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04/30/2004 - Lingraphica Eases Aphasia

Intellectual property, technology transfer, research commercialization --- several state and local institutions are poised to help take ideas and the research based on those ideas to the market place. The Washington Technology Center (WTC), SIRTI, and INTEC have machinery in place to help technology prosper in the marketplace. The experience of the person who has actually "done it" gives the best indication of the complexities faced in research-to-market. Richard Steele, PhD, Associate Professor of Computer Science at Eastern Washington University (EWU) has the voice of experience. As Chief Scientist for Lingraphicare America, Inc., Steele has witnessed the entire process.

In 1976, a Veterans Administration (VA) based group in Boston reported their VIC (VIsual Communication) system allowed some patients to achieve a level of communication competence which exceeded their residual language capabilities. In 1984, researchers, including Steele, at the Palo Alto VA Medical Center began to adapt and extend the VIC approach using microcomputers. The company now known as Lingraphicare America, Inc. (LCA) was founded in 1990 to turn these new technologies into a practical product that would help people with aphasia and related communication disorders.

LCA created Lingraphica which is integrated durable medical equipment dedicated to helping adults with aphasia communicate. Aphasia is a language disorder that results from damage to portions of the brain that are responsible for language. The disorder impairs a person's ability to understand and express language, as well as reading and writing. Lingraphica uses icons, animation, text and spoken words to unlock communication for people with aphasia. The device used in rehabilitation of aphasia patients is both hardware and software and reimbursable through Medicare.

According to Steele, aphasia happens quickly, and its most common cause in the United States today is a stroke. The stroke that causes aphasia causes a lesion in the area of the brain devoted to language. The stroke kills a portion of the brain tissue. This leaves a hole which fills with brain fluid. There is limited capacity for regeneration of the lost brain tissue.

According to Steele, using modern imaging techniques, scientists are beginning to see in which areas of the brain activity takes place during various tasks. Results suggest that language use and speech production are highly skilled performances, requiring finely choreographed interactions. After a stroke, a localized portion of the brain may be removed, but the absence can result in more widespread disruptions of performance. Removal of any portion can introduce disorganization that results in the inability to do things as before. After a stroke, a different system remains that is trying to integrate itself with the new system.

The first six to eight months following a stroke, the victim will usually exhibit quite large improvement. During this time the brain is healing itself as swelling diminishes, pressure is reduced, and functioning improves via other mechanisms as well. After six months, the victim enters the "chronic stage" when big improvements are not expected. According to Steele, Lingraphica helps during both the acute and chronic stages by allowing those areas trying to do their job in the brain to perform better. Among other things, the Lingraphica appears to help reintegrate remaining capabilities more effectively.

Steele offers an analogy from the field of physical therapy. The first task is to try to restore as much natural function as possible -- to get back the maximum possible remaining powers. Then, where appropriate, the clinician will look to provide assistive devices such as prostheses or orthoses to improve functioning yet more. The use of such devices, by providing exercise and practice, often helps the individual achieve yet further gains. Lingraphica is used as an assistive device for stroke victims experiencing aphasia. If a patient will benefit from Lingraphica, the speech pathologist will write a "letter of medical necessity," the physician will write a prescription, and third-party payers such as Medicare or private insurers reimburse, when criteria are met.

Steele is working with the UPCE, an EWU/WSU joint clinical program for treating communicative disorders, where staff and students use the Lingraphica when appropriate. He also teaches Human-Computer Interface Design at EWU, and with the help of his students, is constantly striving to make the Lingraphica an even better machine.

To learn more about Lingraphica, go to: http://www.aphasia.com. Dr. Steele can be reached by e-mail at: rsteele@mail.ewu.edu.

Billie Moreland
 
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