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What is aphasia?

With City hosting the 17th International Aphasia Rehabilitation Conference, find out more about aphasia

by George Wigmore (Senior Communications Officer)

Aphasia is a communication disability which affects around 350,000 people in the UK, but the condition is not particularly well known. With City hosting the 17th International Aphasia Rehabilitation Conference, researchers from City and other institutions around the world are hoping to change this by speaking about the condition and raising awareness of its effects and also possible treatments.

Organised by conference chair Dr Lucy Dipper from the Division of Language and Communication Science (LCS) in the School of Health Sciences at City along with co-chairs Dr Madeline Cruice and Dr Rachel Holland, the internationally-renowned conference is based on a tradition of excellence, and which brings together both researchers and clinical specialists dedicated to aphasia rehabilitation.

Including a range of presentations from world leading academics, clinical researchers, and practising clinicians, the IARC will share the latest healthcare research designed to impact policy, service delivery and practice, and to improve the lives of people living with aphasia.

But what actually is aphasia, and how is research at City is helping people address the issues associated with the condition? In the UK alone it is estimated that a third of the 152,000 people who have a stroke each year will have aphasia. That works out as around one person every 15 minutes.

“Aphasia occurs when the communication centres of the brain are damaged,” said Dr Lucy Dipper, Chair of the IARC and also clinical linguist with a particular interest in aphasia in the LCS at City. “It is often caused by stroke but it can also arise from brain haemorrhage, head injury or tumours.”

“In particular, aphasia can mean different things for different people, as each person with aphasia experiences it differently,” said Dr Rachel Holland, co-chair of IARC and a lecturer in LCS. “In general terms, aphasia affects communication, both when it comes to getting the message in, such as when we have conversations or read, and also getting the message out in terms of speech and writing.”

At City, the Division of Language and Communication Science in the School of Health Sciences has long been known for its excellence when it comes to aphasia research.

Research into the area is thriving and diverse, and the School includes 5 permanent staff members with a primary research interest in aphasia, 10 staff members on fixed term grant or fellowship funds and 7 current or very recent PhD students investigating everything from speech and language therapy interventions to virtual treatments, IT assistance and narrative intervention.

This includes:

  • A virtual reality world called EVA Park developed by Professor Jane Marshall and colleagues in LCS and also the Centre for Human Computer Interaction Design can improve the communication of those who have impaired speech and language following a stroke
  • Dr Madeline Cruice, students and community Speech and Language Therapists have been helping people with aphasia to improve their IT skills and gain access to much of the technology society takes for granted in a series of classes at City
  • Dr Katerina Hilari is part of a new international study looking at the rehabilitation and recovery of people with aphasia after stroke. Funded by the National Institutes of Health Research (NIHR) for two years, the RELEASE (REhabilitation and recovery of peopLE with Aphasia after StrokE) project aims to explore the contribution that individual characteristics and intervention components make to the natural history of recovery and rehabilitation of people with aphasia following stroke
  • Work by Dr Lucy Dipper and Dr Madeline Cruice has shown that therapy supporting personal narratives can improve speech in people with aphasia
  • Research by Dr Celia Woolf  and colleagues also showed that speech therapy delivered remotely using video chat software applications such as Skype may be as effective as traditional face-to-face therapy
  • Another project, called CommuniCATE, was launched in 2014  and aims to use devices such as e-readers and text-to-speech software to deliver technology-enhanced therapies to people with aphasia
  • Abi Roper and Becky Moss, two PhD students, are also developing and researching two different assistive technologies. The first is based around using a novel computer-delivered gesture therapy for adult, while the latter is investigating whether two mainstream assistive technology software packages, Dragon NaturallySpeaking™ and ClaroRead™, can compensate for writing deficits for people with aphasia
  • A team of researchers – led by Dr Hilari – also received one of The Stroke Association’s prestigious Priority Programme Awards this year to investigate the benefits of peer-befriending for people with aphasia. The team will use the SUPERB trial (SUpporting wellbeing through PEeR Befriending) to specifically find out if peer support can avert some of the adverse psychological consequences of aphasia
  • In 2016 Dr Sarah Northcott was also the first ever recipient of the Stroke Association’s Jack and Averil (Mansfield) Bradley Fellowship Award. Dr Northcott will use the three-year fellowship to explore whether a particular type of talking therapy can help people with aphasia. In particular the study will investigate participants' experiences of the intervention, and prepare the groundwork for a future larger scale trial

“With aphasia, some people cannot speak at all while others who can speak just have a few words. The condition can also mean that people can no longer read, write or use numbers,” says Dr Madeline Cruice, co-chair of the IARC and a researcher in LCS. “This can mean that everyday activities such as having a conversation, answering the phone or even watching television can become a source of profound frustration and anxiety.”

“Aphasia can also affect mental well-being, as it can make people with the condition depressed, anxious, lonely or embarrassed, as the frustration of knowing what you want to say but struggling to say it, can lead to anger. As a result, it’s very important for us at City and at IARC to help these people to not only develop mechanisms to help support them with everyday tasks, but also show them ways to improve speaking and narrative that can help them reduce the impact of the condition on their lives. As a result, we hope by sharing our research at the conference we can improve not only knowledge of the condition, but also approaches to help people with aphasia in their daily lives,” added Dr Cruice.

Recent funders also include The Stroke Association, The Barts Charity, The Tavistock Trust for Aphasia, British Aphasiology Society and The BUPA Foundation.

City researchers in LCS are also supporting the Stroke Association’s Lost for Words campaign, to find out more visit: https://www.stroke.org.uk/take-action/lostforwords

Read more about IARC http://www.city.ac.uk/iarc-2016

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