Why is this research needed?
When we communicate, we usually use sentences. In fact, you're reading whole sentences right now. Imagine how difficult it would be to understand what this research is about if you were instead reading single words. Despite this, most of the research on rehabilitation for aphasia (language difficulties after stroke) has been about therapies that help people recover individual words, not whole sentences. Focusing on sentences instead could help people with aphasia to take part in everyday conversations again.
For this reason, we previously funded Professor Rosemary Varley as she developed and tested UTILISE, a computer-based therapy that helps people with aphasia regain their ability to use sentences. From early testing, UTILISE looks promising, so we are funding Kerry Dathan and Dr Claudia Bruns as they develop it further.
What are the aims of this research?
In its current form, UTILISE is a face-to-face therapy, which limits how much time people can spend doing it. Kerry will be testing an app-based version of UTILISE that can be used remotely. Participants will trial the app as Kerry and others in the UTILISE team monitor progress remotely and offer support if needed.
Specifically, Kerry will investigate:
1 - Does the UTILISE app help with speaking and understanding what others are saying? She will measure these using standard tests before participants start using the app, after several weeks of using the app each day, and then eight weeks after they finish using the app to check whether it has had positive long-term effects.
2 - Speech and language therapy traditionally targets words before trying any sentence therapy, but is that how we should use UTILISE? Kerry will again use standard tests of speaking and understanding to see whether it's better to use the traditional order or to have UTILISE first, then word therapy. She will also ask participants to video conversations with friends and family so she can see which order is more helpful for real-world communication.
3 - What do people with aphasia and their loved ones think of the UTLISE app? Kerry will run focus groups with people who've used the app to understand whether it's an acceptable therapy for them, how much it's helped them, and what their preferences are regarding things like how often and how long they want to use the app for.
What is the benefit of this research?
If it works as well as predicted, the UTILISE app has two key benefits. First, being able to have everyday conversations is a priority for many people with aphasia, and UTILISE has been specifically designed to help with that aspect of language. Second, access to in-person speech and language therapy is limited, and app-based therapies could help to overcome this problem.
Kerry says, 'I'm excited to have a part to play in increasing our knowledge of self-directed computer therapies as they have a key role in the future of stroke rehabilitation as a leap forward in the amount of therapy people with post-stroke difficulties can access. '
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.
Kerry'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
Kerry is a speech and language therapist and a PhD student at University College London. During this PhD project, she will be supervised by Professor Rosemary Varley and Dr Suzanne Beeke, also of University College London. After her PhD, Kerry wants to carry on in stroke research. She plans to continue working alongside people affected by stroke to understand how to improve the experience and availability of communication therapies. She also wants to find ways to share findings from stroke research not just with other researchers, but with the people at the heart of the research - stroke survivors and their loved ones.