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Exploring Discourse Therapy for Aphasia in a Virtual World


1st supervisor: Dr Madeline Cruice

2nd supervisor: Dr Lucy Dipper

Research Centre

Language and Communication Sciences Research

Project description

Discourse has reached a tipping point in aphasia research (Dietz & Boyle, 2018). Although there is yet no consensus on discourse measures to use (Bryant et al., 2016), discourse treatment is articulated as an area for SLT treatment in international clinical guidelines (e.g. Herbert et al. 2016), and best practice statements (Power et al., 2015). People with chronic aphasia want to work on everyday talking (Worrall et al., 2011), and identify verbal expression beyond the sentence level, and meaningful and normal conversation, as priorities for aphasia rehabilitation research (Wallace et al., 2017).

LUNA is a novel discourse treatment for people with chronic aphasia that draws on personal narratives, and treats these using a combination of word, sentence and discourse level therapies, in a theoretically-sound and personally meaningful way. [LUNA is currently in development at City by PIs Cruice and Dipper.]

EVA Park is a stimulating language-rich virtual world environment that has shown to produce functional communication gains for people with chronic aphasia engaged in regular communicative interaction with volunteers (Marshall et al., 2016). EVA Park provides multiple opportunities for practice of word level targets, phrase, sentence, and discourse immediately in a dynamic environment that both the participant and therapist can see, making it a useful environment in which to practice the LUNA techniques.  A different storytelling intervention approach has already been trialled in EVA park, with promising results (Carragher et al., 2018) indicating the feasibility of delivering a complex intervention via a virtual reality platform.

This LUNA in EVA PhD project would allow us to explore how to maximise these positive indications, and how best to adapt the LUNA protocol to capitalise on the benefits to the intervention arising from the unique environment of EVA Park.  EVA Park contains a number of functional and fantastic locations and allows for interactive communication between multiple users.  This would provide multiple sources of creative stimulation for the stories as well as numerous opportunities to practice them in conversation, in this supportive environment. EVA Park offers a number of potential benefits for aphasia therapy as it provides a playful, immersive experience that has been shown to aid motivation and encourage intensive language practice (Marshall et al., op cit.).

Proposed Methods

  1. Development Phase: the PhD student will support the co-design phase of LUNA from February - June 2019, whilst also submitting ethical approval. July – August: adaptation of LUNA for EVA Park with expert panel of people with Aphasia who are familiar with EVA Park.
  2. Experimental phase: the PhD student will consider the most appropriate design for the study, with support from supervisors. Similar studies have largely employed one of two designs: a) a waitlist-control design, comparing a group that receives immediate intervention with a waitlist control group, with participants randomly assigned to the groups; b) a series of single case studies.

Supervisory Team: In addition to the named supervisors the candidate will be able to draw on the expertise of the wider LCS aphasia team and EVA Park research team. Professor Jane Marshall (LCS) and Professor Wilson (Centre for Human Computer Interaction design, SMCSE) will be invited to join this project as advisors.

Potential for a field of strong candidates:

The potential here is extremely strong, given that we have had a number of doctoral students in LCS successfully winning PhD studentships in aphasia topics in recent years (Pritchard, Galante, Roper, Kistner, Caute, Hickin, Kladouchou).

If you would like to have an informal discussion please contact M.Cruice@city.ac.uk.