The present pilot investigation sought to examine the potential of Snapchat to be used as a social exchange tool and to identify the types of information individuals with aphasia would share through this picture-based, multi-modality application.
Thirteen individuals with aphasia were involved in a two-day trial of Snapchat at an aphasia camp given a group training and ongoing access to volunteer support. Quantitative measures included frequency counts and use of text and/or drawing functions. Qualitative outcomes used open and axial coding methods to characterize communication intent. These were triangulated through multiple coders, multiple rounds of consensus coding, and three coding schemes.
Participants successfully used the Snapchat application to generate 174 total posts, all of which used images and some included text, drawing, or multiple modalities. Three coding schemes emerged, which characterized the intent of post exchanges.
Snapchat appears to be a feasible tool to foster social exchange among individuals with aphasia, when given guided, incremental learning, and troubleshooting supports. Individuals with aphasia, given no constraints on what to post, demonstrated their communication intent through the images of people and interactions they exchanged. Availability of scaffolded, incremental supports and ongoing troubleshooting for exploring this picture-based, social networking application appears to be important to successful use. Individuals with aphasia can share what matters to them through images, augmented with text, drawings, or other multi-modal inputs.
The rise of social exchange applications such as Facebook, Twitter, Instagram, blogs, and others has expanded the opportunities for individuals to traverse former barriers of time, geographical locations, and even physical impairments to some extent. Individuals with aphasia have expressed a desire to engage in social interactions using internet and mobile technologies [
Physical, attitudinal, and communication impairments place individuals with aphasia at risk for social isolation [
Acknowledging that loss of identity may be at the root of social isolation, it is important to minimize the potential barriers that restrict sharing of one’s identity [
With the emergence of internet-based resources, several researchers have examined accessibility of internet materials for individuals with aphasia [
Gao and colleagues [
Altered interface can scaffold exchange of mundane-everyday experiences, facilitate sharing of identity, provide a forum to discuss living with aphasia, and foster a sense of community [
Recognizing that modified access through privacy-controlled tools such as blogs and applications like AphasiaWeb limit social exchange to interactions with other individuals with aphasia, there is a need to consider more universal social network platforms (e.g., Facebook, Twitter, Instagram, Snapchat, etc.). Given findings from Buhr and colleagues [
Participant-generated photography has been identified as a way to augment other forms of expression [
Evidence for photo-initiated social networking exchanges [
Aphasia camps provide opportunities for individuals with aphasia and their close partners to engage in meaningful activities within a supportive environment [
The present pilot investigation sought to examine the potential of Snapchat as a multi-modality social exchange tool for individuals with aphasia at an aphasia camp. The primary intent was to identify the type of information individuals with aphasia would exchange, along with the feasibility of using this application for exchanges by individuals with aphasia.
Every individual with aphasia that attended the Chippewa Valley Aphasia Camp in the fall of 2014 (n=20) was given the option to participate in the pilot study by using Snapchat (IRB protocol number 38452015). This included 9 females and 11 males, age range of 23–82 years (mean=58.24 years). There were no restrictions dependent on age, gender, or type or severity of aphasia. Multiple descriptors were utilized to describe each individual’s communication status. Following camp, three speech-language pathologists (the 1st, 3rd, and 4th authors) with a combined 80 years of clinical and community aphasia experience discussed each participant’s overall communication. Based on each clinician’s interactions and experiences with the participant at camp, consensus was reached for each of the three measures used. The Adult Functional Communication Measures (FCM) of Spoken Language Expression and Comprehension were used to characterize expressive and receptive language [
Of this group 13/20, including 6 females and 7 males, actively engaged in using the Snapchat app. Note that all campers who desired to use the application did so, with one exception, P5. When asked about this, the participant related that she did not know where to access an iPod and may have missed that information during the initial large-group overview at camp. Note that distribution of posts among campers could not be determined because devices were not intentionally paired to specific individuals. Because the Chippewa Valley Aphasia Camp emphasizes the development of an environment built on the premise of participation in natural contexts, investigators did not conduct formal assessments of language abilities. Thus experimental control was sacrificed for ecological validity in this pilot investigation. While all individuals with aphasia were encouraged to participate, not all chose to do so. Because the Snapchat experience was a part of the standard curriculum at camp, consent was implied. All content was de-identified and classified by the IRB as archival data.
