Advances in Communication and Swallowing

The use of telediagnostics for people with primary progressive aphasia (PPA) could improve access to specialised care. There is a gap in research, especially regarding to the evaluation of communicative-pragmatic measurement tools in a digital setting.

This study examined the equivalence, modality use, and patient satisfaction of telepractice administration of the Scenario Test (ST) in people with PPA.

In a cross-over design, the ST was conducted once by videoconferencing and once in person. Fifteen people with PPA participated. Participant satisfaction was assessed after each test session using a short self-designed questionnaire. The total ST scores, the use of the different communicative modalities and the participant satisfaction scores were evaluated using the equivalence and McNemar test.

Statistical equivalence was established for the present sample with regard to the total score of the ST. Regarding the use of the different modalities, no significant difference was found. Sample satisfaction was positive for both diagnostic settings, but there was no statistical equivalence of satisfaction. Severe psychiatric and cognitive symptoms affected the test performance.

This study highlights opportunities and limitations of telepractice administration of the ST in people with PPA. There is some evidence that testing with the ST via videoconferencing is feasible. Differences in the use of communication modalities and participant satisfaction should be further investigated. Influencing factors such as psychiatric symptoms and cognitive deficits should be considered in future research projects.

Research indicates that speech and language therapy for individuals with aphasia delivered via telehealth is acceptable and facilitates good outcomes. Although adoption of telehealth has increased following COVID-19, it has not been implemented broadly. Telehealth could assist services to meet the recommended intensity of therapy for individuals with aphasia.

The study aimed to investigate the barriers and facilitators to adopting telehealth for individuals with aphasia at two local NHS trusts; and to co-design a telehealth solution responding to these challenges. The feasibility of this solution was also investigated. A secondary objective is to highlight the value of real-world data (RWD) collection in evaluating clinical practice.

An experience-based co-design study was conducted, which developed and piloted a bespoke telehealth solution across service pathways at two NHS sites. Feasibility was evaluated qualitatively through interviews and quantitatively from RWD collected through the telehealth software.

The telehealth solution incorporated outsourcing of the service to a specialist company, provision of hardware and software and regular support for individuals with aphasia and their carers. Take up was associated with a positive impact and the RWD revealed a substantial increase in the hours of therapy the individuals with aphasia received.

Personalised telehealth solutions which respond to local and personal needs are feasible and an acceptable way to increase the intensity of speech and language therapy for some individuals with aphasia, bringing services more in line with evidence-based recommendations and optimising patient outcomes. Embedded RWD collection systems are valuable for evaluation.

There are few applications of virtual reality (VR) in aphasia rehabilitation. EVA Park is an online VR platform developed with and for people with aphasia. Our research is testing its potential to host aphasia therapies.

Two case studies evaluated if delivery of Script Therapy in EVA Park is feasible and acceptable to participants, whether it improved production of trained scripts and promoted generalisation to untrained scripts, narrative speech and functional communication.

Two participants with aphasia received 20 hours of Script Therapy in EVA Park. Feasibility was assessed through session attendance, completion of practice and ratings of treatment fidelity. Acceptability was explored via post therapy interviews. The impact of therapy on script production, narrative production and functional communication was assessed through measures administered twice before therapy, immediately post therapy and at 5 weeks follow up.

Participants attended at least 85% of sessions. Compliance with practice was good for one, but not the other. Fidelity ratings indicated that over 80% of core treatment components were fully present in recorded sessions. Participants expressed positive views about the intervention. Therapy significantly improved the production of words in trained scripts, with maintenance for one participant. Neither participant improved in the production of untrained scripts or personal narratives. One improved on the assessment of functional communication, but the margin of change was small.

The study adds to the evidence that EVA Park can host a range of interventions and that this platform is acceptable to its intended user group.

Aphasia is an impairment of language as a result of brain damage which can affect individuals after a stroke. Recent research in aphasia has highlighted new technologies and techniques that fall under the umbrella of big data and artificial intelligence (AI).

This review aims to examine the extent, range and nature of available research on big data and AI relating to aphasia post stroke.

A mapping review is the most appropriate format for reviewing the evidence on a broad and emerging topic such as big data and AI in post-stroke aphasia. Following a systematic search of online databases and a two-stage screening process, data was extracted from the included studies. This analysis process included grouping the research into inductively created categories as the different areas within the research topic became apparent.

Seventy-two studies were included in the review. The results showed an emergent body of research made up of meta-analyses and quasi-experimental studies falling into defined categories within big data and AI in post-stroke aphasia. The two largest categories were automation, including automated assessment and diagnosis as well as automatic speech recognition, and prediction and association, largely through symptom-lesion mapping and meta-analysis.

The framework of categories within the research field of big data and AI in post-stroke aphasia suggest this broad topic has the potential to make an increasing contribution to aphasia research. Further research is needed to evaluate the specific areas within big data and AI in aphasia in terms of efficacy and accuracy within defined categories.

People with Aphasia (PwA) experience detrimental consequences post-stroke which can result in limited opportunities for social engagement and poor psychosocial ramifications. Peer support can improve psychosocial outcomes. Unfortunately, Covid-19 related social restrictions resulted in the closure of social outlets for PwA, further exacerbating social isolation. Some social networks transitioned online during this period. One such network was the Aphasia Café, a social group for PwA, supported by Speech and Language Therapy students (SLTS).

This study aimed to investigate the experiences, knowledge, attitudes, and beliefs about the Aphasia Café (in-person and online), within the context of pandemic-related social restrictions, from the perspectives of PwA and the SLTS who support them.

16 SLTS participated in one of five focus groups. Six PwA were individually interviewed. Semi-structured questionnaires facilitated inductive and deductive data collection which were analysed using Framework Analysis.

Observed themes related to the in-person and online Aphasia Café will be reported in this paper. Overarching themes observed from both SLTS and PwA include: ‘Socialising changes during Covid-19 pandemic’, ‘Awareness and Purpose of the Aphasia Café’, ‘Perceptions of an Online and In-Person Aphasia Café” (subthemes –accessibility, technology, time/timing, non-verbal communication, and social environment), and ‘Optimal Aphasia Café’ (PwA only).

This study provides a unique perspective on the delivery of a supported informal conversation group from both PwA and the SLTS who facilitate it. Both online and in-person social spaces were considered to enhance the quality of life for PwA and give valuable experience for SLTS.