Recursive Self-feedback Improved Speech Fluency in Two Patients with Chronic Nonfluent Aphasia

Area of Science:

• Neurology
• Speech-Language Pathology
• Digital Health

Background:

• Previous research shows people with nonfluent aphasia (PWNA) benefit from scripted speech therapy with clinician feedback.
• Automated feedback could overcome barriers like limited clinician availability and patient mobility issues in aphasia treatment.
• This study investigates if PWNA can improve language production using self-generated auditory feedback without direct speech-language pathologist (SLP) input.

Purpose of the Study:

• To determine if recursive self-feedback, delivered via a smartphone app, can enhance speech fluency in individuals with chronic nonfluent aphasia.
• To compare the efficacy of automated recursive self-feedback against a control condition lacking self-feedback.
• To assess improvements in speaking rate and speech initiation latency.

Main Methods:

• Two individuals with chronic nonfluent aphasia participated in the study.
• Participants underwent two remote treatments via smartphone app: script production with recursive self-feedback and a non-self-feedback control training.
• Each treatment was administered for approximately three weeks, with improvements analyzed using quantitative trend analysis and nonoverlap of all pairs (NAP).

Main Results:

• Recursive self-feedback significantly improved speaking rate and speech initiation latency for both trained and untrained scripts in both participants.
• The control training also yielded improvements, but these were less pronounced for speaking rate and only affected speech initiation in one participant.
• Automated recursive self-feedback demonstrated a clear benefit for speech fluency in PWNA.

Conclusions:

• Preliminary findings suggest that fully automated recursive self-feedback can effectively improve speaking rate and speech initiation latency in PWNA.
• The success of this automated method indicates that traditional components like speech unison and repeated written script exposure may not be essential for script-based aphasia therapy.
• Recursive self-feedback presents a promising, accessible avenue for aphasia rehabilitation.