Snapchat is a social exchange app that allows individuals to take an image with their smartphone, iPod, or tablet to be sent directly to friends within their selected network. Photographs are taken and sent directly within the application and there is no need to attach them from the users’ camera roll. Users have the option of sending it to selected friends in their network by selecting them individually or to send the photograph to all friends by posting it to the “My Story” area. When using the “My Story” function, viewing of the image and associated text or drawing is limited to networked friends, chosen by the user. Individuals can choose to add text, draw, and use filter features. Images posted in the “My Story” area remain for 24 hours (i.e., unless user chooses to delete their post), whereas images sent directly to an individual remain until that person views the post. Viewing images requires the viewer to touch the message while retaining contact by holding a finger on the screen until the set amount of time expires (e.g., 1–10 seconds), which is selected by the individual sending/posting the image. Users can use the “screenshot” function to capture images for later viewing or simply view in-the-moment, thus losing access to the image for later viewing. Note that when viewing images in the “My Story” function, users could view an image as many times as they wish during a 24 hour period from onset of post. The text function allows users to add text to the image by typing or using the speech-to-text technology to include a brief message (i.e., 43 characters total). A drawing function is accessed by selecting the drawing tool and using a finger to draw or write on the touch screen. Filter features, which add time, temperature, or change aspects of the image (i.e., color tone) can be accessed by a swipe to the right.
Camp staff/investigators provided overview training on the use of Snapchat in the opening session with aphasia-friendly techniques and technologies. A document camera (Samsung SDP-900DXA), projected on a large screen in the camp’s main lodge, was used to demonstrate use of the Snapchat app. Demonstrations included how to capture photos/videos, optional features (i.e., text, drawing, and/or filters), and how to post to “My Story.” Campers were asked to post only to the “My Story” function, so that all generated posts could be seen by all fellow campers using the application. Direct messaging, from one individual to another was discouraged as it was not possible to collect data on these exchanges. The group training did not include instruction on how to send messages from one individual to another, only posting to “My Story.” Achieving proficiency in operational competence for use of the Snapchat application was not an expected outcome of the overview training. It was recognized that potential participants had a range of previous experience with mobile technologies and apps. Further, potential participants presented with a range of aphasia types and severity, which is also likely to impact their proficiency. Part of the intent was to support each individual participant’s learning and use of the iPod device and Snapchat app, providing assistance and instruction as needed in the moment of device/app use. In that manner, each individual with aphasia received the support they needed and ongoing support for troubleshooting.
Attendees were given the opportunity to take pictures of anything they wished at Aphasia Camp from late Friday morning (11:00 am) to Saturday evening (10:00 pm). Fifteen iPods (16 GB Apple 6th generation iPod touch) equipped with Snapchat and networked as “friends” were distributed to share among campers. Attendees had no set time for their part of the trial and were not restricted regarding what images to take. Investigators reserved the right to censor inappropriate images in the event that they occurred; however, this was not necessary.
Photos that were identified as taken by staff, based on content or history of the photo, were eliminated. While staff may have taken some Snapchat photos (e.g., as a means of demonstrating or modeling use), they were instructed to support campers with aphasia in taking and posting images. Thus, although procedures were in place to minimize the likelihood of staff-generated Snapchat images, there is the potential that some of the identified photos were generated from staff (i.e., perhaps posted inadvertently). This was deemed an acceptable occurrence given the interactive nature of Snapchat and camp. The iPods were returned to researchers Friday and Saturday nights to be charged and to screenshot images posted to “My Story” on each of the iPods. The captured images shared through the Snapchat application were downloaded each day and posted in a running news feed of camper-generated images by a designated camp staff member. Some images were also used in the Sunday slideshow along with other camp photographs taken with dedicated cameras. After the trial period was complete, researchers downloaded images captured through Snapchat onto a secure computer database for further analyses. All campers signed a consent for photograph release.
