- Richard D. Steele. "AAC use and communicative improvements in chronic aphasia: Evidence comparing global with severe Broca's aphasia." AAC Perspectives (ASHA SID-12), vol. 15, no. 4, pp. 18-22, 2006. Click to Read an Abstract of this Article and Access the Full Text
- Richard D. Steele. "Benefits of advanced AAC technology uses to adults with acquired aphasia." AAC Perspectives (ASHA SID-12), vol. 13, no. 4, pp. 3-7, 2004.Click to Read an Abstract of this Article and Access the Full Text
- Richard D. Steele, Lefkos B. Aftonomos, Marilyn W. Munk. "Evaluation and treatment of aphasia among the elderly with stroke." Topics in Geriatric Rehabilitation, vol. 19, no. 2, pp. 98-108, 2003. Click to Read an Abstract of this Article and Access the Full Text
- Lefkos B. Aftonomos, Richard D. Steele, James S. Appelbaum, Veronica M. Harris. "Relationships between impairment-level assessments and functional-level assessments in aphasia: Findings from LCC treatment programmes." Aphasiology, vol. 15, no. 10/11, pp. 951-64, 2001. Click to Read an Abstract of this Article and Access the Full Text
- Lefkos B. Aftonomos, James S. Appelbaum, Richard D. Steele. "Improving outcomes for persons with aphasia in advanced community-based treatment programs." Stroke, vol. 30, no. 7, pp. 1370-79, 1999. Click to Read an Abstract of this Article and Access the Full Text
- Lefkos B. Aftonomos, Richard D. Steele, Robert T. Wertz. "Promoting recovery in chronic aphasia with an interactive technology." Archives of Physical Medicine and Rehabilitation, vol. 78, no. 8, pp. 841-46, 1997. Click to Read an Abstract of this Article and Access the Full Text
- Michael Weinrich, D. Weber, K. Thomas, L. Thornburn. "Training on an iconic communication system for severe aphasia can improve natural language production." Aphasiology, vol. 9, pp. 343-64, 1995. Click to Read an Abstract of this Article and Access the Full Text
- Richard D. Steele, Maria K. Kleczewska, Gloria S. Carlson, Michael Weinrich. "Computers in the rehabilitation of chronic, severe aphasia: C-VIC 2.0 cross-modal studies." Aphasiology, vol. 6, no. 2, pp. 185-94, 1992. Click to Read an Abstract of this Article and Access the Full Text
- Gunnar Fagerberg, Adele S. Raade, "Icon access times in computer-based visual communication system for global aphasics," AAC: Augmentative and Alternative Communication, vol. 8, no. 2, p. 131, June, 1992. Click to Read an Abstract of this Article and Access the Full Text
- Ann Gaddie-Cariola, Kevin P. Kearns, Lori A. DeFoorHill. "Response elaboration training: treatment effects using a visual communication system." ASHA Journal, vol. 32, no. 10, p. 107, October 1990. Click to Read an Abstract of this Article and Access the Full Text
- Michael Weinrich, Richard D. Steele, Maria K. Kleczewska, Gloria S. Carlson, Errol Baker, Robert T. Wertz. "Representation of 'verbs' in a computerized visual communication system." Aphasiology, vol. 3, no. 6, pp. 501-12, 1989. Click to Read an Abstract of this Article and Access the Full Text
- Richard D. Steele, Michael Weinrich, Robert T. Wertz, Gloria S. Carlson, Maria K.Kleczewska. "Computer-based visual communication in aphasia." Neuropsychologia, vol. 27, no. 4, pp. 409-26, 1989. Click to Read an Abstract of this Article and Access the Full Text
- Michael Weinrich, Richard D. Steele, Gloria S. Carlson, Maria K. Kleczewska, Robert T. Wertz, Errol Baker. "Processing of visual syntax in a globally aphasic patient." Brain and Language, vol. 36, pp. 391-405, 1989. Click to Read an Abstract of this Article and Access the Full Text
- Michael Weinrich, Richard D.Steele. "Prospects for a cognitive orthosis." Advances in Neurology, vol. 47, Functional Recovery in Neurological Disease, Stephen G. Waxman, editor, New York: Raven Press, pp. 583-600, 1988. Click to Read an Abstract of this Article and Access the Full Text
- Richard D. Steele, Michael Weinrich, Gloria S. Carlson, Maria K. Kleczewska, Robert T.Wertz. "Evaluating performance of severely aphasic patients on a computer-aided visual communication system." Clinical Aphasiology Conference, 1987, Minneapolis: BRK Publishers, 1987. Click to Read an Abstract of this Article and Access the Full Text
- Alexander R. Luria. "Traumatic Aphasia: Its Syndromes, Psychology and Treatment." The Hague: Mouton, 1970 (translated from the Russian, published Moscow: Medgiz, 1947). Click to Read an Abstract of this Article and Access the Full Text
1. Richard D. Steele. "AAC use and communicative improvements in chronic aphasia: Evidence comparing global with severe Broca's aphasia." AAC Perspectives (ASHA SID-12), vol. 15, no. 4, pp. 18-22, 2006.
