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To some, Dining With Doug may seem like just another culinary blog鈥攁 chronicle of the Italian-focused kitchen adventures of Doug Volland of Rochester. But peppered between the recipes is usually some variation on this enthusiastic declaration: 鈥淪INCE A STROKE I USE ONLY MY LEFT HAND!!!鈥�

Volland鈥檚 blog is more than a place to find a recipe for Chicken Francese. It鈥檚 a form of brain-injury rehabilitation, and just one example of an innovative trend at Nazareth鈥檚 Communication Sciences & Disorders (CSD) Department. There, student and faculty clinicians use commonplace technology鈥攊ncluding iPads and iPhones, consumer software, and even websites like YouTube鈥攖o help patients achieve their goals.

Technology has long been ubiquitous in therapy settings, but once upon a time the tech was notable for high price tags and never leaving the clinic. Times have definitely changed, says Heather Coles, clinical assistant professor and manager of the Neurogenic Communication and Cognition Clinic (formerly the Brain Injury Clinic) at Nazareth鈥檚 York Wellness and Rehabilitation Institute.

鈥淭echnology is an exploding toolbox today,鈥� Coles says. 鈥淲e鈥檙e finding new, creative ways to incorporate these tools into our work with clients.鈥�

For Volland, blogging is part of a coordinated treatment array that gradually helped the stroke survivor recover functional skills as well as those associated with language and speech. Complex words like Taleggio and Bolognese are difficult for a stroke patient to utter, but they become useful motivational tools as he sounds out the recipe ingredients so they can be entered in his blog.

Technology even brings clinical benefits at Starbucks, via Volland鈥檚 directed use of an iPhone-based communication app that allows him to order complex coffee drinks without slowing down his barista. Coles encourages the use of adaptive tools to help clients build their confidence and return quickly to their normal activities. 鈥淚ndividuals with aphasia are faced with many discouraging situations, but resources that help them engage with the world are incredibly valuable,鈥� she says.

From TED Talks to fantasy football

Digital advances take many therapeutic forms in clinical work at Nazareth. More specialized technology still plays an invaluable role, to be sure, but with critical differences compared to several years ago. Take the sophisticated Aphasia Scripts system鈥攊t鈥檚 no iPad app, but its PC-based accessibility speaks to modern advances in clinical tech. 鈥淣ot long ago, we would have had to spend thousands or even tens of thousands of dollars to use this鈥攏ot only the software, but the advanced hardware we鈥檇 need to run it,鈥� Coles says.

Aphasia Scripts employs an onscreen speech-therapist avatar to articulate words based on highly customizable dialogue. 鈥淭he conversations can be about anything,鈥� Coles says. 鈥淔or instance, for one man who鈥檚 incredibly passionate about football, we wrote a script that lets him choose players for his fantasy team.鈥�

鈥淏rady or Roethlisberger? Roethlisberger, Roethlisberger鈥︹�� the avatar intones, using a variety of drills to tug the client into the virtual conversation by taking the words right out of his mouth.

On the opposite end of the spectrum from the complexity of Aphasia Scripts, YouTube has provided a wealth of clinical resources. Nazareth clinicians leverage YouTube鈥檚 archived TED Talks鈥攚ith their encyclopedic detail about myriad topics鈥攖o help groups of clients perform project-based therapy assignments in which they take notes, summarize, and discuss a selected issue. 鈥淭here鈥檚 nothing particularly clinical in a TED Talk about, say, nuclear power,鈥� Coles says, 鈥渂ut the structured content makes it a useful clinical tool.鈥�

Meanwhile, part of the undeniable appeal of working with scalable apps is the ability to create one yourself. Coles has co-developed an original piece of diagnostic technology: the iPad-based Functional Standardized Touchscreen Assessment of Cognition (FSTAC), whose hands-on user interface lets clients respond to simulated scenarios as a way of determining the severity of their condition or a suggested treatment path.

Distinct challenges, diverse solutions

Adult reactions to these therapeutic tools can vary based on their prior familiarity with personal tech, but for patients literally born in the 21st century, the comfort zone is much wider. Lisa Hiley '02, Ph.D., clinical assistant professor, and Megan Tobin, Ph.D., assistant professor, work primarily with children ages 5 to 18. 鈥淜ids鈥� familiarity with the technology allows us to use it really effectively,鈥� says Hiley.

For a young girl with Down syndrome, the lingWAVES digital system generates immediate onscreen visual biofeedback that corresponds to her progress in voice and articulation therapy. 鈥淪he鈥檒l say the word 鈥榟ap-py, hap-py鈥� into a calibrated microphone and the lingWAVES software shows a dolphin jump over a buoy as a way to help her monitor vocal quality,鈥� Hiley says. 鈥淭he output is simple and relatable to keep the client engaged. It鈥檚 been really effective for her and promotes progress.鈥�

For several years, Hiley and CSD majors in the Social Communication Club At Nazareth (SCCAN) have partnered with teens at Henrietta鈥檚 Norman Howard School (NHS), which serves children with developmental disabilities as well as with the AutismUp organization to facilitate afterschool social skills groups for teens. One ongoing SCCAN/NHS project utilizes digital video as a therapeutic medium for helping NHS youth cope with challenges associated with autism and social communication disorders.

In the most recent project, inspired by TV鈥檚 Law and Order, the teens developed dramatic scenarios allowing participants to explore the importance of social rules. 鈥淭hey wrote the scripts and produced the videos鈥攖hey鈥檙e really committed to it. It鈥檚 amazing,鈥� Hiley says.

The SCCAN/NHS partnership is 鈥渁 win-win situation,鈥� says Rosemary Hodges, NHS director of education. 鈥淚t offers our students a wonderful opportunity to interact and work together in authentic activities that promote the development of relationship building and social skills, [and] affords Nazareth students an opportunity to develop a repertoire of clinical skills they can draw upon in their future work.鈥澛�

The acceleration of digital technology development over the last decade has been astounding, Hiley says. 鈥淥ur clinic has a strong foundation of base technology鈥攊Pads, laptops, what have you鈥攕o when new applications come our way, we have the hardware and the connectivity we need to make it all work together.鈥�

Coles agrees. 鈥淭he tech doesn鈥檛 do it all on its own; we have to figure out how to carry it over into general use. But it鈥檚 exciting to have access to so many different tools鈥攏ot only to help patients, but to help our students build a better understanding of how they will be able to work with technology in the years to come.鈥�

Erich Van Dussen is a Rochester-based freelance writer.