In addition to the initial group training, all individuals with aphasia, who chose to use Snapchat, had access to camp staff/investigators and volunteer assistance throughout the trial period. Note that 24 student-volunteers and ten professional staff (five speech-language pathologists, three physical therapists, one occupational therapist and one nurse) were dispersed among sessions. As such, when participants encountered device- and app (platform)-specific barriers to use, incidental support was always accessible and available in a timely manner.
The pilot study facilitated guided-exploration of the Snapchat app within the Chippewa Valley Aphasia Camp setting. It was not established as a formal investigation but rather as an opportunity for campers with aphasia to explore social exchange technologies in a supportive context. Staff intentionally avoided imposing too much control over the trial to assure that it was a natural, uncontrived interaction. The primary interest of the investigation was the type of photographic images, which the individuals with aphasia shared. Social interactions initiated by the posts were not measured formally but camper comments to staff and program feedback surveys were reported.
The primary data generated by this trial included photographic exchanges and some with additional text or drawing features. Quantitative data included frequency counts, including use of text and drawing functions to augment the photographic exchange. Qualitative coding conducted by the three primary researchers involved open and axial coding techniques.35 As it was clearly possible to characterize captured images in multiple manners, the researchers coded the images through multiple lenses. Each researcher initially sorted images according to their own individual lens through a unique scheme. After individualized coding, all three researchers examined each other’s coding schemes. Through discussions, each of the three coding schemes that emerged from the initial sort were vetted and finalized, achieving agreement based on the operational definition established for each coding scheme, category, and subcategory. The three coders negotiated consensus on placing for placement of individual images into categories and sub-categories established through within each coding scheme. Consensus and triangulation solidified categories and subcategories of schemes, along with development of operational definitions for each coding scheme established.
The researchers acknowledge their individual biases towards the coding schemes they developed given their experiences at the Chippewa Valley Aphasia Camp. The second author was an undergraduate student at the University of Wisconsin-Eau Claire who served as a student volunteer at the 2014 Aphasia Camp. The first and third authors are co-founders and staff members at the Chippewa Valley Aphasia Camp and Professors at the University of Wisconsin-Eau Claire where student-volunteers are recruited and trained. The fourth author is the Chippewa Valley Aphasia Camp founder and Mayo Clinic Health System-Eau Claire employee.
A total of 174 posts were collected and analyzed from the trial study. All of the images captured through Snapchat were posted. A small number of photographs were inadvertently sent only to another individual iPod and were not included in these analyses. Unfortunately, the exact number could not be tallied as those messages were only posted to specific “friended” iPods. The majority (n=174) were posted to the “My Story” function, so that others could see the post.
Along with the ability to capture and share images with the application, some campers utilized other Snapchat features. There were 38 out of 174 posts that contained a Snapchat feature (22%). The specific features included the following: text feature (n=29), drawing feature (n=4), both text and drawing features (n=3), other swiping/filter application features (e.g., speed, time) (n=2). For examples of each feature, see
Authors one, two, and three analyzed the images individually, categorizing by their own lens using non-hierarchical, open and axial coding techniques.[
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The exploration of Snapchat within the Aphasia Camp setting allowed for campers to share a variety of experiences with others. It is pertinent to recognize that the photographs that campers chose to take and share represent some level of intent. Campers had a variety of options of what to photograph, including other campers, students, or staff; equipment and materials within sessions; and the buildings or outdoor environments at camp. Thus, distribution of photograph posts across those elements indicates some intent to convey what they valued and wished to share with others. By examining camper posts through three coding schemes, we can derive some information about the camp experience and the potential of Snapchat as a social exchange tool for individuals with aphasia. Quantitative information about number, type, and posting features addresses feasibility, while qualitative analyses provide important information about the types of information individuals with aphasia may choose to share. The posting of 174 posts over the course of two days, in the midst of other camp activities, suggests that individuals with aphasia can use the Snapchat app somewhat proficiently, given support of staff and volunteers. They also demonstrated the ability to add text, drawing, and swiping/filter features to enhance their photographic message.