Abstract:
Using outcome data from valid, reliable assessment instruments, we quantitatively compare and contrast improvements in specific capabilities in persons with global aphasia and severe Broca's aphasia. Data analysis reveals that within both aphasia diagnostic categories, all changes following Lingraphica use were positive (i.e., improvements), and the large majority (80%) of those improvements were statistically significant at the P= .05 level. Inter-group comparisons show that persons with Broca's aphasia scored higher than those with global aphasia in the overwhelming majority of both impairment level assessments (90%) and functional communication assessments (93.8%). In contrast, the groups diverged in their improvement patterns at the different assessment levels.
Full text of article is available for purchase on the "Back Issues of ASHA's Serial Publications" page on the ASHA website.
www.asha.org/about/publications/backissues.htm
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2. Richard D. Steele. "Benefits of advanced AAC technology uses to adults with acquired aphasia." AAC Perspectives (ASHA SID-12), vol. 13, no. 4, pp. 3-7, 2004.
Abstract:
This paper discusses the three distinct types of benefits accruing to individuals with acquired aphasia from practice on, and use of, advanced communication aids such as Speech Generating Devices (SGDs). Specifically, advanced SGDs can: (1) speak in place of the user (i.e., 'replacement of speech') in those cases where speech is required or preferable, yet not available; (2) prompt, support, and extend speech communication in instances where unaided speech production might be inadequate (i.e., 'scaffolding of speech'); and (3) provide therapy and practice opportunities that can help users significantly improve their natural speech communication over time (i.e., 'restoration of speech'). In discussing each benefit, we discuss reasons why each might be important independently and in conjunction with the others, and provide selected concrete examples, drawing on extensive experience dealing with aphasic users specifically of the Lingraphica Speech Generating Device.
Full text of article is available for purchase on the "Back Issues of ASHA's Serial Publications" page on the ASHA website.
www.asha.org/about/publications/backissues.htm
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3. Richard D. Steele, Lefkos B. Aftonomos, Marilyn W. Munk. "Evaluation and treatment of aphasia among the elderly with stroke." Topics in Geriatric Rehabilitation, vol. 19, no. 2, pp. 98-108, 2003.
Abstract:
While aphasia is not per se a geriatric disorder, risk factors for aphasia increase with age, and effective treatments for older individuals must be sensitive to age related needs and circumstances. This article first reviews evaluation tools, with their assessment domains and ways of using them, then moves to treatment approaches, with an eye in particular to describing experiences using advanced treatment programs with older aphasic patients, and concludes with discussions and examples of outcomes analyses that contribute to our understanding of improvements following treatment in older patients.
Full text of article is available for purchase on the Topics in Geriatric Rehabilitation website.
pt.wkhealth.com/pt/re/tgr/toc.00013614-200304000 00000.htm;jsessionid=Gp2QGHtwkjtXdnRn9GSbVTfz6CFFnjTDt1fjf8fSwhRGfGjGkVXJ!1646970248!181195628!8091!-1
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4. Lefkos B. Aftonomos, Richard D. Steele, James S. Appelbaum, Veronica M. Harris. "Relationships between impairment-level assessments and functional-level assessments in aphasia: Findings from LCC treatment programmes." Aphasiology, vol. 15, no. 10/11, pp. 951-64, 2001.
