Evaluating the effects of a virtual communication environment for people with aphasia

INTERVENTION: Participants were recruited in 4 cohorts. Two cohorts (1 and 4) were randomly allocated to the immediate group and two (2 and 3) to the waitlist control group. Assignment of the cohorts was determined at the outset of the study, before any recruitment took place. Participants were assigned to the cohorts in order of recruitment; i.e. the first five recruits were assigned to cohort one, the next five to cohort two and so on. This meant that there were four periods of intervention, one for each cohort. Testing occurred at three time points following participant recruitment: week 1, week 7 and week 13. Participants in the immediate group received the intervention between week 2 and week 6, and no further intervention between week 7 and week 13. Participants in the waitlist control group received no intervention between week 1 and week 7; but received the intervention between week 8 and week 12. The intervention consisted of five weeks (25 hours) of language stimulation provided in a bespoke virtual communication environment called Eva Park. Treatment was provided by trained support workers. All participants received the same protocol of intervention, either immediately or after a delay. CONDITION: Aphasia ; Signs and Symptoms ; Aphasia PRIMARY OUTCOME: 1. Functional communication, assessed by the Communication Activities of Daily Living ‐ 2 Test (CADL‐2, Holland et al, 1999); 2. Communicative confidence, assessed by the Communication Confidence Rating Scale for Aphasia (CCRSA, Babbitt & Cherney, 2010); 3. Feelings of social isolation, assessed by the Friendship Scale (Hawthorn, 2006); Measures were administered at three time points post participant recruitment: week 1, week 7 and week 13 SECONDARY OUTCOME: 1. Verbal fluency, using a category naming task; 2. Word retrieval in conversation, using indices from the Profile of Word Errors and Retrieval in Speech (POWERS, Herbert et al, 2013); 3. Word production in narrative, using indices from the Quantitative Production Analysis, Berndt et al, 2000); 4. The Social Network Analysis (Antonucci & Akiyama, 1987) examined whether participants’ social contacts expanded as a result of the intervention; All measures were administered at week 1, week 7 and week 13; ; Participants' views about the intervention were also probed with post intervention interviews; Human Computer Interaction assessments, involving structured observations during intervention, explored their use of Eva Park INCLUSION CRITERIA: 1. Diagnosis of aphasia following a stroke that occurred at least 4 months prior to the study 2. Fluent users of English prior to their stroke 3. Some spoken output (scoring at least 20% correct on the picture naming subtest of the Comprehensive Aphasia Test (Swinburn et al, 2004) 4. Impaired functional communication