Background: People with aphasia (PWA) who cannot meet their needs through natural speech alone can benefit from using an augmentative and alternative communication (AAC) device as support (Hux, Weissling, & Wallace, 2006). In structured settings, alternative modes of communication can assist individuals with moderate to severe aphasia (Garrett & Kimelman, 2000). Low and high technology are forms of AAC to help individuals with communication and language impairments. Learning how to use an AAC system can be difficult for people with aphasia, yet, with training, AAC can be used to effectively address deficits in spoken language comprehension and expression. Objective: The investigation’s purpose was to determine whether a low-tech (communication board) device compared to a high-tech (Proloquo2Go® text-to-speech voice on iPadTM device was more effective for functional communication for adults over the age of 50, diagnosed with expressive aphasia. Method: Two participants with severe non-fluent aphasia who were immediately post-stroke with lesion to the language-dominant hemisphere received six days of training with a communication board and Proloquo2Go software system on an iPad in an alternating treatment single case research design. The participants were taught 20 pictures on both AAC systems (ten pictures on each low and high-tech device) during speech therapy. The null hypothesis that there would be no difference in patients’ responding using functional words on an AAC device trained was rejected. A difference in performance was observed between the two devices. Results: Criterion score of 75% and/or higher was the goal intended to be met for each AAC system. Outcomes showed an increase in communication using both low and hi-tech AAC devices; however, Participant 1 achieved five points below the established criterion with a communication board, and Participant 2 met the criterion on the last treatment day using Proloquo2Go. Conclusions: Further investigation of AAC treatment during speech therapy rehabilitation is necessary. Future studies should control for participant age and device preference (i.e. low-tech versus high tech), with the current investigation indicating that the younger participant favored the iPad, whereas the older participant preferred the communication board. Both subjects demonstrated improvement although only Participant 2 met criterion.
Keywords: augmentative and alternative communication, AAC, cerebrovascular disease, high-tech, low-tech
