Outcomes of computer‐provided treatment for aphasia

Abstract
Background: Computers have become a familiar component of aphasia treatment over the past 20 years. Published research continues to indicate the influence computerised treatment may have on improving language performance of aphasic adults. As a result of the move to develop evidenced‐based clinical guidelines, there is a need to evaluate the research methodology and the level of evidence provided by computerised interventions for aphasia. Aims: The purposes of this paper are to evaluate examples of reports in the computerised treatment for aphasia outcomes research literature by applying precise definitions of the treatment outcome research terminology, placing the examples within the context of the five‐phase treatment outcomes research model, applying a level of evidence scale to rate the evidence provided by the selected examples, and speculating where we are and where we may need to go in demonstrating the influence of computer‐provided treatment on improvement in aphasia. Methods & Procedures: We applied Robey and Schultz's (1998) model for conducting clinical‐outcome research in aphasia and the level of evidence scale developed by the American Academy of Neurology (1994) to the results of computer‐provided aphasia treatment studies. Eight Phase 1 studies, three series of Phase 2 studies, and one Phase 3 study are described as examples. Outcomes & Results: While several Phase 1 and 2 studies imply that computer‐provided treatment is active in the treatment of people with aphasia, evidence to support the efficacy of computerised treatment for adults with aphasia is based on a single Phase 3 study. Additional Phase 3 studies are needed to demonstrate the efficacy of additional treatment software, and Phase 4 and Phase 5 studies are necessary to demonstrate the effectiveness and efficiency of computerised treatment for people with aphasia.