Speech Therapy Software Proven Effective

Research shows that speech & language treatment software is effective.

When creating speech therapy software we always ask How would a speech pathologist do it? Then we look at whether this accepted by the profession as the right way to do it and if there is evidence showing that treatment is effective. We then look at whether we can emulate what a speech therapist would do. Sometimes we can, such as with the Rosenbek Apraxia Hierarchy. In addition, there is research showing speech therapy software is effective. Our software is based on that research. There is also research showing that Bungalow programs, in particular are effective.

Research on Specific Bungalow products

MoreSpeech.com, our new webapp is used in a recent research study.

Improvement demonstrates the effectiveness of intensive at-home computer based applications like MoreSpeech

Hibbs, V. et al. (2015), "Computer
based aphasia treatment: A case study.” Poster session presented at ASHA
Convention (Denver)

Clinical Research on SentenceShaper shows improved speech

Below is a brief summary of research studies about SentenceShaper as a language therapy tool, conducted at two sites: the University of Maryland School of Medicine in Baltimore, MD, and Moss Rehabilitation Research Institute in Philadelphia, PA.

Studies at the University of Maryland School of Medicine

First four utterances BEFORE treatment	First four utterances AFTER treatment
frog in the bottle	the boy and the frog is having a good time
frog in the top	the frog is getting out of the jar
frog in the window	the boy and the dog are sleeping
frog gone	the dog and the boy are aware the frog is gone

Before After (treatment) Results

Studies at Moss Rehabilitation Research Institute

The first study to show treatment effects – that is, the positive impact of SentenceShaper use on spontaneous, unaided speech -- was reported in Linebarger, Schwartz, & Kohn (2001). Two people with non-fluent aphasia participated in an extended treatment program in which the system was used alternately (but not concurrently) with another language therapy program. As indicated in Linebarger et al. (2001: Tables 7 and 9), the first 15 hours of home use of SentenceShaper (after several hours of training in the lab) had a marked impact on the quality of these participants’ unaided retellings of silent videos viewed before and after (but never during) training. For example, both participants showed changes in Median Length of Utterance; one participant increased from a median 2 words per utterance pre-training to 4 words per utterance post-training, and the other participant increased from a median 3 words per utterance pre-training to 5 words post-training.

These gains are particularly encouraging because they were achieved through largely independent home use of the system. After learning how to operate the program effectively, participants were provided with computers in their homes and asked to use the system to create narratives – describing life events, expressing opinions, or retelling movies and television shows.

In a subsequent project, SentenceShaper was used in the context of aphasia groups. In this project, participants met weekly in supported conversation groups and also underwent weekly training on the system, which was used for two “offline” functional purposes: email (productions on the system were emailed to friends and fellow group members as sound file attachments) and a group web site (photographs and other images were accompanied by spoken comments created on the system). In the second half of the study, participants were instructed to engage in regular homework constructing narratives on SentenceShaper. For six of the 10 participants in this phase of the study, treatment gains were observed (Schwartz, Linebarger, Brooks, & Bartlett, 2007; some results reported in Linebarger & Schwartz, 2005:Table 1) across a variety of unpracticed narrative tasks, ranging from Cinderella story retellings to the less demanding task of describing wordless picture books; and across a number of different structural measures.

You can download a summary of the research on SentenceShaper.
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Citations

As reported in Linebarger, McCall, & Berndt (2004), Linebarger, McCall, Virata, & Berndt (2007), and McCall, Virata, Linebarger, & Berndt (in press)

More information about these SentenceShaper research studies and the scientists and clinicians involved may be found on the grants page; full references to articles cited below are on the publications page. This page is derived from our Research Report, which is in PDF format; click here to view the entire report, or right-click the link and then select "Save target as..." to download it to your computer. You may also wish to read the page describing research on the effectiveness of SentenceShaper as a communication aid.

Research behind Bungalow's Software

Computers can be powerful clinical tools.",
from clinical study by Dr. Katz & Wertz. The efficacy of computer-provided reading treatment for chronic aphasic adults. [J Speech Lang Hear Res. 1997 Jun;40(3):493-507. ]

Specific measures of language function can be broadly, positively, and significantly influenced by computer-based language therapy in chronic aphasia",
From a Study by Aftonomos LB, Steele RD, Wertz RT, Promoting recovery in chronic aphasia with an interactive technology, Arch Phys Med Rehabil. 1997 Aug;78(8):841-6. ]

Jaqueline Hinkley a renowned speech & language researcher (Associate Professor, Communication Sciences & Disorders, University of South Florida; noted in a National Aphasia Association report:
Certain kinds of computer practice can help to maintain or improve language skills. However, the computer practice needs to be appropriate to the skills and need areas of the person with aphasia.

Bungalow has programs focusing on all the major skill areas and at hundreds of different difficulty levels. (Direction Following +Outloud, alone, has over 200 difficulty levels and 500,000 exercises and works on auditory comprehension, reading comprehension, sequencing and working memory)

While no computerized therapy can (or should) replace a speech therapist, therapy software, such as the Aphasia Tutor series, can be very effective, as demonstrated by numerous clinical research.

Researchers agree: Practice and Repetition helps patients. Technology can help.

