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FEATURE:  Emerging Neurotechnologies 


Editor's Note:
At aphasiatoolbox, we strive to leave no stone unturned in helping our clients recover their communication skills. Often, this involves our staff providing our clients with reviews of the advances in aphasia treatments.  For a no-cost consultation on how technology may assist you or your client in maximizing aphasia recovery, contact us.



A recent report released by Policy Horizons Canada and written  by futurist and data visualizer Michell Zappa of Envisioning Technology called MetaScan 3: Emerging Technologies  discusses new and emerging technologies.



A large portion of his report analyzes how neurotechnology and cognitive technology are likely to manifest over the next 15 years, identifying three key areas: Neural Networking Computing, Extended Cognition and Neural Interfaces.


- In neural networking computing, significant changes are expected in proactive software agents, neural network image recognition, emotion tracking and tools;.  
This could lead to improvements in computer vision and analysis, such as detecting emotions and moods, which may have safety and security applications. 


- In extended cognition, changes are likely to come through neural feedback, capacitive micro machined ultrasonic transducers, next-generation neuropharmacology and neuroprosthetics. Extended cognition may involve direct connections to people's brains, allowing mood, thought patterns and information to be altered in the brain.


- In neural interfaces, big changes are expected through advances in brain-to-computer interfaces, transcranial magnetic stimulation, optogenetic implants in humans, and brain-to-brain interfaces. These interfaces may help to get information out of people's brains more efficiently.




Link to Neuro and Cognitive Technologies Report: 


See our  feature article on transcranial magnetic stimulation in this edition.


See the article on neuroprosthetics in this edition.  

FEATURE:   Transcranial  Magnetic  Stimulation 

Transcranial magnetic stimulation, or TMS, is a therapy that involves placing fist-sized coiled magnets on the scalp to stimulate different brain regions.

According to Dr Penelope Talelli, at the Institute of Neurology/Sobel Department of Motor Neuroscience in the UK,

"TMS is a safe and painless method to stimulate the human brain. TMS uses strong, brief magnetic impulses produced by a probe held over the head. These impulses carry a small electric current through the scalp that activates the brain underneath. When a single pulse is given the effect lasts for a few seconds. We can also give TMS in a repeated manner, called repetitive TMS (rTMS). rTMS can change the activation of the brain for much longer, sometimes for up to one hour. Different stimulation patterns can produce different results. For example, we can either increase or suppress the activation of the brain."

Last year,  the U.S. Food and Drug Administration approved several TMS devices for treating migraines and depression. Studies have also shown that the technique can improve performance on different types of memory tests.  

Transcranial magnetic stimulation (TMS)  and transcranial direct current stimulation (tDCS) are two methods currently being investigated as treatments for aphasia in clinical trials.

For More Information:


2.  Torres J.  et al, TMS and tDCS in post-stroke aphasia: Integrating novel treatment approaches with mechanisms of plasticity,  Restor Neurol Neurosci. 2013 Jan 1;31(4):501-15.

3. Fridriksson, J. et al,  Transcranial Brain Stimulation to Treat Aphasia: A Clinical Perspective, Seminars in Speech and Language, Volume 33 Number 3, 2012,  pages 188-202

4. de Aguiar, V.  et al;   tDCS in post-stroke aphasia: The role of stimulation parameters, behavioral treatment and patient characteristics,  CORTEX,  Volume 63, February 2015, Pages 296-316

5.  Current Clinical Trials for TMS or tDCS and Aphasia


FEATURE: Current Articles/ Research covering Technology and Apps for  Aphasia



The speech community is buzzing with information about changes to Medicare's coverage for speech-generating devices (SGDs). Headlines indicate that Medicare wants to limit coverage for individuals with ALS, also known as amyotrophic lateral sclerosis, while other articles point to limits on functionality of SGDs. What the headlines miss are the stories of thousands of people with aphasia who rely on SGDs and their advanced technology to communicate. 


iRehab: Incorporating iPads and Other Tablets in Aphasia Treatment  



This edition of Seminars in Speech and Language is a special edition focusing on apps, iPads and mobile technology. Audrey L. Holland is the Editor in Chief


Scientists have improved memory for associations between faces and words by electromagnetically stimulating neural connections in a brain network. In the process, they produced the first direct evidence that stronger interactions between different areas of the human brain's memory and thinking hubs underlie such associative memory.

