Please examine the material on this site and try our online demos to learn more about MossTalk. It has been designed by experienced, practicing clinicians and researchers and extensively tested with patients at the MossRehab Aphasia Center and in some of the finest aphasia treatment facilities in the country.

We are committed to providing the best treatment available to people with aphasia. Our commitment includes incorporating the latest advances in language research and technology in easy to use software that maximizes the time and energy of both those with language problems and their clinicians.

If you have further questions or would like to talk to one of our clinicians about the philosophy or use of any of our products feel free to contact us.

215-456-6963 (9 a.m. to 5 p.m. EST, Mon through Fri)

Research and Use

Word retrieval difficulty is common to most patients with aphasia, yet the nature of these difficulties may stem from different underlying sources (i.e. semantic versus phonological) and therefore respond to different treatment methods. The MossTalk Words program provides the clinician with flexibility to integrate the modules to address the nature of each patient’s deficit.

The Multi-Modality Matching module is more than a matching program — it’s a semantic processing program that aims to strengthen the association between words and pictures. Research suggests that strengthening the semantic link prior to naming has lasting effects on acquisition of target vocabulary (see Nickels & Best, 1996 for a review of naming studies). As such, specific naming targets can first be presented in a simple exposure/matching format for priming prior to the actual cued naming task (Fink et al, 1997). Also, the flexibility in match types allows the clinician to treat the impaired modality directly or to bypass the deficit and focus on the patient’s strengths.

The Cued Naming module provides built-in cues that can be systematically applied in a hierarchy to promote retrieval. Hierarchical cueing has been demonstrated to be an effective technique in the acquisition of target vocabulary (Linebaugh, 1977, Thompson & Kearns, 1981, Hillis, 1991, Thompson, 1991, Raymer et al. 1993).

The cued naming exercises can be used in more ways than the standard format. (NOTE: Feedback and scoring will not reflect these varied modifications.)

• With nouns, the central picture can be covered and the patient can be asked to produce the noun in response to the fill-in cue or description cue. This will change the exercise to a sentence completion or responsive naming task.
• The patient may look at the picture and provide his or her own description. This will encourage the use of a compensatory strategy for naming.
• With nouns or verbs the module can also function as a confrontation writing tool (off-line). Computer-generated cues are still available for feedback and facilitation, although the patient must use paper and pencil to respond.
• With nouns or verbs, the module can be a stepping stone to sentence production.
• With verbs, picture description can be developed.
• There may be several alternate verbs to describe a particular action. It may be helpful to do a Multi-Modality Matching exercise first, to familiarize the patient with the intended targets. You may also simply prompt for another word to describe the picture or accept the patient’s response as correct realizing that feedback will not match his or her alternative vocabulary choice.

The Multi-Modality Matching and Cued Naming programs in MossTalk Words can be accessed through three different interfaces. Each interface has its strengths and weaknesses for different patients and different goals (diagnosis vs. practice).

The Standard interface has been organized by our clinicians to provide a structured way of organizing the universe of possible exercises. The parameters in the Exercise Setting dialog windows have been organized to present a quick, easy and theoretically motivated way of selecting the difficulty level of the exercise to be run. For many users this will be the most commonly used way to access the programs.

The Custom Exercise interface of MossTalk Words allows flexibility in choosing the number of items to be trained and the relatedness of any accompanying foils in administering treatment protocols. In keeping with an error-less learning paradigm, positive results can be attained when treatment starts with easier words in smaller fields and with unrelated foil choices. Gradually, exercise difficulty can be increased as the patient experiences success. Custom Exercises is as easy to program for the patient who benefits from relearning vocabulary in small sets as it is for the patient who benefits from larger randomized sets (e.g. a general stimulation approach). The Custom Exercise interface makes it simple for clinicians and researchers to design pre- and post-tests, as well as treatment projects for their patients.

The Assigned Exercises interface allows a clinician (or family member) to pre-program up to five customized or standard exercises in just a few minutes. This feature makes it easy for the individual with aphasia to access assignments and practice independently (or with minimal assistance) at home or in the clinic, extending the amount of practice time in a cost-effective way.

The Results feature automatically tracks performance, both within a treatment session and during independent use. This makes it easy to keep accurate and detailed records of responses and progress. Results, which are also automatically saved can be displayed at the end of each exercise or retrieved later and printed for chart documentation. This automated record keeping feature is a real time saver for the clinician. In addition to providing a quantitative summary of performance, it keeps documentation time to a minimum.

References

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Berndt, R.S., Mitchum, C.C., Haendiges, A.N., and Sandson, J. (1997). Verb Retrieval in Aphasia: 2. Relationship to Sentence Processing. Brain and Language, (Vol.56, pp.107-137).

Bluestone, R.,(1998). Computer Applications for Patients and Clinicians. Paper presented at The Tenth Annual Stroke Rehabilitation Conference (October). Cambridge, Massachusetts.

Breedin, S.D. (1993). The Relationship of Syntactic and Semantic Aspects of Verb Representation. (Doctoral dissertation, Rice University, 1991). Dissertation Abstracts International, 53 (7B):3812.

Fink, R.B., Schwartz, M.F., Sobel, P.R & Myers, J.L. (1997). Effects of Multi-level Training on Verb Retrieval: Is more always better ? Brain and Language, (Vol.60, pp.41-44).

Fink, R.B., Brecher, A. and Schwartz, M.F. (2000). Clinician vs. Partially Self-guided Computer Assisted Naming Therapy. Poster presented at the ASHA Convention (November) , Washington, DC.

Francis, W.N. & Kucera, H.(1982). Frequency Analysis of English Usage .Houghton Mifflin Co. Boston, MA.

Hillis, A.E.,(1991). Effects of Separate Treatments for Distinct Impairments within the Naming Process. In T. Prescott (Ed.), Clinical Aphasiology (Vol.19, pp.255-165). Austin, TX: Pro-Ed.

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Howard, D., Patterson, K., Franklin, S., Orchard-Lisle, V., Morton, J. (1985b). The Facilitation of Picture Naming in Aphasia. Cognitive Neuropsychology (Vol.2, pp.49-80).

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Li, E.C., Canter, G.J., (1983). Phonemic Cueing: An Investigation of Subject Variables. In R.H. Brookshire (Ed.), Clinical Aphasiology: Conference Proceedings (pp.96-103). Minneapolis: BRK Publishers.

Linebaugh, C., & Lehner, L.(1977). Cueing Hierarchies and Word Retrieval: A Treatment Program. In R.H. Brookshire (Ed.), Clinical Aphasiology: Conference proceedings (pp.19-31). Minneapolis: BRK Publishers.

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Thompson, C.K. & Kearns, K.P. (1981). An Experimental Analysis of Acquisition, Generalization and Maintenance of Naming Behavior in a Patient with Anomia. In R.H. Brookshire (Ed.), Clinical Aphasiology: Conference Proceedings (pp.35-42). Minneapolis: BRK Publishers.

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Please browse our site, try our online demos and feel free to contact us with your questions, comments or suggestions.