satisfying training the patients should fulfill certain requirements.they should not suffer from manual apraxia or ataxia. Problems relating to muscular movement (motoric problems) in form of hemiparesis do not appear to restrict the indication for computer-aided selftraining. In psychological respect they should be motivated to do the training. On the other side therapists have to make sure that their patients are able to cope with a certain amount of frustration. Furthermore, patients should show a certain level of cognitive capacities as to understand situations and certain routines. They should be able to concentrate for at least 15 minutes. Requirements system The system software as it is being developed at Fachklinik Herzogenaurach fulfills a series of criteria which has shown to be basically important for a high quality of computer-aided therapy. hierarchical structure of exercises in ascending order of difficulty, based on linguistic models randomised retrieve of exerciseitems large database continuous self-adaptation of the system according to current performance self-explaining surface of the screen using a touchscreen Initial pilot studies relating to the use of tele-therapy in the case of aphasics indicate that this form of therapy is an effective way of supplementing and intensifying the conventional face-to-face-method. Computer-aided therapy has proved to be particularly suitable for intensive, frequent training measures in relation to specific areas of impairment. In addition to providing a high standard of therapy, this method gives the patient a greater degree of independence and enhances his self-esteem. Experience in the therapeutic field has shown that this is something which plays an extremely positive role in the rehabilitation process. First experiences have shown that computer-aided therapy, when used in combination with suitable therapy software, is possible and appropriate for the above mentioned patient groups. The patients undergoing the training showed a clearly higher selfesteem and a lot more independency. They particularly appreciated the high frequency of exercises. These preliminary experiences will be followed by a scientific study. 1. Teletherapy how the system works 2. Contents of the Module The first version of the neurolinguistic module enables therapists and patients to treat the following main areas of impairment relating to aphasia: Management of patient data base In order to avoid overtax the therapists can define the frequency of exercises per day and per week. Auditory speech comprehension, e.g. choosing correct picture after presentation of auditory stimulus Therapists choose from a finely differentiated range of exercises. The level of difficulty can be defined to increase according to semantic distance, phonematic distance, word-length and word-frequency. The patients can give feedback concerning severity of exercise by clicking smily buttons Written language comprehension, e.g. choosing correct written word fitting to a present picture Therapists configure some special parameters for the exercises The system provides continuous statistical documentation during patients exercises. Production of written language, e.g. written naming Contact: Dr. Wilfried Schupp Medical Head Department of Neurology/Neuropsychology Fachklinik Herzogenaurach In der Reuth 1 D-91074 Herzogenaurach Phone: ++49-9132-83-1035 Fax: ++49-9132-83-1030 Email: heike.eckhof@fachklinik-herzogenaurach.de Probedruck For technical questions: Dr. Barbara Seewald Eckart Rupp Department for Speech Therapy Fachklinik Herzogenaurach In der Reuth 1 D-91074 Herzogenaurach Phone: ++49-9132-831806 Email: neurolinguistik@web.de Robert Setz Dr. Hein GmbH Fürther Straße 212 D-90429 Nürnberg Phone ++49-911-32380-0 Fax ++49-911-32380-19 Email: robert.setz@dr-hein.com