Cathy Hutchinson suffered a brain-stem stroke that left her paralyzed and unable to speak. But 12 years later, a brain implant gave her the ability to move a robotic arm to pick up a bottle and drink from it, using her thoughts alone.

DARPA's first contracts under its Restoring Active Memory (RAM) program challenge two research groups to construct implants for veterans with traumatic brain injuries that have impaired their memories. Over 270,000 U.S. military service members have suffered such injuries since 2000, according to DARPA, and there are no truly effective drug treatments. This program builds on an earlier DARPA initiative focused on building a memory prosthesis, under which a different group of researchers had dramatic success in improving recall in mice and monkeys.




Future medications for brain disorders could be delivered through electrodes rather than pills.   


- Transcranial direct-current stimulation (tDCS) applies a weak electric current to the scalp to modulate signals in the brain. 


- This technique shows promise in treating several brain-based conditions that have stumped pharmaceutical researchers, including migraine pain and depression. 


- Once scientists establish a more uniform procedure and comprehensive understanding of dosage, tDCS could become a widely used therapy.


Of the 152, 000 individuals in the UK to survive a stroke each year, approximately 20-30% of them will experience slurred speech (dysarthria). Dysarthria is caused by muscle weakness and is known to impact significantly on psychological well-being and recovery after stroke.

In a new study, led by speech and language therapist Claire Mitchell at Manchester Royal Infirmary (MRI), will pilot an app called ReaDySpeech that Claire developed with funding from Central Manchester University Hospitals NHS Foundation Trust. The app is designed to provide patients with a more personalized speech and language therapy, as it creates a tailored program for each individual. The individual program will then be adapted based on patient feedback, as they work through the program, depending on how easy or hard they find tasks.  
FEATURE:  What is AAC?


Editor's Notes:
Aphasiatoolbox is including information on Augmentative and Alternative Communication as a service for SLPs and PWA. Historically, our clients have not needed a dedicated AAC device since we have been able to get them to at least speak and communicate basic needs but more often do much better ( Success Stories  ). What we do is to incorporate AAC techniques and strategies into our clients' recovery program. That way clients are able to express basic needs while continuing to aggressively travel the pathway of aphasia recovery.  We feel the need to avoid dependence on external devices for communication to avoid learned helplessness and to encourage independent, propositional conversation. Moreover, it has been our experience that people with aphasia rarely accept the use of a formal AAC device.  There appears to be a variety of reasons including: apraxia; initiation difficulties; cognitive inflexibility; executive function deficits; the cumbersome, unnaturalness of a separate device, among other identified reasons. This reluctance may change with the advent of mobile devices and applications, but the fact remains, people recovering from aphasia do not want a machine talking for them. They want to independently  converse on their own.  Contact us if you want more information on  how to converse independently.
According to The International Society for Augmentative and Alternative Communication  (ISAAC), Augmentative and Alternative Communication is a set of tools and strategies that an individual uses to solve everyday communicative challenges.   


Communication can take many forms such as: speech, a shared glance, text, gestures, facial expressions, touch, sign language, symbols, pictures, speech-generating devices, etc. Everyone uses multiple forms of communication, based upon the context and our communication partner. Effective communication occurs when the intent and meaning of one individual is understood by another person. The form is less important than the successful understanding of the message.


Note: Text in this section of the website has been provided by Linda J. Burkhart, Technology Integration Specialist.


