Building on residual speech: a portable processing prosthesis for aphasia.

This article examines the challenges of developing electronic communication aids for individuals with mild-to-moderate aphasia and introduces a new portable aid designed for this population. People with some residual speech are often reluctant to use communication aids that replace their natural speech with synthesized speech or the recorded utterances of another individual. SentenceShaper (computer software; Psycholinguistic Technologies, Inc; Jenkintown, Pennsylvania; www.sentenceshaper.com), a computerized "processing prosthesis," allows the user to record spoken sentence fragments and hold them in memory long enough to combine them into larger structures. Previous studies have shown that spoken narratives created with SentenceShaper--composed of concatenated, recorded segments in the user's own voice--may show marked superiority to the individual's spontaneous speech and that sustained use may engender treatment effects. However, these findings do not guarantee the program's efficacy to support functional communication or its acceptance by people with aphasia. Here, we examine strengths and weaknesses of SentenceShaper as the basis for a communication aid for individuals with mild-to-moderate aphasia and review factors guiding the design of SentenceShaper To Go, a portable extension to the program. Data from a "proof-of-concept" pilot study with the portable system suggest the viability of providing computer-based support for users' residual speech in composing and delivering spoken messages.