The effects of aphasia severity on the ability to assess language disorders via telerehabilitation

Background: Telerehabilitation is the remote delivery of rehabilitation services via information technology and telecommunication systems. There have been a number of recent studies that have used video conferencing to assess language skills in people with aphasia. These studies have highlighted the possibility that severity of impairment and aetiology may have an effect on the administration of telerehabilitation language assessment protocols. Furthermore, anecdotal accounts of difficulties in administering language assessment via telerehabilitation also demonstrate the need for research into the effects of severity of aphasia. It is important that the effects of severity of aphasia are determined as part of the overall evidence base for telerehabilitation language assessment protocols. Aims: To investigate the influence of severity of aphasia on the ability to assess acquired aphasia via telerehabilitation methods. Methods Procedures: A total of 32 participants with an acquired aphasia were assessed simultaneously via telerehabilitation and face-to-face methods on the Boston Diagnostic Aphasia Examination 3rd Edition Short Form (BDAE-3) and the Boston Naming Test (BNT) (2nd Edition Short Form). A custom-built telerehabilitation system developed at the University of Queensland enabled real-time telerehabilitation assessment over a 128kbit/s Internet connection. Participants were grouped according to their severity level. Data analysis was conducted on the differences in scores from the two assessors. Outcomes Results: Results revealed that severity of aphasia did not greatly influence the accuracy of the telerehabilitation assessment for the majority of the BDAE-3 clusters. However, severity of aphasia appeared to affect the ability to assess naming and paraphasia via telerehabilitation methods. Post-hoc analysis revealed that the scores given in the face-to-face and telerehabilitation environments were comparable within each severity level. Conclusions: Results suggest that severity of aphasia may influence the ability to assess some language parameters via telerehabilitation. Further research should use larger sample sizes to confirm these results and to refine the telerehabilitation technology to enable these parameters to be adequately assessed. Additionally, clinician satisfaction with telerehabilitation assessment should be qualitatively researched so as to widen clinician acceptance of this method.