An AAC aid is any device, either electronic or non-electronic, that is used to transmit or receive messages; AAC devices could be either low tech or high tech:

Low-tech communication aids are defined as those that do not need batteries, electricity or electronics to meet the user's communication needs. These are often very simple aids created by placing letters, words, phrases, pictures and/or symbols on a board or in a book, which may be accessed. (Source:  http://www.ussaac.org/aac-devices.cfm)

High-tech AAC aids are electronic devices that permit the storage and retrieval of messages, many of which allow the use of speech output. Such devices can also be referred to as Speech Generating Devices (SGDs) or Voice Output Communication Aids (VOCAs). High-tech systems can be divided intodedicated devices developed solely for the purpose of communication and AAC, and non-dedicated devices, such as computers, which have been adapted for use as
communication tool, but which can also be used for other functions. (Source: http://www.ussaac.org/aac-devices.cfm)

For more information:

Apps for AAC  - http://appsforaac.net/applist

Quizlet on aphasia.    
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"Don't be app happy; use technology in a smart recovery program that truly exploits your neuroplasticity."   - Bill Connors 
November  27, 2014
SPECIAL EDITION - Technology in Aphasia Treatment and Recovery
This is Sharon Rennhack, the chief editor for the aphasiatoolbox newsletter.  Can you  believe that some people think that wearing this "hat" could help your aphasia? 

Photo: Nick Moranis

Technology has changed almost every dimension of our lives within just a few  generations.This month's special edition looks at Technology that may help people with aphasia. Specifically,  we look at  current and future technologies:  ACC, Mobile Technology and Apps, Transcranial Magnetic Stimulation  and of course - telepractice: These are some things that  people with aphasia  may try or use to help them to  communicate, read and write again.  We also look at potential treatments - some far off and some closer than we think.

Note: Our newsletter has received many words of praise and accolades, from SLPs, scientists and consumers.  While we work  to make our content "aphasia-friendly", we do not believe in "dumbing down"  that content. We, and I in particular as a person well-recovered from aphasia, believe that people with aphasia are smart with a burning determination to  get better and be challenged in their recovery.  If you are a person with aphasia and have trouble reading or understanding  the content in our newsletter editions,  please contact us OR ask your SLP or coach to explain our content.  We welcome your   calls and ideas.  Contact us at information@aphasiatoolbox.com.

Sharon Rennhack
Chief Editor 
NEWS: Aphasiatoolbox offers intensive online treatment 


Editor's Note:   

Aphasiatoolbox has five clients now working in our intensive, online treatment program.   This one-of- a kind program provides the benefits of intensive aphasia treatment without the burdens of travel, room and board expense, exhausting daily schedule, and expensive tuition. 

These clients work 5 days a week - with the experts: speech pathologists and practice coaches, and groups, all from the comfort of their homes. Family, friends and collaborating SLPs receive training and support resulting in an additional 2-4 hours a day of individualized practice supported by innovative tools, technology and peer support.


To schedule a free consultation or for more information, contact us   or  call us at 724 - 494 -2534. 


FEATURE:  Apps and Mobile Technology  


Editor's Note:  

In one of our conversational groups last week, the question was poised - how can technology help to make better readers of PWA?  


While pondering this question, I thought of all the hardware and software:- apps - (how many apps ARE there?), Text to speech, AAC devices,   computers and mobile technology - ,   ipad, iphones, etc. Do these various forms of technology help people with aphasia to speak better ? read better?   Write better?


Technology - especially mobile technology, helps in the regard of access and accessibility, allowing a person with aphasia to do his/her daily practice on their own. But technology and mobile technology - especially apps, are the means to an end, not the end itself.


A recent special edtion in Seminars in Speech and Language, 2014; 35 (01), Ramsberger and Messamer [1] noted: "we must strive to integrate technology into therapy in a manner in which "the treatment plan drives the decisions about which app is used rather than the app driving. "


The advent and use of mobile technology, including apps, ipad and iphone, is a growing trend among adults nationwide, and its potential use in aphasia rehabilitation has created much clinical interest. However, both Szabo [2] and Brandenburg [3] indicate that adults living with aphasia are less likely than other adults to go online, citing multiple barriers.  Since aphasiatoolbox clients have decided to not just live with their aphasia, they are breaking through these barriers routinely, using technology as it is meant to be used.   


A recent article in StrokeSmart [4] talked about the use of apps - both aphasia -focused and general apps: 


The apps alone won't help stroke survivors reach their potential-it takes a      commitment to utilizing them on a regular basis.


Says Linda Samuels about her husband's use of apps and mobile technology, "[Motivation] has to come from the patient-no matter what anybody else might say, if they don't want to help themselves then they won't."


