The New Bilinguals have read all of your feedback for our two solutions, thank you to everyone who gave us some thoughtful comments!
Solution #1: Biological cure directly approaching the brain
The first solution we found realistic is a combination of (2) and (3). By detecting where the lost language was stored in the individual’s brain (which could be related to when and how the patient acquired the language), we thought that we may be able to implement new stem cells in that particular part. By having healthy stem cells, the patient’s brain is ready to learn a new language just like a newborn child. More research and thinking on how the actual process will be like is needed.
- “Maybe take a look at brain stimulation rather than injections (less invasive)”
We agree to the point that direct stem cell injections can be highly dangerous to the patients. Therefore, we decided to first investigate on 1) the brain areas that are responsible for productive aphasia, and then search for 2) prior research that deals with therapeutic methods using brain stimulation.
2. “Which specific area is related to the lost language? Has there been a research related to it?”
Expressive aphasia, as the name suggests, is relevant to language production. Thus, it is believed to be caused by damage to Broca’s area, which is located in the anterior regions of the brain (i.e., left posterior inferior frontal gyrus or inferior frontal operculum).
Indeed, there are some research that address the correlation between the location of the brain damage and the symptoms. However, considering that most of the research are case studies, the range of damage and the symptoms are hard to generalize.
3. “With regard to stem cells, we know that it had been implemented in organs and skin, but does it work/rejuvenate the same in the brain?
Yes! It has been reported that neural stem cells (NSCs), which is a type of adult stem cells, in fact seem to work in the central nervous system (CNS). Recently, there are some researches on the NSCs in hope to find cure for neurodegeneration or traumatic damage, such as the Parkinson disease.
- “This solution, though innovative would take a lot of resources to master and apply.”
We fully agree with that comment, and while we believe that it would be a fundamental cure, we are also concerned about how much people can actually afford the cure. On the other hand, considering how aphasia patients will continue to suffer (because it’s so hard to prevent a stroke), we also think that it is worth the resources to invent a new cure.
2.“Recovery of language cannot just be biological (more to it than stem cells).”
Yes, we agree. However, without the biological solution, we feel that the brain is not even ready to relearn the language. Therefore, we believe that the first step is to biologically solve the problem that parts of the brain are dead, and then tackle the more linguistic-related problems regarding language learning.
3. “If the brain goes back to a newborn's state, does this mean the patient will have to re-learn the language from scratch?”
Yes, that is right. Since the part that was damaged by the stroke is already “dead”, we decided that reviving the dead part is unrealistic (just like how dead people cannot revive). Therefore, by implementing new stem cells, the cells are alive and ready to learn. Although this may also be a long-term process, it would allow for more language acquisition than thinking about what the brain can do without the dead damaged parts.
Solution #2: A new type of therapy that stimulates the brain
The second solution focuses on improving the current behavioral therapies. Rather than implementing biological cures that can cause severe, long-term consequences to the patients, we aim to develop effective intervention programs that can replace the current ones.
One of the solutions may be creating an educational application that helps stimulate patients’ brain areas relevant to language production. Actually, there have been similar attempts to help ASD children acquire language and sociability skills via robots and computer programs (e.g., MILO). This would also enable us to provide affordable cures to wider scope of patients.
- “Maybe explore what ages this treatment would be most beneficial for”
Studies show that the best time to learn a new language would be before the age of 10. Unfortunately, most people with aphasia are middle-aged or older so we definitely have to take into account the fact that the App would be targeting older minds. This feedback was a helpful reminder that children may store two languages in one area of the brain, if learned early enough, whereas adults learning a second language, or trying to recover it, will be activating two different parts of the brain rather than one. This was great feedback and will definitely affect the way in which we approach creating the app to target adult brains.
2. “Look at other therapies in other diseases and try to benchmark it. How did other companies or scientists turn around failing therapies?”
One type of therapy is naming therapy. Patients look at ann image and are asked to name what it is with the help of small hints, like the first letter of the word. This therapy can be very frustrating and discouraging to patients because it is extremely difficult for them to simply remember forgotten words, especially during the first round of therapy. Other types of therapies include watching videos that show images and say what the image is, so that the patient sees and hears the word. We believe that writing is also key for learning and would make a therapy such as this one even more effective. Finally, many therapies simply give patients a document to read, and then aim to help them understand what they read- almost like a reading comprehension activity. We think this method has not been totally successful because it does not include a visual aspect, crucial for connecting words to images. Looking into therapies like these have helped us steer away from simply repeating what others have tried, and has inspired us to try and think of ideas different from those that have already been tried.
3. “This is a lot more feasible than solution 1 (not as risky and expensive)”
Thank you! We agree with this and have decided to focus on this solution in particular. Affordability is very important to us as we seek to find a treatment that is accessible to all people. We also agree that attempting to use stem cells is very invasive and extremely risky, not something we are totally equipped for!
- “Unclear about the direction because the focus is just on improving rather than creating new therapies →Should you wish to continue on this path, provide greater specificity in how you will go about improving the therapies.”
This may be true, but we are thinking about fully using technology (phone applications) which will help us reduce the cost and the time to go out to see a therapist. Also, this would solve the problem of not enough therapists that can conduct the therapy in the patient’s preferred language. While it may not be fully creative, we think this is a big step to tackle many social and environmental problems related to bilinguals with aphasia.
2. “Specify why current behavioral therapy does not work and how to improve it”
Similar to our response for 2a, current therapies are somewhat effective in recuperating a good amount of lost language, but none of them are completely successful. We believe this is because none of them target visual, auditory, written, read, and comprehension aspects of learning a language, rather only visual or auditory. We believe that in combining all these aspects into one type of therapy, that is enjoyable for the patient, we could truly have a groundbreaking method of language recuperation, that is affordable and accessible.
3. "Patients may benefit more from human interaction rather than computers/robots. They may sacrifice development of interpersonal skills."
a. We agree to the point that parents may benefit more from human interaction. In fact, the reason robot/machine was adopted for education of ASD children was because of the specific features of ASD - that is, ASD patients have difficulty in engaging in social interactions.
b. However, we think that developing software programs does have its benefits:
- Software programs allow consistent and repetitive learning for aphasic patients. In that aphasic patients have trouble producing language, they would need consistent and repetitive training (which human interaction may lack.).
- Software programs are affordable and easily-accessible. Today, over 2 million people (and this is just from the U.S. population!) are suffering from aphasia, and no fundamental cure was found yet. In that the world is growing more and more global, we think that technology can definitely play a role in tackling this huge problem.
- Also, we are not saying that we should get rid of human interaction - the education via robot/machine will not prevent one from having social interaction!
After receiving feedback from the class, we are definitely leaning towards focusing on solution 2, creating a new type of therapy that stimulates the brain. We are leaning towards this solution because we agree with feedback that it will be much more affordable and less invasive. We have decided that solution one, using stem cells to biologically cure aphasia, puts patients at extremely high risk of even further brain damage, and the treatment would vary upon each individual, as aphasia affects many different parts of the brain. We are still awaiting feedback from experts, and hope that they will agree, and further help develop our ideas for creating a therapeutic app that truly targets all activities important for learning language.