Why is this research needed?
About one in three people who have a stroke will experience language difficulties afterwards. These difficulties, called aphasia, can affect any aspect of language, including speaking and understanding others' speech.
Many people with aphasia are still able to say and understand some common phrases, like 'I made it,' or 'I suppose'.
Claudia worked as a postdoctoral researcher with Professor Rosemary Varley on a Stroke Association-funded project to develop and test UTILISE, a new kind of aphasia therapy. UTILISE is designed to help people regain their ability to say and understand whole sentences. It works by strengthening common phrases and expanding on them to build longer sentences.
From early testing, UTILISE looks promising, but at the moment it can only be used face-to-face. We are funding Claudia and PhD student Kerry Dathan as they test out a remote version that allows users to access the UTILISE app in their own time at home to practice the therapy tasks more frequently, and get the most out of this therapy.
What are the aims of this research?
Claudia will be working on several questions about remote sentence therapy.
Specifically, she will investigate:
1 - How good is the app at helping people with aphasia improve their language skills and what is the best way to measure that? Participants in this part of the project will use UTILISE at home for several weeks. Claudia will look at different ways to measure language skills before, during and after access to the app. She will also explore the ideal amount of therapy and find out from participants whether it has made a difference to their quality of life.
2 - What barriers might there be to using the app? Claudia will interview people who've used the app to find out what they think about it, then discuss the findings from these interviews with stroke clinicians to identify barriers to tele-therapy, which will help to make UTILISE widely available to people with aphasia.
3 - How can UTILISE's automated speech recognition (ASR) software be improved? Existing ASR software for aphasia is typically designed to provide feedback on single words, but UTILISE needs to be able to do that for whole phrases (for example, if a user wants to practice saying the phrase 'I made it', the app needs to be able to rate how clearly they said the whole phrase). Claudia will combine user and stroke clinician feedback from earlier stages with information from speech and language therapists to find ways to make ASR solutions more effective and user-friendly for aphasia.
What is the benefit of this research?
Our everyday conversations usually involve sentences like 'I made tea.' UTILISE uses common sentences like these as a starting point. It targets 'everyday grammar' and should help people regain their conversational skills. This makes it useful in different ways from most other aphasia therapies, which are designed to help people name objects and say individual words,
The evidence regarding the effectiveness of sentence tele-therapy for aphasia is limited. Claudia's work will help ensure that the UTILISE app is effective, accessible and acceptable to people with aphasia, and her research will increase our knowledge of automatic speech recognition for impaired speech.
Claudia says, 'In the longer term, this project will make it easier for people with aphasia to access effective sentence therapy. I will also be able to create recommendations on automatic speech recognition tools that other researchers and clinicians can use in the future. '
What PSP priorities does this research link to?
From 2019 to 2021, we worked with the James Lind Alliance on the Stroke Priority Setting Partnership (PSP). During the PSP process, we collaborated with people with lived experience of stroke and stroke professionals to find out what they thought were the top priorities in stroke research. From this, we identified the top ten priorities in two areas: prevention, diagnosis and short-term care, and rehabilitation and long-term care.
Now, when a researcher applies to us for funding, we require that their work addresses at least one of these priorities.
Claudia's project addresses the following priorities:
- Rehabilitation 3: Communication difficulties.
- Rehabilitation 7: What is the best time, place and amount of therapy?
- Rehabilitation 10: Improving stroke survivor and carer experiences of treatment.
You can learn more about how the PSP worked and get a full list of stroke research priorities on the Stroke Priority Setting Partnership page.
Meet the researcher
Claudia is an aphasia researcher with a background in speech and language therapy. During this postdoctoral fellowship, she will be supervised by Professor Rosemary Varley and Dr Suzanne Beeke of University College London. By the end of the fellowship, she hopes to have gained the skills and knowledge to become an independent researcher and an expert on sentence therapy for aphasia. In the future, she hopes to lead her own group of researchers who will work together to make aphasia therapy and tele-rehabilitation better.