See our list of apps for adults with aphasia - [5, 6].


AphasiaToolbox is the leading telepractice company focusing on aphasia recovery; our clients use technology every day in therapy and in independent practice. For our younger clients, we have just started a young person's aphasia treatment group incorporating mobile technology - using apps, email, and contact us at information@aphasiatoobox to learn how you can join the mobile generation, whether you are  a digital native or not.




1. Ramsberger, G. and Messamer, P., Best Practices for Incorporating Non-Aphasia-Specific Apps into Therapy, Seminars in Speech and Language, 2014; 35 (01): 003-004


2. Szabo, G. et al.   Using mobile technology with individuals with aphasia: native iPad features and everyday apps, Seminars in Speech and Language, 2014; 35 (1): 05 - 16,


3. Brandenburg, C. et al. Mobile computing technology and aphasia: An integrated review of accessibility and potential uses, Aphasiology, 2013 Vol. 27, No. 4, 444-461


4. StrokeSmart, Recovering Communication Skills With Technology Therapy, Posted by Emily Shearing, Oct 23 2014  


5. The 30 Best Mobile Apps for Speech Pathologists,

Posted on April 18, 2012


6. App List, Aphasia Software Finder 


VIDEO:  Master Clinician Bill Connors discusses Technology in Aphasia Treatment and Recovery 


Bill Connors  discusses technology. November 2014
Bill Connors discusses technology.
November 2014
If you have questions about this video, please contact us or call  us at 724-494-2534.   


FEATURE:  Telepractice for People with Aphasia 


Editor's Note: 

Technology continually expands with each passing year, and so do the industries it affects. This year the world has been seen wearable technology to 3D printing, prime examples of the merging of technology and healthcare.


Telecommunication is also evolving, allowing individuals to communicate more quickly and effectively than ever before; Videoconferencing technology, for example, is allowing cheaper, faster and more efficient connections, across a range of devices.


The healthcare and Speech Therapy industries are no strangers to advancements in technology with telehealth/telepractice. Per the American Speech-Language-Hearing Association (ASHA), Telepractice "is the application of telecommunications technology to the delivery of speech language pathology and audiology professional services at a distance", and that it is "is an effective service delivery model for adults with aphasia".


The clients and staff at aphasiatoolbox.com certainly know how effective telepractice is. Our numerous clients - including intensive treatment clients, use telepractice every day in online sessions with SLPs, coaches and groups.  


We highlighted Telepractice in our August 2013 newsletter:


- Sharon Rennhack interviews Bill Connors, owner of Aphasiatoolbox.com, on the use of telepractice in aphasia recovery.   Video Link


- In this interview about telepractice, Sharon Rennhack interviews Bill Connors (SLP and owner of Aphasiatoolbox.com) and Christine Huggins ( co-founder of the Aphasia Recovery Connection and feature correspondent for the Aphasiatoolbox newsletter.  

Video Link


Master Clinician Bill Connors   created this video presentation from Homeceuconnection covering Telepractice:  Start your Telepractice Now!


For more information:  


1. Hal, N.   et al. Telepractice in the Assessment and Treatment of Individuals with Aphasia: A Systematic Review,   International Journal of Telerehabilitation,  Vol. 5, No. 1 Spring 2013  


2. Technology Innovations That Are Changing the Face of Health Care, Posted November 6, 2014


3. Telemedicine Market Shows Strong Growth Due to Healthcare Changes,  Posted November 19, 2014


If you have questions about how telepractice can help you and your aphasia, please contact us or call  us at 724-494-2534.  


New Book:  When the Milk Sours  


Frank Austin, a co-founder of the  the Canadian stroke/aphasia support group - The Expressive Caf�,   and a stroke survivor,  is the author  of "When the Milk Sours";  this  book  discusses the realities of what it's like to have a stroke, and primarily, how to deal with aphasia.  It is not just his story but it's also the stories of other survivors.       


For more information:

 > about  the Expressive Cafe


The Expressive Cafe is a  partnership with the Woolwich Seniors' Association. The Mission of the Expressive Caf� is to improve communication skills using expressive and receptive activities in a safe environment.   



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