Computer therapy can help people with aphasia find lost words

Computer therapy can help people with aphasia learn new words even years after a stroke, a new study conducted by the University of Sheffield has revealed.

Researchers from the University's School of Health and Related Research (ScHARR) found there are a number of significant benefits to using computer therapy for people affected by aphasia, in comparison to usual speech and language therapy alone.

The pioneering £1.5 million study, funded by the National Institute for Health Research (NIHR), offered people with aphasia the opportunity to take part in self-managed speech and language therapy using a computer at home, in addition to face to face therapy available to them.

More than 350,000 people in the UK are living with aphasia. The language disorder, which is caused by an injury to the brain, can make it difficult for people to talk, understand, read and write. One in three people are affected by aphasia after a stroke.

Currently there is limited speech and language therapy available for patients in the long term after a stroke and a lot of people with aphasia want more therapy than they receive.

More than 270 people from 21 NHS Speech and Language departments across the UK took part in the trial—all were between four months and 36 years post-stroke.

Results of the five-year study showed computer therapy enabled patients to increase their speech and language practice – 28 hours on average compared with 3.8 hours of usual speech and language therapy over a six month period.

Participants also significantly improved their ability to say the words they chose to practise. This showed that people with aphasia can learn new words even after a long time post-stroke with computer therapy. They could still say the words six months after the computer therapy had finished.

The computer therapy approach tested, which included a combination of tailoring the programme to the individual with aphasia by a speech and language therapist, independent practise at home by the person with aphasia, and volunteer or speech and language therapy assistant support, cost half as much as providing the same amount of extra therapy face to face. The software used in the Big CACTUS study was StepByStep from Steps Consulting Ltd.

Sue Hutchings had a stroke four years ago, she said: "I find it very frustrating. You just can't get it out and in the end I give up."

Sue's husband Richard noticed a big difference in Sue since taking part in the computer therapy.

"I don't think you can beat having a professional coming in, but you can't have a professional with you 24 hours a day," said Richard.

"I think the programme is helpful in as much as it kick started Sue's progress again.

"Just recently she has felt comfortable, or it has been natural even for her to have a polite conversation with people and that is really good to see. I believe it all started with the programme."

The approach tested is most likely to be a good value for money option for people with mild and moderate word finding difficulties.

Dr. Rebecca Palmer, from ScHARR at the University of Sheffield and Chief Investigator of the study, said: "People with aphasia tend to do quite well with therapy but that isn't usually available to them after a few months.

"Our study showed that 61 per cent of people continued to use the computer therapy after the end of the trial intervention period showing that people with aphasia want to continue learning words and can do this independently."

Dr. Palmer added: "Although people were able to say more words they didn't always automatically use these words in conversation. One in three were able to use some of the words they had learnt but the majority of people weren't automatically making that transition. This would suggest we need to do something to help people practise more in everyday communication situations.

"I hope the results of this study give both speech and language therapists and people with aphasia and their carers hope for further recovery."

The results of the Clinical and cost effectiveness of Aphasia Computer Therapy versus Usual Speech and language therapy alone in the longer term post-stroke (Big CACTUS) study were presented at a special event at the University of Sheffield earlier this week.

Representatives from the Royal College of Speech and Language Therapists, the Stroke Association, speech and language therapists, people with aphasia and their carers attended the celebration which coincided with National Aphasia Awareness month.

Researchers are now hoping to focus on how to encourage the use of new words in everyday communication to further improve quality of life.