Smartphone-assisted Language Training (SaLT) in Aphasia: Insights from the design and development of a multilingual smartphone application

Background Technology-based aphasia rehabilitation has witnessed steep growth over the past decades with the availability of several commercial apps. While such apps facilitate the intensity of rehabilitation, certain limitations including low multi-language capabilities and/or task-customization (for client-specific needs) result in lower uptake in multilingual countries like India. Aim We describe the development and pilot-testing of the S martphone- a ssisted L anguage T raining (SaLT) app – a new application for both mono- and multilingual people with aphasia that facilitates cross-lingual and cross-national sharing of intervention resources. Methods SaLT is a novel, clinician-prescribed, android-based therapy application for mono- and multilingual people with aphasia (SaLT-Home). It can be personalized and customized for individual clients through the clinician-operated web application (SaLT-SLP). Further, it permits asynchronous remote monitoring of therapy progress and sharing of therapy resources with other clinicians across the globe. We present details of the development and structure of the app. We also present pilot testing with four multilingual people with aphasia who undertook clinician-delivered therapy and SaLT-based home therapy. The clinician uploaded personalized tasks and training materials for practice into the SaLT app. Participants with aphasia and their caregivers were asked to practice tasks at home. The focus of this study was not on effectiveness but rather on usage and feasibility. We collected both quantitative and qualitative data regarding the use of the app. After the intervention, participants rated the user experience using the User Mobile Rating Scale. Outcomes & Results Three of the four participants with aphasia across two different languages were motivated to practice and used SaLT-Home. These participants were generally positive about the app. They provided useful insights regarding training in the use of app-delivered therapy, the transition to independent use of such apps and need for support during practice. Conclusions The SaLT application, with its customization and multi-language capabilities, hopes to redefine technology-based intervention in aphasia. Further, it provides the scope for collating and sharing therapy resources by clinicians around the world which could foster the rehabilitation of aphasia, globally. The data from pilot testing also provide insights into the prescription and use of mobile-based home therapy applications which is of general applicability to app-based therapy. The results of this study suggest that future exploration of the use of SaLT is warranted in experimentally controlled treatment studies.