The Self-Instructed Use of the Speech-Generating Device B.A.Bar in the Treatment of Aphasia
A Single Case Study
Within the framework of the International Classification of Functioning, Disability and Health (ICF), methods of augmentative and alternative communication (AAC) have become increasingly important in the rehabilitation of aphasia. In this study we apply B.A.Bar, an electronic speech-generating device, which can be used as communication aid as well as language training aid. B.A.Bar is a barcode-reader that enables the user to record, store and replay spoken words and sentences. In a person with severe chronic agrammatism, spontaneous and self-instructed application of B.A.Bar was trained over a period of 3 weeks. The aim was to assess whether B.A.Bar is mainly used to support or to substitute natural speech.
The treatment was carried out in a pre-post-test design. The aphasic person was asked to describe pictures that show social situations. The obligatory propositions were labelled with barcodes to allow the usage of B.A.Bar. The patient was free to use B.A.Bar and received no instructions concerning possible performance strategies. Frequency and kind of usage of B.A.Bar were measured. Change in linguistic performance was assessed by comparing oral picture descriptions before and after treatment. The frequency of the usage of B.A.Bar increased significantly during the treatment period and B.A.Bar was used predominantly as an augmentative aid to support natural language. The trained items improved significantly from pre- to post-test, while the untrained items showed a trend for generalisation.
Despite severe chronic agrammatism, B.A.Bar was mainly used to facilitate rather than to substitute the aphasic person's speech. Impaired word finding was successfully practised by the use of B.A.Bar.
The results show that a combination of methods of AAC with methods of systematic language stimulation may lead to significant training effects even in chronic aphasia.