Abstract:
We report an outcome study of persons with aphasia participating in community-based treatment programmes. Patients (n = 50) were assessed before and after treatment using: (1) a standardised test of impairment , the Western Aphasia Battery , administered by treating clinicians; and (2) a standardised assessment of disability (functional communication), the Communicative Effectiveness Index , rated by family members. Pretreatment and post-treatment means are calculated and compared, with matched t -tests utilised to probe statistical significance of improvements after treatment. We then calculate impairment- and functional-level means by aphasia diagnostic categories, assigning rank orders and calculating Spearman rank-order correlations. Data analysis shows that, before treatment, patients spanned a wide range of times after onset, aphasia diagnostic types, and severity levels at start of care. Following treatment, means of the 50 patients improved significantly on every measure administered at both the impairment and the functional levels. Absolute improvements ranged from 6.5% to 26.2%, with statistical significance ranging from P < .01 to P << .0001. Before treatment, there is strong positive correlation ( = +.90) between impairment-level and functional-level assessment means by diagnostic categories; after treatment, improvement means by these diagnostic categories show moderate negative correlation ( =-.60). Further examination shows that post-treatment improvements are found to be best viewed as functions of same-type severity levels pretreatment, with patterns of improvement at the impairment and functional levels diverging distinctly.
Full text of article is available for purchase on the Aphasiology website.
www.informaworld.com/smpp/content~content=a729249363~db=jour
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5. Lefkos B. Aftonomos, James S. Appelbaum, Richard D. Steele. "Improving outcomes for persons with aphasia in advanced community-based treatment programs." Stroke, vol. 30, no. 7, pp. 1370-79, 1999.
Abstract:
Background and Purpose-Studies have yet to document that community-based aphasia treatment programs routinely produce results comparable or superior to published research protocols. We explore this issue here in an outcome study of individuals with aphasia enrolled in 2 community-based, comparably managed and equipped therapy programs, which use a specially designed computer-based tool that is employed therapeutically in adherence to an extensive, detailed, and formally trained patient care algorithm.
Methods-Patients (n=60) were assessed before and after treatment with standardized instruments at both the impairment and the disability levels. Pretreatment and posttreatment means were calculated and compared, with statistical significance of differences established with the use of 1-tailed matched t tests. One-way ANOVAs were used to analyze the comparability of patient performance changes among various subgroups, e.g., patients in acute versus chronic stages of aphasia, patients by aphasia diagnostic type at start of care, patients by severity level at start of care, and patients by treatment location.
Results-Analysis shows that patients spanned a wide range of aphasia diagnostic types, impairment severity levels at start of care, and times after onset. Patients' mean performance scores improved significantly in response to treatment in all measures assessed at both the impairment level and the functional communication level. Mean overall improvements ranged from 6.6% to 19.8%, with statistical significance ranging from P=0.0006 to P<0.0001. ANOVAs revealed no significant differences between improvements in patients in the acute versus chronic stages of aphasia, between those at different impairment severity levels at start of care, between those treated at different locations, or, at the functional level, between those with different diagnostic types of aphasia at start of care.
Conclusions--Measures of both language impairment and functional communication can be broadly, positively, and significantly influenced by therapy services that are delivered to persons with aphasia in these community-based programs. The significant improvements are shown to be available to individuals with chronic as well as acute aphasia and independent of diagnostic type of aphasia, impairment severity at start of care, or geographic program location.
Full text of article is available for viewing on the Stroke website.
stroke.ahajournals.org/cgi/content/full/30/7/1370
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6. Lefkos B. Aftonomos, Richard D. Steele, Robert T. Wertz. "Promoting recovery in chronic aphasia with an interactive technology." Archives of Physical Medicine and Rehabilitation, vol. 78, no. 8, pp. 841-46, 1997.
Abstract:
Objective: To assess chronic aphasic patients' responses to resumption of therapy using an innovative, computer-based treatment system.
