Speech Hero: a rhythm-based speech therapy app for individuals with aphasia

It is estimated that 1 in 6 people worldwide will experience a stroke, with about 30% of those individuals experiencing aphasia, which is a loss in their ability to understand or express speech. Aphasia is associated with increased mortality, decreased rates of functional recovery and reduced probability to return to work compared with nonaphasic stroke patients. While intensive speech and language therapy can reduce impairment, most individuals do not receive enough therapy under standard clinical practice to recover to their full potential. Additionally, patients with large lesions in the left-hemispheric language regions of the brain have shown extremely limited recovery with traditional speech therapy methods. For these individuals, therapies that specifically engage homologous right-hemispheric regions have the potential to facilitate the language recovery process. Rhythm-based treatments are particularly well- suited to engage these specific right-hemispheric regions, leading to promising improvements in speech recovery. However, to maximize potential speech recovery with rhythm-based treatments, the therapy dosage needs to be much higher than is typically provided. Home therapy programs could increase the dose of rhythm-based therapy that individuals with aphasia receive, but available options are not motivating, lack performance feedback, and have failed to gain widespread adoption. Therefore, for this Phase I SBIR, we propose to develop an engaging, rhythm-based therapy app that is based on Flint Rehab’s successful MusicGlove game design for use both in the clinic and at home. Our specific aims for Phase I are to: Aim 1) Develop a prototype Speech Hero app based on iterative expert feedback. Aim 2) Perform structured interviews with clinical experts (n = 10) to optimize the design of Speech Hero. Aim 3) Perform three-week usability study of Speech Hero with individuals (n=10) with chronic stroke and aphasia to determine if it can safely promote unsupervised at-home speech therapy. Our hypothesis is that Speech Hero will increase user engagement and compliance with expert-designed rhythm-based speech exercises at home, thus leading to significantly greater improvements in speech generation compared to conventional therapy. We plan to test this hypothesis in Phase II. At the end of this project, we will have completed initial development and usability testing of a novel speech therapy app for home use. We will refine and clinically validate Speech Hero in Phase II, leading to eventual commercialization of a convenient, effective, and affordable product for treating aphasia after stroke.This research is relevant to public health because it will increase accessibility to a fun, engaging, and effective speech and language therapy for individuals with aphasia. As people with aphasia report higher levels of social and emotional isolation and higher incidences of major depression, improvements in recovery will provide a pathway to a better life for millions of U.S citizens suffering from language impairment after a stroke.