Dysgraphia therapy using iPad App with adults who have aphasia

Background: The use of electronic, computerised tablets specifically the iPad by people with aphasia is an exciting new route to explore (Van de Sandt-Koenderman, 2004). A recent survey conducted by the PSHA, (2012) found that a majority of clinicians are currently using iPads with their clients including people with aphasia (Atticks, 2012). In light of this, ever growing phenomena, it is essential that more research is carried out. In this study an iPad application using a genetic algorithm was explored as a therapy tool to improve writing skills. Aims: The main objectives were to consider the feasibility of using this iPad app to deliver therapy and to investigate if the app improves writing skills of adults with aphasia at single word level. Methods and Procedures: The design of the research project was a mixed methods approach. The Comprehensive Aphasia Test (CAT) was also used to assess receptive and expressive language skills. A dysgraphia assessment was designed to assess for successful word production. Baselines were recorded pre and post therapy. Pre and post qualitative interviews were conducted and analysed. The app uses a cueing hierarchy to help the participant access the target word and then type this using the iPad keyboard. Five adult participants with aphasia and dysgraphia impairment were recruited for the research project and three completed the therapy course. Outcomes and Results: The quantitative data revealed no significant improvements in the participants writing skills (P = 1.000). One particpant diagnosed with phonological dysgraphia showed an increase on number of target words achieved. However, those with a peripheral diagnosis of dygraphia showed no improvement on written word output. This indicates that the app may be more suitable for those with a less severe diagnosis. Qualitative interviews revealed a number of positive outcomes from using the application; common themes included motivation and ease of use, which are a positive finding for this research. Conclusion: Therapy delivered through the use of an iPad app is motivating for the participant. The app was well designed and easy to use. Further research into the use of iPad and apps to deliver dysgraphia therapy is clearly indicated