Yes! It's for those who can't afford an iPad and apps, or can't afford or use the computer software available. I want people with aphasia to be able to practise at home with more than pen and paper, without needing assistance from carers and without spending money. I don't make any profit or take any payment and volunteer the coding and time. You might like to buy me a coffee if it has helped someone you know ☕️.
I am a speech pathologist from Melbourne, Australia working in the CRE in Aphasia Recovery and Rehabilitation based at La Trobe University.
My other interests lie in Parkinson's disease, evidence-based practice and technology in speech pathology.
John E. Pierce
Generalisation of treated items to conversation has been demonstrated in studies(e.g., 1 2 3), but evidence for generalisation of treated items to untreated items is not promising(e.g. 4 5). It is therefore important that words chosen for therapy are highly useful1. The words for this website are chosen in order of frequency to be most functional. This was, of course, limited by what words can accurately be represented by images.
Each wordlist has approximately 40-50 words (see table below). There are some studies suggesting that even people with severe aphasia can benefit from a high number of treatment words6 so I saw no need to limit word lists to less than this.
For English, I used the SUBTLEXUS corpus which contains verbal frequency ratings for words. While it is based on subtitles and is therefore only 'TV' vocabulary, it is likely more representative of real verbal communication than written frequency. There were some items with high frequency (e.g. 'bomb') that I excluded as they are [hopefully] not often used in everyday language. For colour, clothing and numbers I added relevant words myself, and for gardening I retrieved the highest frequency words from the full text of a gardening book. For other languages, words were largely translated from the English words after excluding culturally irrelevant concepts and wordlists were regrouped according to frequency data for each language (See details).
An increasing cueing hierarchy is used. Increasing and decreasing cues appear to be equally efficacious (7 8 9). The cues used (semantic → sentence → letter → phonemic → written) are based loosely on Abel et al. (2005) and general clinical practice.
Vocabulary and audio are specific to three English-speaking countries – Australia (my location), the USA and England. For example, the same image is depicted as ‘lollies’, ‘candy’ or ‘sweets’ depending on the region. The region should default to your location automatically. I am happy to hear from people interested in adapting materials to other English-speaking countries!
Mandarin translation was completed by the speech pathology department at Changi General Hospital.
Frequency data was sourced from Cai & Brysbaert (2010) which is based on subtitles.
The Malay translation was also completed by the Changi General Hospital team. They volunteered many hours to complete this!
Frequency data sourced from https://invokeit.wordpress.com/frequency-word-lists/
Translation completed with a lot of labour by José Grincho, while Speech Pathologist Luísa Rezende, Occupational Therapist Ana Tavares and Professor José Fonseca provided support and advice.
Frequency data is specific to European Portuguese, from www.linguateca.pt
Dr Roxele Ribeiro Lima (aphasia researcher) and Marina Antoniazzi Mancini (speech pathologist) volunteered many hours of time to adapt into Brazilian Portuguese and record audio.
Eventually, I would like to offer the most common twenty or thirty languages (or more!). However, each one takes a lot of time and effort for volunteers and for me – the site uses nearly 600 target words, and each needs checking for cultural relevance, a translation, a sentence and semantic cue, a phonemic cue, a list of homophones and other appropriate responses to the pictures. Then, there are the hundreds of audio recordings and finally translation of the yes/no questions.
If you think you can manage all this work, I would be happy to hear from you. Because of the time involved (and the fact that I work on this website for free), only a few languages are in progress at any one time. I prefer to have a team of translators for each language rather than one person. Each language also needs a speech pathologist who is a native speaker and experienced with aphasia. I am especially interested in Hindi, Arabic and Bengali at present.
No, this is the only task that can’t give feedback on responses. Open source speech recognition is becoming more widely available, but I haven’t had time to code this.
Yes, though they’re not my finest work. There are simple yes/no questions (some reversible, some not), comparative questions (e.g. Is x bigger than y), and passive questions.
Yes, go nuts. The images are all public domain. Friendly reminder though - while there is nothing wrong with practising general language and vocabulary, your patient should ideally have personalised wordlists as well. These should have the most relevant words for their life.
1. Conroy, P., Sage, K., & Ralph, M. L. (2009). Improved vocabulary production after naming therapy in aphasia: can gains in picture naming generalise to connected speech?. International Journal of Language & Communication Disorders, 44(6), 1036-1062.
2. Best, W., Grassly, J., Greenwood, A., Herbert, R., Hickin, J., & Howard, D. (2011). A controlled study of changes in conversation following aphasia therapy for anomia. Disability and rehabilitation, 33(3), 229-242.
3. Carragher, M., Conroy, P., Sage, K., and Wilkinson, R. (2012). Can impairment-focused therapy change the everyday conversations of people with aphasia? A review of the literature and future directions. Aphasiology, 26(7):895-916.
8. Conroy, P., Sage, K., and Lambon Ralph, M. A. (2009). The effects of decreasing and increasing cue therapy on improving naming speed and accuracy for verbs and nouns in aphasia. Aphasiology, 23(6):707-730.