Design: Patients were assessed pretreatment and posttreatment using standardized assessment tools. Pretreatment and posttreatment performance score means were computed and compared, with statistical significance of the differences established using a one-tailed, matched t test.
Setting: The work was conducted at (1) a Veterans Affairs medical center participating in treatment research and (2) a regional aphasia center delivering therapy services for reimbursement.
Patients: Chronic aphasic patients (n = 23) from 6 months to more than 15 years postonset were enrolled in the study. They included a wide range of types and seventies of aphasia, and all had received traditional speech-language therapy services earlier.
Interventions: All patients were treated in 1-hour clinical sessions by speech-language pathologists using the designated computer-based treatment system. All but one of the patients had access to the computer-based treatment system at home for practice between clinical therapy sessions.
Main Outcome Measures: The outcome measures used were (1) the Porch Index of Communicative Ability (PICA), (2) the Boston Naming Test (BNT), (3) the Western Aphasia Battery (WAB), and (4) the Boston Diagnostic Aphasia Examination (BDAE).
Results: The majority of patients improved significantly in multiple modalities as assessed by these instruments.
Conclusions: Specific measures of language function can be broadly, positively, and significantly influenced by computer-based language therapy in chronic aphasia.
Full-text PDF of article is available for purchase on the Archives of Physical Medicine and Rehabilitation website.
www.archives-pmr.org/issues
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7. Michael Weinrich, D. Weber, K. Thomas, L. Thornburn. "Training on an iconic communication system for severe aphasia can improve natural language production." Aphasiology, vol. 9, pp. 343-64, 1995.
Abstract:
Two patients with chronic Broca's aphasia were trained in the production of locative prepositional phrases and S-V-O sentences on C-VIC, an alternative communication system. After training, their verbal production of these constructions improved markedly. The implications of these results for shared processes between natural language production and C-VIC production are discussed.
Full text of article is available for purchase on the Aphasiology website.
www.informaworld.com/smpp/content~content=a776019854~db=jour
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8. Richard D. Steele, Maria K. Kleczewska, Gloria S. Carlson, Michael Weinrich. "Computers in the rehabilitation of chronic, severe aphasia: C-VIC 2.0 cross-modal studies." Aphasiology, vol. 6, no. 2, pp. 185-94, 1992.
Abstract:
We describe the C-VIC 2.0 system for use by severe, chronic aphasic patients, and give an account of its use in helping a globally aphasic patient in a cooking-related task. In this controlled study, we conducted cross-modal comparisons of acontextual execution of single steps, delivered in C-VIC, spoken, and written modalities. We report results of the experiment, and discuss the findings along with some of their possible implications.
Full text of article is available for purchase on the Aphasiology website.
www.informaworld.com/smpp/content~content=a778325088~db=jour
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9. Gunnar Fagerberg, Adele S. Raade, "Icon access times in computer-based visual communication system for global aphasics," AAC: Augmentative and Alternative Communication, vol. 8, no. 2, p. 131, June, 1992.
Abstract:
Severely expressively impaired aphasic individuals with spared visual skills can communicate using pictures or icons as a form of augmentative and alternative communication (AAC). In recent research projects, computer technology has been used to store, retrieve, and present the pictures and icons. The objective of this study was to determine the effect of training on the access times of the icons used in the Lingraphica communication device. There were eight right-handed adult subjects who had experienced unilateral, left-hemisphere cerebrovascular accidents and were at least 12 months post onset. A multiple baseline design across behaviors was used to assess treatment effects. Anticipated results indicated that for some subjects, icon access times did decrease following training and that there was a generalization effect to non-trained icons. (Abstract of technical panel presentation).
Full text of article is available for purchase on the "Back Issues of ASHA's Serial Publications" page on the ASHA website.
www.asha.org/about/membership-certification/divs/backissues.htm
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10. Ann Gaddie-Cariola, Kevin P. Kearns, Lori A. DeFoorHill. "Response elaboration training: treatment effects using a visual communication system." ASHA Journal, vol. 32, no. 10, p. 107, October 1990.
