From the Coordinator

Abstract

Telepractice is an appropriate model of service delivery for a person with aphasia (PWA). We define telepractice and its two modes of delivery (i.e., synchronous and asynchronous). We detail a technology, web-Oral Reading for Language in Aphasia (webORLATM), developed to provide aphasia treatment intensively from a distance and subsequently evaluated during a clinical trial. In this article, we describe our experiences using web-ORLATM, highlighting the role of the speech-language pathologist (SLP) and discussing the advantages and disadvantages of this unique combination of synchronous and asynchronous telepractice. Web-ORLATM was delivered to PWAs in their homes by a digital agent, or “virtual therapist,” who served as a model and provided instructions similarly to a real therapist. An SLP at a distant geographical location monitored the sessions remotely, either synchronously or asynchronously, provided feedback, made appropriate adjustments to the difficulty level of the stimuli, and conducted weekly probe assessments of the participants’ performance. Advantages of web-ORLATM include increased practice, SLP oversight, guidance by the agent, program simplicity, and a level of autonomy and flexibility afforded to the PWA. Given the rapid advances in technology, current technological problems that were encountered are likely to be mitigated. Advances in telecommunication technology hold great promise as a means of delivering speech and language services to an increasing number of people, regardless of location, with greater intensity, and over longer periods of time, thereby overcoming barriers to treatment accessibility, therapist time, and cost. Furthermore, technology that provides an opportunity for more intensive treatment can be a crucial aspect of rehabilitation for a person with aphasia (PWA), given that research indicates intensive treatment is more efficacious than treatment applied less frequently (Cherney, Patterson, Raymer, Frymark, & Schooling, 2008, 2010). In