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Using technology to overcome the language barrier: the Cognitive Assessment for Aphasia App

Abstract Purpose: We developed and explored the feasibility and user acceptance of the Cognitive Assessment for Aphasia App: a non-immersive virtual reality cognitive assessment for stroke survivors, designed to be inclusive of individuals with aphasia. Methods: Participants were assessed on a battery of pen-and-paper cognitive tests and the Cognitive Assessment for Aphasia App. Feasibility was explored by quantifying missing data for test completion, determining user acceptance for the app by measuring participants’ preferred testing method, enjoyment and perceived task difficulty and time-taken to complete the test. Results: Sixty-four stroke participants (35 with aphasia, 29 without aphasia) and 32 controls were recruited. Only one participant with aphasia was unable to complete all the Cognitive Assessment for Aphasia App tasks, whereas 13 participants were unable to complete all pen-and-paper tasks. Only 14% of participants preferred the pen-and-paper tests, and preference did not significantly differ between groups. Ninety-five per cent of participants were neutral or enjoyed the app and 4% perceived it to be very difficult. Higher age was negatively associated with user acceptance measures. Conclusion: The study shows preliminary evidence for the Cognitive Assessment for Aphasia App to be a feasible cognitive assessment for stroke survivors with and without aphasia. The app is currently being validated in stroke. Implications for rehabilitation The Cognitive Assessment for Aphasia App is a feasible tool for assessing post-stroke cognition in acute, inpatient rehabilitation and community settings. In research trials examining cognition, individuals with aphasia are often excluded. The Cognitive Assessment for Aphasia App permits the inclusion of these individuals, enhancing generalizability. The Cognitive Assessment for Aphasia App provides an alternative method to assess cognition that is quicker and preferred over standard neuropsychological tests.