Medical News Observer

Key Points:

• iTalkBetter offers a digital platform with over 200 commonly used words, incorporating confrontation naming therapy and real-time feedback.
• It demonstrated a 13% improvement in naming ability for trained items in a phase II trial, with benefits persisting for three months.
• Associated with increased brain volume in language processing regions and dose-related activity, showing tangible changes in brain structure and function, supporting long-term rehabilitation prospects.

iTalkBetter, a medical app developed by the Neurotherapeutics Group at the University College London Queen Square Institute of Neurology, offers a digital approach to speech therapy for individuals suffering from aphasia. Aphasia is a condition affecting many stroke survivors by impairing their communication ability. This app development addresses the critical need for more extensive speech therapy than what is currently provided by healthcare systems, such as the NHS, which offers around 12 hours of speech and language therapy.

iTalkBetter App

The app provides a user-friendly digital platform for users to practice over 200 commonly used words at patients’ convenience. Therefore, the limitations on the amount of therapy received were removed. This app employs confrontation naming therapy and a real-time utterance verification system. It utilizes engaging games and an integrated speech recognizer that gives real-time feedback.

Clinical Trial Results

In a phase II, item-randomized clinical trial conducted involving 27 participants with aphasia, iTalkBetter demonstrated a notable improvement in naming ability by 13% for items specifically trained using the app, compared to no change in untrained items. This improvement translates to an average increase of 29 words per person, with beneficial effects persisting for three months. 

The app enhanced propositional speech. It is also shown to increase brain volume in specific language processing and control areas. Moreover, iTalkBetter was associated with dose-related activity in key brain regions, underscoring the app’s effectiveness in inducing observable changes in brain structure and function. Journal eClinicalMedicine published this study’s results.

Implications

Research demonstrates transfer to naturalistic speaking tasks, marking a pivotal step in using digital speech and language therapy interventions in aphasia patients. The app is now available for broader use. It aims to provide an accessible solution for individuals seeking to increase their practice-based speech and language therapy. Increasing speech therapy access digitally could contribute to lower costs and better outcomes.

References

Upton, Emily, Catherine Doogan, Victoria Fleming, Pedro Quijada Leyton, David Barbera, Peter Zeidman, Tom Hope, et al. “Efficacy of a Gamified Digital Therapy for Speech Production in People with Chronic Aphasia (iTalkBetter): Behavioural and Imaging Outcomes of a Phase II Item-Randomised Clinical Trial.” eClinicalMedicine 0, no. 0 (February 21, 2024). https://doi.org/10.1016/j.eclinm.2024.102483.

UCL. “Digital Interventions in Neuro-Rehabilitation: iTALKbetter.” Institute of Cognitive Neuroscience, February 28, 2019. https://www.ucl.ac.uk/icn/research/research-groups/neurotherapeutics/projects/digital-interventions-neuro-rehabilitation-0.