Campers took these images while engaged in other camp sessions, such as archery, hiking, crafting, meal times, down times, and others. It is clear that certain session types were more conducive to capturing images than others, where physical engagement was more intensive or activity context reduced opportunities to capture images (e.g., woodworking). Data about how often others viewed posts within the “My Story” area is not available. However, campers reported seeing pictures of other campers in different sessions. Further, many of the images posted to “My Story” were played on a slideshow loop, which was displayed in the main lodge and ran several hours each day. Campers specifically commented about images shared by other campers via “My Story” (i.e., a stone arch taken by campers on a hike, images of bullseye arrows taken during archery, campers engaged in laughter-yoga, etc.). There was chatter and excitement as several campers commented about the potential use of Snapchat on their own devices (i.e., cell phones, tablets, etc.) outside of the camp setting. Campers asked questions about how to download the app and how to add friends once they returned home. Unfortunately, because many of these comments took place in conversations between staff or student volunteers and campers, rather than directly between “investigators” and campers, we are unable to report specific numbers of camper statements. Further, it is not clear whether these comments arose from campers viewing posts on Snapchat versus viewing the posts on the daily digital slideshow display or both. A number of the images were group selfies, which indicates that some social exchange occurred through mutual engagement in Snapchat.
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This pilot investigation demonstrates the feasibility of using Snapchat as a social exchange tool for individuals with aphasia. Participants posted images of a variety of experiences and encounters during a two-day trial at an aphasia camp. It is clear that the camp environment and accessibility to staff support influenced the success and nature of images posted. The images campers chose to capture and share appear to reflect something about what they value within the context of those interactions. Further, the pilot offers insights into the aphasia camp experience through the lens of campers. It is possible that the participants’ posting success and the nature of images captured may differ in other community-based contexts.
Researchers recognize several limitations within the pilot study. This study was an exploration of Snapchat within the natural aphasia camp setting, which resulted in limited control. In order to avoid creating the sense of the camp environment as a petri dish for research, investigators intentionally sacrificed experimental control for ecological validity. Because other individuals were allowed to experiment with and/or model use of Snapchat, investigators had to eliminate some posts to assure that analyzed posts were made by individuals with aphasia. Despite these efforts, it is possible that some of the analyzed posts were made by partners of individuals with aphasia.
While incidental supports and troubleshooting provided by student volunteers and staff contributed to successful usage of Snapchat, these supports also served as a limitation and intervening variable in this pilot. When campers encountered difficulty using the device or application, they were able to ask a volunteer or staff member in-the-moment to receive immediate troubleshooting and resolution. This likely contributed to the proliferation of posting, which may be constrained by situations where support is not immediate. While training was not extensive, campers were able to learn how to use the device and Snapchat app implicitly and through guided learning.
One of the primary functions of social exchange platforms is to foster reciprocal interactions between participants. While campers were able to view each other’s respective posts through the “My Story” function, they were also able to view camper posts through the video news feed that looped captured images on a monitor in the camp’s Main Lodge. While posting captured images in this forum may have motivated participants to post more, it may have reduced camper need or initiative to view and respond to posts in the “My Story” area. Further, there were inconsistencies in the fidelity of WiFi signals throughout the camp, which delayed post-release times, thus changing the spontaneity and potential for immediate reciprocal exchanges.
One of the challenges of using a universal application such as Snapchat is limited access to metadata from individual devices or a central server. This limited the ability of investigators to examine which posts were opened by other campers and which posts resulted in a posted response. This further limited potential follow-up questions about the social exchanges that may have occurred. These are all questions the investigators hope to address in a more controlled trial of Snapchat, which is forthcoming.
