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Journal Articles on Aphasia

Dr. Richard Steele

Lingraphica's Chief Scientist Richard Steele, PhD has been a thought leader in the field of Augmentative and Alternative Communication (AAC) for more than thirty years. Below is a sampling of his published work:

Richard D. Steele. "Telepractice in the Assessment and Treatment of Individuals with Aphasia: A Systematic Review." International Journal of TeleRehabilitation, vol. 5, no. 1, 2013.

Abstract: Telepractice involves the application of technology to deliver services over a geographical distance. Studies in which telepractice procedures were used in the assessment or treatment of individuals with aphasia were reviewed. Systematic searches identified 10 studies meeting inclusion criteria. These studies were evaluated in terms of the: (a) characteristics of the participants, (b) technology utilized, (c) services delivered via telepractice, (d) research methodology, and (e) results and conclusions of the study. Telepractice was used by speech-language pathologists and allied health professionals to assist with the delivery of services to participants with aphasia by their caretakers or clinicians. The services delivered included appraisal, diagnostic assessments, interventions, and consultation. This review suggest that telepractice is a viable method of service delivery for individuals with aphasia, however further research is warranted. Guidelines for practitioners and potential directions for future research are discussed.

Richard D. Steele, Lefkos B. Aftonomos, Rajinder K. Koul. "Outcome Improvements In Persons with Chronic Global Aphasia Following the Use of a Speech-Generating Device." Acta Neuropsychologica, vol. 8, no. 4, pp. 342-359, 2010.

Abstract: We analyze WAB (impairment level) and CETI (functional level) assessment data for twenty persons in chronic global aphasia who used a Speech Generating Device at home for therapy and communication. We use matched t-tests to determine magnitude and significance of differences of means following SGD use, and investigate relationships between WAB AQ and CETI Overall by impairment severity levels. Data analysis reveals that most CETI means and some WAB means improved significantly after SGD use. Functional-level improvements appear to be relatively constant across impairment severity levels. We discuss contributions of findings to understanding improvements in persons with chronic global aphasia. 

Richard D. Steele. "AAC use and communicative improvements in chronic aphasia: Evidence comparing global with severe Broca's aphasia." AAC Perspectives (ASHA SID-12), vol. 15, no. 4, pp. 18-22, 2006.

Abstract: Using outcome data from valid, reliable assessment instruments, we quantitatively compare and contrast improvements in specific capabilities in persons with global aphasia and severe Broca's aphasia. Data analysis reveals that within both aphasia diagnostic categories, all changes following Lingraphica use were positive (i.e., improvements), and the large majority (80%) of those improvements were statistically significant at the P= .05 level. Inter-group comparisons show that persons with Broca's aphasia scored higher than those with global aphasia in the overwhelming majority of both impairment level assessments (90%) and functional communication assessments (93.8%). In contrast, the groups diverged in their improvement patterns at the different assessment levels.

Richard D. Steele. "Benefits of advanced AAC technology uses to adults with acquired aphasia." AAC Perspectives (ASHA SID-12), vol. 13, no. 4, pp. 3-7, 2004.

This paper discusses the three distinct types of benefits accruing to individuals with acquired aphasia from practice on, and use of, advanced communication aids such as Speech Generating Devices (SGDs). Specifically, advanced SGDs can: (1) speak in place of the user (i.e., 'replacement of speech') in those cases where speech is required or preferable, yet not available; (2) prompt, support, and extend speech communication in instances where unaided speech production might be inadequate (i.e., 'scaffolding of speech'); and (3) provide therapy and practice opportunities that can help users significantly improve their natural speech communication over time (i.e., 'restoration of speech'). In discussing each benefit, we discuss reasons why each might be important independently and in conjunction with the others, and provide selected concrete examples, drawing on extensive experience dealing with aphasic users specifically of the Lingraphica Speech Generating Device.

Richard D. Steele, Lefkos B. Aftonomos, Marilyn W. Munk. "Evaluation and treatment of aphasia among the elderly with stroke." Topics in Geriatric Rehabilitation, vol. 19, no. 2, pp. 98-108, 2003.

Abstract: While aphasia is not per se a geriatric disorder, risk factors for aphasia increase with age, and effective treatments for older individuals must be sensitive to age related needs and circumstances. This article first reviews evaluation tools, with their assessment domains and ways of using them, then moves to treatment approaches, with an eye in particular to describing experiences using advanced treatment programs with older aphasic patients, and concludes with discussions and examples of outcomes analyses that contribute to our understanding of improvements following treatment in older patients.

Lefkos B. Aftonomos, Richard D. Steele, James S. Appelbaum, Veronica M. Harris. "Relationships between impairment-level assessments and functional-level assessments in aphasia: Findings from LCC treatment programmes." Aphasiology, vol. 15, no. 10/11, pp. 951-64, 2001.

Lefkos B. Aftonomos, James S. Appelbaum, Richard D. Steele. "Improving outcomes for persons with aphasia in advanced community-based treatment programs." Stroke, vol. 30, no. 7, pp. 1370-79, 1999.

Lefkos B. Aftonomos, Richard D. Steele, Robert T. Wertz. "Promoting recovery in chronic aphasia with an interactive technology." Archives of Physical Medicine and Rehabilitation, vol. 78, no. 8, pp. 841-46, 1997.

Michael Weinrich, D. Weber, K. Thomas, L. Thornburn. "Training on an iconic communication system for severe aphasia can improve natural language production." Aphasiology, vol. 9, pp. 343-64, 1995.

Richard D. Steele, Maria K. Kleczewska, Gloria S. Carlson, Michael Weinrich. "Computers in the rehabilitation of chronic, severe aphasia: C-VIC 2.0 cross-modal studies." Aphasiology, vol. 6, no. 2, pp. 185-94, 1992.

Michael Weinrich, Richard D. Steele, Maria K. Kleczewska, Gloria S. Carlson, Errol Baker, Robert T. Wertz. "Representation of 'verbs' in a computerized visual communication system." Aphasiology, vol. 3, no. 6, pp. 501-12, 1989. 

Richard D. Steele, Michael Weinrich, Robert T. Wertz, Gloria S. Carlson, Maria K.Kleczewska. "Computer-based visual communication in aphasia." Neuropsychologia, vol. 27, no. 4, pp. 409-26, 1989.

Michael Weinrich, Richard D. Steele, Gloria S. Carlson, Maria K. Kleczewska, Robert T. Wertz, Errol Baker. "Processing of visual syntax in a globally aphasic patient." Brain and Language, vol. 36, pp. 391-405, 1989.

Michael Weinrich, Richard D.Steele. "Prospects for a cognitive orthosis." Advances in Neurology, vol. 47, Functional Recovery in Neurological Disease, Stephen G. Waxman, editor, New York: Raven Press, pp. 583-600, 1988.

Richard D. Steele, Michael Weinrich, Gloria S. Carlson, Maria K. Kleczewska, Robert T.Wertz. "Evaluating performance of severely aphasic patients on a computer-aided visual communication system." Clinical Aphasiology Conference, 1987, Minneapolis: BRK Publishers, 1987.