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Cantonese Apps for Speech Therapy-Adult (CASTA): Development and application to native Cantonese speakers in Hong Kong with stroke-induced aphasia and motor-speech disorders

Anthony Pak Hin Kong1*, Diana Wai Lam Ho2, Iris Hang Ching Lam2, Olivia Ho Yi Yeung2, Jenny Lau3, Christy Ting3 and Kwok-Wai Tao4
  • 1 University of Central Florida, Department of Communication Sciences and Disorders, United States
  • 2 The Hong Kong Polytechnic University, Department of Chinese and Bilingual Studies, Hong Kong, SAR China
  • 3 The Hong Kong Society for Rehabilitation, Hong Kong, SAR China
  • 4 Hong Kong Productivity Council, Hong Kong, SAR China

Background Stroke-induced communication disorders usually require long-term rehabilitation (Pedersen, Vinter, & Olsen, 2004) but relevant speech therapy services in Hong Kong have been inadequate (Kong, 2011). Blended-learning intervention has gained attention for stroke management by combining face‐to-face and technology‐mediated instructional forms and practices (Bersin, 2004). In the past decade, using apps to conduct language therapy has grown in the field of communication sciences and disorders (Atticks, 2012; Holland, Weinberg, & Dittelman, 2012), with relevant investigations reporting their effectiveness (Des Roches et al., 2015; Kurland, Wilkins, & Stokes, 2014). This investigation is part of a pilot study titled “Evolution of Community Alliance of Rehabilitation to Empower Persons with Chronic Illness (e2care),” funded by Hong Kong Jockey Club Charities Trust. A main project deliverable is the development of apps “Cantonese Apps for Speech Therapy-Adult” (CASTA; https://play.google.com/store/apps/details?id=aphasia.e2care.hk.aphasia), designed in collaboration with Hong Kong Productivity Council, and setup of a databank of CASTA training materials that clinicians can assign to apps users for self-practice. CASTA exercises include those addressing Chinese aphasia and motor speech disorders. The contents were designed and created with specific considerations of the features of Chinese culture and linguistic, with suitable items tapping various levels of performance (from phonemic, single-word, phrase, sentence, to post-sentential levels). CASTA also contained instructions, cueing, and models that were suitable for Cantonese speakers to facilitate clinician-mediated training and self-practice. Aims This study aims to (1) introduce the theoretical background behind the design and development of CASTA, (2) report and illustrate how blended-learning using CASTA was effective in enhancing communication performance for native Cantonese speakers with neurogenic communication disorders, and (3) provide a qualitative examination of factors on the part of CASTA, its users, and service providers that would lead to more favorable treatment outcomes. Method Since 2015, CASTA has been applied to 58 Cantonese-speaking subjects with acquired communication disorders. To estimate treatment outcome in a subset of chronic clients, assessments were administered within six weeks prior to the start and immediately after the completion of treatment. Each subject received ten weekly face-to-face treatment sessions (each consisted of one-hour individual therapy, with optional one-hour group therapy) in which CASTA exercises deemed to address each subject’s impaired communication skills was conducted. Moreover, daily home practice exercise using individually-assigned CASTA exercises were involved. Weekly Output data logs were reviewed to summarize subjects’ home practice involving CASTA. Results Most participants with aphasia showed a higher degree of improvement in Cantonese version of Western Aphasia Battery (Yiu, 1992) and Functional Assessment of Communication Skills (as compared to ratings of Apraxia Battery; Dabul, 2000 and/or Frenchay Dysarthria Assessment; Enderby & Palmer, 2008), although changes varied individually depending on factors such as impairment severity. Users’ responses to the blended training, i.e., overall treatment outcome, seemed to be affected by practice intensity, age, and post-onset time. A clear advantage of blended learning involving CASTA as home practice was that the apps could provide clear verbal instructions, clinician-designed cues, instant feedback and models, that supported self-administered practice (Code & Petheram, 2011; Stark & Warburton, 2016).

Acknowledgements

This project was supported by a funding by Hong Kong Jockey Club Charities Trust to the Hong Kong Society for Rehabilitation.

References

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Holland, A. L., Weinberg, P., & Dittelman, J. (2012). How to use apps clinically in the treatment of aphasia. Seminars in speech and language, 33(3), 223-233.
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Pedersen, P. M. O. L., Vinter, K., & Olsen, T. S. O. J. (2004). Aphasia after stroke: Type, severity and prognosis. Cerebrovascular Diseases, 17(1), 35-43.
Stark, B. C., & Warburton, E. A. (2016). Improved language in chronic aphasia after self-delivered iPad speech therapy. Neuropsychological rehabilitation, 1-14.
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Keywords: Aphasia, Apps, intervention, Motor speech disorder, Cantonese, Hong Kong

Conference: Academy of Aphasia 55th Annual Meeting , Baltimore, United States, 5 Nov - 7 Nov, 2017.

Presentation Type: poster presentation

Topic: Aphasia

Citation: Kong A, Ho D, Lam I, Yeung O, Lau J, Ting C and Tao K (2019). Cantonese Apps for Speech Therapy-Adult (CASTA): Development and application to native Cantonese speakers in Hong Kong with stroke-induced aphasia and motor-speech disorders. Conference Abstract: Academy of Aphasia 55th Annual Meeting . doi: 10.3389/conf.fnhum.2017.223.00082

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Received: 08 Apr 2017; Published Online: 25 Jan 2019.

* Correspondence: Prof. Anthony Pak Hin Kong, University of Central Florida, Department of Communication Sciences and Disorders, Orlando, FL, 32816, United States, akong@hku.hk