Quick Recap:

Moonshot Topic: How can we cure expressive aphasia among bilingual people?

Current Idea: We have decided to narrow it down to a new type of therapy that stimulates the brain through visual, written, auditory and spoken ways. We are trying to create an educational application that would allow patients to access treatment easier and under less cost.

Feedbacks:

1.We need to be even more specific:

This has made us think about what languages we should focus on when creating the application. We are planning to focus on Romance languages (Spanish, Portuguese, French, Italian, and Romanian) since they are more similar to each other compared to other languages in different language families. Since they have many sounds or grammatical structures in common, we are assuming that the similarity would help it the patients to relearn the languages. This is aimed to help bilingual aphasia patients who have both L1 and L2 in the Romance languages.

2.Our second solution was too moonshot:

After hearing back from an expert, it seems that our second solution, using stem cell therapy in conjunction with traditional aphasia therapy, was too moonshot. This is because it would almost be impossible to create one standard cure as each individual affected by aphasia may have damage in a different part of the brain. Also, we have found that patients are affected differently depending on which languages they were bilingual in, whether they had a pre, or post-stroke, and where in the brain the stroke happened.

3.We were led to resources that were performing similar therapies to those that we plan to use in our app:

After talking to Swathi Kiran’s Aphasia Research Lab at Boston University, we were introduced to one of their therapies they are currently developing: Kiran et al. (2013) examined if there is a rehabilitation model for bilingual aphasia that is generalizable and predictable. This study is relevant to our project, in that our group is seeking a general treatment (i.e., mobile application) for bilinguals with aphasia (BWA).

Kiran et al. (2013) tested seventeen English-Spanish speaking bilinguals with naming deficits; that is, the patients had trouble naming letters, phonemes, words, words chunks, or objects in a quick and automatic way. To test their treatment, Kiran et al. (2013) provided semantic-based treatment two times per week, for 2 hr each session. The treatment involved 1) giving name/labels (e.g., “apple”) for pictures of items(e.g., APPLE), 2) choosing five features that belonged to the item (e.g., “apple is used for ___”), and 3) generating an association and a non-association (e.g., “apple does/doesn’t remind me of ___”).

The study resulted with within- and between- language patterns varying across patients, but provided insights in curing aphasia: First, it demonstrates the beneficial effects of semantic-based naming treatments, with 14/17 patients showing significant improvement. Second, it provides insight on the connectivity between L1 and L2, in that the variability among patients indicated the interplay between generalization and inhibition. To be specific, in order for bilingual individuals to access the target language, the non-target language must be inhibited. As it takes more effort to inhibit the stronger language, the connectivity of lexical association between L1 and L2 becomes important.

In addition, we were told that there are in fact many studies/researches on using technology for aphasia treatment. It ranges from online platforms that provide assessment and therapy (e.g., matching SLPs from around the world with patients, so that they can offer their services online for a reasonable price) to VR programs (e.g., games that measures patients’ reaction times and gaze patterns which predict recovery). In addition, we were warned that there can be potential social/ethical issues -- involving digital devices may risk patients’ personal information, and SLPs may be sensitive about making their job automated.

Our Next Step:

After receiving feedback from one expert we have finally decided to stick with our first solution, a type of therapy that stimulates the brain through visual, written, auditory and spoken ways that will be in the form of an application.

We will focus on bilinguals in romance languages as we believe that it will be easier for a patient to re-learn two languages of the same language family, as opposed to two very different languages.

Also, after reading some of the resources our expert shared with us, we have learned so much more about the types of therapies that currently exist, and will further investigate how to incorporate those methods into our application.