While there's little evidence indicating an advantage of one aphasia treatment over another, researchers agree that practice and repetition benefit patients. And one of the most cost-effective ways patients can get practice and repetition is through technology, " stated Leora Cherney, PhD, CCC-SLP, BC-ANCDS, director of the Center for Aphasia Research at the Rehabilitation Institute of Chicago in Illinois."
Advance Magazine for Speech-Language Pathologists & Audiologists, Vol. 18 •Issue 14 • Page 6 Aphasia Treatment

Ground-breaking study shows Aphasia Software effectiveness

graph.gif (5393 bytes) While developing our first few programs, we discovered the research below and contacted one of the authors, Dr. Katz, who provided input on our programs. Dr. Katz is now our Research Consultant and helped design our new web-based speech therapy software: MoreSpeech.com

This peer-reviewed research study measured the patients' AQ (Aphasia Quotient) using the WAB (Western Aphasia Battery).

Dr. Richard Katz, a well known researcher in the Speech/Language Pathology field, published this detailed study confirming the effectiveness (efficacy) of computer software for treating language-based deficits, specifically aphasia. He graphed the outcomes data and made several conclusions in favor of computerized therapy.

He compared the following scenarios (graphed above):

Computer Reading Treatment - Each patient received 3 hours per week of therapy (for 26 weeks) using software specifically designed for language therapy (for a total of 78 hours of computer therapy).
Generic Computer Simulation software (such as video games, etc.) not designed specifically for language therapy.
No Treatment - The patient received no treatment

Conclusions of the Study

Computer reading treatment requires only minimal assistance from a clinician.
Improvement on the computer reading tasks generalizes to improvement in language performance
Improvement results from the language content of the software, not simply stimulation provided by a computer
The computer reading treatment for aphasia which they employed is efficacious.

Bungalow's Software incorporates the above research

Features the study's author thought were critical to the success, which we incorporated into the Bungalow PC programs and our new webapp

	Bungalow's Treatment Software
Critical Feature	Classic PC Software	MoreSpeech webapp
Designed for independence Designed for patient to use independently without requiring a clinician to be present to provide feedback and to adjust the program.
Patients control how long they work Patients can work for as little or as long as they like. Patients can quit the program whenever they wish.
Difficulty can be adjusted to patient's skill level You can change the number of choices (in multiple choice) and the complexity and vocabulary level of the stimulus.
Simple screens to minimize distraction
Response format is consistent across the program (Matching, Filling, etc.)
Immediate Feedback Shows patient their performance (score) after each exercise and lesson.
Visual feedback on performance (accuracy)
Program increases or decreases difficulty level automatically when patient reaches criteria, or is having difficulty.	Patient chooses level
Program remembers the final Lesson from the last session so patient can start from that point.

* Classic PC Software: This comparison applies to: Understanding Questions (which is based Understanding Stories (another program Dr. Katz did research on ) , Aphasia Tutor 1 thru 4, Synonyms..., and Understanding Questions, Sights'n Sounds 1 and 2, Numbers and Sounds and Direction Following ( as well as the +Outloud versions where applicable)

Clinical evidence on specific programs

Research Basis for our new MoreSpeech.com Web App

The treatment used in this app incorporates the stimulation/facilitation model. Duffy & Coelho's (2001) provides an excellent description and analysis of Schuell's (1953, 1964, 1974) original theory and the subsequent work of researchers who support the concepts that

Sensory stimulation influences brain activity;
Repetition of sensory stimulation is needed for acquisition, organization, and retrieval of patterns of behavior;
The auditory modality is central to acquisition and maintenance of language;
The auditory modality is severely compromised for most aphasic people; and
If aphasia is defined as a multimodal language impairment, then intense stimulation treatment should be directed through the auditory modality because of its essential role in language processing.

All lessons use an easy-to-understand match-to-sample format, which remains virtually unchanged throughout the app so as to minimize task and response requirements, allowing the user to focus solely on the content of each lesson.

Apraxia Skill area implements the Rosenbek Hiearchy

The Motor Speech/Apraxia of Speech lesson block is adapted for the app from the 8-step treatment continuum described by Rosenbek and his colleagues in their classic Rosenbek article. Visual modeling of articulatory posture and movement (referred to in their article as v1) is provided in the app by videos detailing closeups of the speaker's lips, tongue and jaw. Auditory (referred to as a) and printed text (referred to as v2) are also presented during presentation of the appropriate steps.

REFERENCES

Coelho, C.A., Sinotte, M. P. & Duffy, J. R. Duffy (2001). Schuell's Stimulation Approach to Rehabilitation (403-449). In Chapey, R. (Ed.), Language Intervention Strategies in Aphasia and Related Neurogenic Communication Disorders (Fifth Edition). Philadelphia: Wolters Kluwer/Lippincott Willians & Wilkins.

Rosenbek, J. C., Lemme, M. L., Ahern, M. B., Harris, E. H., & Wertz, R. T. (1973). A treatment for apraxia of speech in adults. Journal of Speech and Hearing Disorders, 38, 462–472.

Schuell, H. (1953). Auditory impairment in aphasia: Significance and retraining techniques. Journal of Speech and Hearing Disorders, 18, 14-21.

Schuell, H., Jenkins, J. J., & Jiménez-Pabón, E. (1964). Aphasia In Adults. New York: Harper & Row.

Schuell, H. (1974). Aphasia theory and therapy: Selected lectures and papers of Hildred Schuell (Sies, L. F., Ed.). Baltimore: University Park Press.