Abstract:
This study assessed the effectiveness and generality of Response Elaboration Training (RET) using a computer aided visual communication system as the response modality. Treatment effects were investigated using a multiple baseline design. Results suggested that RET was an effective means of increasing the amount of visual and verbal information produced by a nonfluent aphasic patient. Discussion will focus on generalization issues as well as on the possible facilitatory effects of visual communication on verbal responding. (Abstract of technical panel presentation).
This article is not available online. Contact Lingraphicare to request a reprint.
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11. Michael Weinrich, Richard D. Steele, Maria K. Kleczewska, Gloria S. Carlson, Errol Baker, Robert T. Wertz. "Representation of 'verbs' in a computerized visual communication system." Aphasiology, vol. 3, no. 6, pp. 501-12, 1989.
Abstract:
Abstract versus concrete representations for verbs in a visual, non-verbal communication system for severe aphasics were investigated. Two patients with comparable agrammatic aphasias were studied in paired counter-balanced experiments. Concrete symbols were learned more quickly and generalized slightly faster to apply to new objects. However, neither abstract nor concrete symbols were generalized very well to novel situations. The implications for the organization of semantic information in aphasic patients and for future research on visual communication systems are discussed.
Full text of article is available for purchase on the Aphasiology website.
www.informaworld.com/smpp/content~content=a778332840~db=jour
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12. Richard D. Steele, Michael Weinrich, Robert T. Wertz, Gloria S. Carlson, Maria K.Kleczewska. "Computer-based visual communication in aphasia." Neuropsychologia, vol. 27, no. 4, pp. 409-26, 1989.
Abstract:
The authors describe their recently developed Computer-aided VIsual Communication (C-VIC) system, and report results of single-subject experimental designs probing its use with five chronic, severely impaired aphasic individuals. Studies replicate earlier results obtained with a non- computerized system, demonstrate patient competence with the computer implementation, extend the system's utility, and identify promising areas of application. Results of the single-subject experimental designs clarify patients' learning, generalization, and retention patterns, and highlight areas of performance difficulties. Future directions for the project are indicated.
Full text of article is available for purchase on the Neuropsychologia website.
www.sciencedirect.com/science
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13. Michael Weinrich, Richard D. Steele, Gloria S. Carlson, Maria K. Kleczewska, Robert T. Wertz, Errol Baker. "Processing of visual syntax in a globally aphasic patient." Brain and Language, vol. 36, pp. 391-405, 1989.
Abstract:
A globally aphasic patient was trained on a computerized visual communication system. His ability to comprehend reversible locative prepositional phrases after training was studied and compared with the performance of Broca's aphasics on a similar task. This patient's ability to generalize symbols for actions was also investigated. The results demonstrate our patient's capacity to master a formal visual syntax in the absence of natural language and illustrate how this capacity may be used successfully in a visual communication system. A problem in generalizing symbols for actions is demonstrated, suggesting that certain heuristic and cueing capabilities in the approach may be helpful.
Full text of article is available for purchase on the Brain and Language website.
www.sciencedirect.com/science
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14. Michael Weinrich, Richard D.Steele. "Prospects for a cognitive orthosis." Advances in Neurology, vol. 47, Functional Recovery in Neurological Disease, Stephen G. Waxman, editor, New York: Raven Press, pp. 583-600, 1988.
Description of article is available for purchase on the Advances in Neurology website.
www.medscape.com/medline/abstract/3278531
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15. Richard D. Steele, Michael Weinrich, Gloria S. Carlson, Maria K. Kleczewska, Robert T.Wertz. "Evaluating performance of severely aphasic patients on a computer-aided visual communication system." Clinical Aphasiology Conference, 1987, Minneapolis: BRK Publishers, 1987.
Full-text PDF of article is available on the Clinical Aphasiology website.
aphasiology.pitt.edu/archive/00000919/
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16. Alexander R. Luria. "Traumatic Aphasia: Its Syndromes, Psychology and Treatment." The Hague: Mouton, 1970 (translated from the Russian, published Moscow: Medgiz, 1947).
Book is available for purchase on Amazon.
www.amazon.com/Traumatic-Aphasia-Syndromes-Psychology-Treatment/dp/902790717X/ref=sr_1_2/002-3325209-8592033?ie=UTF8&s=books&qid=1189006108&sr=8-2
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