Supporting adherence to a home practice reading program using self-monitoring in persons with aphasia

Research Objectives: Factors that enhance adherence to home programs are poorly understood. We examined a logbook with a timer as a potential mechanism to support adherence to home programs.

Design: Non-concurrent multiple baseline single-case experimental design with three intervention schedules across seven participants with chronic aphasia.

Setting: Procedures were completed either virtually or in person. Testing was completed either in the clinic or at the participant’s home. All interventions were completed at home.

Participants: All participants were at least six months post-stroke and diagnosed with aphasia.

Interventions: During the baseline phase, participants received training on an iPad mobile application focused on reading. They were instructed to practice reading for 80 minutes daily and provided with the goal statement on the back of the iPad. The schedule determined the length of the baseline. At the end of baseline, participants received training on using a timer and an aphasia-friendly logbook for recording minutes of practice. They were then instructed to continue practicing at the same dose. Participants received weekly technology check-ins in the baseline and intervention phases to ensure they were not experiencing difficulties using the app.

Main Outcome Measures: The main outcome measure is percent adherence. Participants' experiences with the intervention were gathered via post-intervention interviews.

Results: Data analysis is complete for six out of the seven participants. Within participant visual analysis showed two participants’ percent adherence increased by 10% and 32%, respectively; with the logbook and timer, three participants’ adherence remained the same, and one decreased by 15%. Four out of five participants ranked logbooks as one of the top two most beneficial supports to their practice. Graphed adherence data and corresponding visual analyses for all participants will be presented.

Conclusions: Responses to the logbook and timer intervention were variable across participants. All participants could utilize this strategy, and most found it supportive of their practice.

Author(s) Disclosures: Drs. Donoso Brown and Wallace worked with Tactus Therapy to modify the app for this study. This study was funded through an internal grant from Duquesne University.