REmote Speech entrainment Therapy with people with long-term acquired and developmental communication disORdErs (RESTORE)

The Kinephonics speech entrainment software is a communication app used on portable devices such as phones, laptops, and tablets. It incorporates multiple outputs of visualisation (camera filming the speaker; written text) and audio (text-to-speech generation) produced simultaneously on the screen. Written text and audio outputs of scripts entered into the software allow the speaker to listen to and read the script, as well as observe their face and mouth while speaking. Support workers (SW) and allied health assistants (AHA) will be trained by Kinephonics staff to implement the app with adult participants with various etiologies who experience chronic communication disorders. Individual training for each participant's SW/AHA will be completed following the participant's enrollment into the project and prior to their first intervention session (week -1 to week 0). Each participant will attend 12 in-person intervention sessions over 6 weeks with a SW/AHA for approximately 30 minutes each. The intervention is completed within the community during everyday activities. Family members/carers may also be present during the intervention sessions. support workers/allied health assistants will meet with participants in either their home or a community setting, rather than in a clinic environment. Examples of exercises could include ordering their regular coffee, common phrases used when buying items in stores, or introducing themselves. To monitor adherence to the intervention, the SW/AHA will complete a form after each intervention session to record that it occurred and whether there were any issues. SW/AHAs will be trained by Kinephonics staff prior to the intervention period, over 3 20-minute sessions. The SW/AHAs will learn how to use the Kinephonics technology, how to prepare the material and stimulus for each intervention session, and how to run a session with minimal assistance. The feasibility, acceptability, and adherence to completing the intervention with SW/AHAs for the purpose of conducting a larger clinical trial will be investigated as the primary outcome. Feasibility outcomes include participant fatigue, attendance rate to intervention sessions, and fidelity of intervention delivery is captured. Process evaluation interviews will also be conducted for an in-depth investigation of the trial feasibility with participants and SW/AHAs. Language outcomes before and after the intervention sessions will also be collected as secondary outcomes of this pilot trial. 20 participants with previous history of stroke will also be enrolled to complete 2 fMRI scans, one before the intervention and one after. These will be the first 20 eligible stroke participants who give consent to participate in fMRI component of the study. fMRI’s will be completed by the research staff of the Research Imaging NSW located at the Prince of Wales Hospital. This scan will take in total 60 minutes.