Effective writing rehabilitation for people with acquired dysgraphia following a stroke could lead to more opportunities to communicate, reduce isolation and improve quality of life. Previous research has suggested that both impairment-focused spelling therapies and assistive technologies can support writing rehabilitation, although the strength of the evidence is limited. The central aim of this PhD study was to investigate whether a combined approach to writing therapy, including impairment-based therapies and assistive technologies, could improve the email writing of participants with varying severity of acquired dysgraphia. An email writing assessment was developed for outcome measurement and data from 42 control participants were collated to determine the neuro-typical range of email writing performance on this task. A within-participants, multiple case design was used to evaluate the effects of two different approaches to therapy with participants with dysgraphia. In the first study, two impairment-based therapies (uni-modal and multi-modal) were compared with eight participants with dysgraphia and the effects of these on spelling accuracy of treated and untreated words were measured. The functional outcomes (email writing, written picture description, writing frequency and perception of disability) of these therapies were also investigated in a second study. The third study evaluated the effects of training eight participants with dysgraphia (six of whom had participated in the first two studies) to use an assistive writing technology for functional writing. There was a wide range of performance in neuro-typical participants on email writing, with both age and education emerging as determinants of performance. Within the clinical studies, there were no significant differences between uni-modal and multi-modal therapies with respect to spelling accuracy, but these lexical therapies led to significant improvements to accuracy of treated and untreated words, written picture description and word length within emails. Training and use of assistive writing software resulted in significant improvements in spelling accuracy and word length within emails. All participants with dysgraphia showed some responsiveness to intervention. Both impairment-based and compensatory approaches to writing rehabilitation were found to have benefit, although the effects varied across participants and outcome measures. This study has highlighted the need for further research into assessments and therapies for writing in aphasia, specifically focusing on candidacy for specific approaches to writing rehabilitation.
|Date of Award||31 Dec 2015|
- The University of Manchester
|Supervisor||Paul Conroy (Supervisor) & Karen Sage (Supervisor)|