The current investigation was conducted as a pilot study for a follow-up investigation, which will examine a one-month trial of the device for social exchanges between individuals with aphasia. Drawing upon the principles of Dynamic Capture identified by Beukelman [
This project was supported by a small research grant from the Center for Excellence in Teaching and Learning at the University of Wisconsin-Eau Claire for the purchase of ten iPod touch devices. Cooperating partners include the Chippewa Valley Aphasia Camp, Chippewa Valley Aphasia Group, Mayo Clinic Health System-Eau Claire, and the University of Wisconsin-Eau Claire. Our sincerest thanks go to the Ronald E. McNair Achievement Program for fiscal support and technical advice as we undertook this project. Travel for this project was funded by the Office of Research and Sponsored Activities at the University of Wisconsin-Eau Claire. Portions of the content within this paper were presented in poster format at the American Speech-Language Hearing Association’s National Convention on November 14th, 2015 in Denver, Colorado.
The authors declare that they have no conflict of interests.
Examples of images that included Snapchat features (from left to right: text feature, drawing feature, text and drawing, time and drawing/writing).
Objective coding scheme, distribution of category and subcategories.
Exemplars of images within the Objective lens.
Participation coding scheme, distribution of category and subcategories.
Exemplars of images within the Participation lens.
Formal-task associated interactions versus informal interactions coding scheme, distribution of categories.
Exemplars of images within the Formal-task associated interactions versus informal interactions lens.
Participant demographic, social, and linguistic status
# | Age | Gender | Relationship | Used Snapchat at camp | Desired to use Snapchat | NOMS FCM scores | Communicator Type | Aphasia Severity & Type |
---|---|---|---|---|---|---|---|---|
P1 | 58 | F | Married, lives with spouse | Yes | Yes | Comp-4 |
Stored message | Global |
P2 | 55 | F | Married, lives with spouse | Yes | Yes | Comp-5 |
Stored message | Moderate-severe non-fluent |
P3 | 72 | F | Single, lives alone | Yes | Yes | Comp-6 |
Nonuser | Mild anomia |
P4 | 35 | F | Single, lives next door to mother | Yes | Yes | Comp-5 |
Transitional | Moderate fluent |
P5 | 70 | M | Married, lives with spouse | Yes | Yes | Comp-6 |
Specific needs | Mild-moderate non-fluent |
P6 | 63 | M | Married, lives with spouse | Yes | Yes | Comp-5 |
Transitional | Severe non-fluent |
P7 | 70 | M | Single, in long-term relationship | Yes | Yes | Comp-7 |
Nonuser | Mild anomia, agraphia, alexia |
P8 | 64 | F | Married, in long-term relationship | Yes | Yes | Comp-2 |
Contextual choice | Global |
P9 | 49 | F | Single, lives alone | Yes | Yes | Comp-5 |
Nonuser | Mild moderate non-fluent |
P10 | 57 | M | Married, lives with spouse | Yes | Yes | Comp-5 |
Stored message | Moderate non-fluent |
P11 | 55 | M | Married, lives with spouse | Yes | Yes | Comp-4 |
Transitional | Moderate-severe non-fluent |
P12 | ? | M | Married, lives with spouse | Yes | Yes | Comp-4 |
Nonuser | Moderate primary progressive aphasia |
P13 | 23 | M | Single, lives with parents | Yes | Yes | Comp-4 |
Transitional | Global |
P14 | 61 | F | Single, in long-term relationship | No | Yes | Comp-6 |
Specific needs | Mild non-fluent |
P15 | 82 | M | Married, lives with spouse | No | Unsure | Comp-2 |
Contextual choice | Severe fluent |
P16 | ? | M | Married, lives with spouse | No | Unsure | Comp-3 |
Contextual choice | Mod Severe non-fluent |
P17 | 50 | M | Married, lives with spouse | No | Unsure | Comp-3 |
Contextual choice | Global |
P18 | 39 | F | Single, lives alone | No | Unsure | Comp-4 |
Transitional | Mod Severe non-fluent |
P19 | 58 | F | Married, lives with spouse | No | Unsure | Comp-2 |
Emerging | Global |
P20 | 68 | M | Married, lives with spouse | No | No | Comp-6 |
Transitional | Moderate non-fluent |
Communicator Type determined using Categories of Communicators with Aphasia by Lasker, Garrett, & Fox in Beukelman, Garrett, & Yorkston, 2007.