Further development and evaluation of the TALES (technology and literacy engagement after stroke) programme with stroke survivors with chronic aphasia: A mixed-methods case series study.

Abstract

Aims: Having previously reported a case-series study indicating early-stage efficacy, this follow-up evaluation aimed to include treatment modifications, a wider range of people with aphasia in terms of baseline severity and incorporate qualitative feedback as to participants’ perceptions of the treatment. Methods: A mixed-methods case series study was conducted with six participants with varying severities of aphasia who were recruited to take part in an 8-week TALES programme. The intervention involved weekly online group sessions, a weekly one-to-one supported online training session, and independent practice using the Cuespeak therapy software. Outcome measures, including the Western Aphasia Battery-Revised (WAB-R), subtests from the Psycholinguistic Assessments of Language Processing in Aphasia (PALPA), and the Communication Outcomes After Stroke (COAST) scale, were administered pretreatment, post-treatment, and at a 12-week follow-up. Semi-structured interviews were conducted with participants to explore their experiences and perceptions of the programme and these data analyzed utilizing content analysis. Results: Overall, significant improvements were observed in language function, reading and spelling skills, and communication confidence across the cohort, though some challenges to engagement were noted which may have related to greater aphasia severity. Qualitative analysis identified themes of perceived programme value and benefits, including skills application. Conclusions: This study provided a clear Phase 1 signal of efficacy in improving language function and communication confidence for this variant of the TALES programme. Pooled results from two studies illustrate individual variation in outcomes across the mild-to-moderate severity range represented in this sample. Participant perceptions supported this use of telehealth with aphasia therapy.