From 2019 to 2021 we conduct the multidisciplinary research project When words fail: advanced communication through digital innovation for persons with aphasia, with support from Vinnova. The project’s aim is to develop a prototype for a mobile application, Dialogica, to support communicative participation for persons with acquired brain injuries and aphasia when joining conversations about deep, personally relevant, and contestable issues. Millions of people each year acquire a brain injury (Colantonio et al., 2016), for instance through stroke or car accidents. The consequences are diverse and may show in the communicative, cognitive, social, emotional, or vocational domains (Cancelliere et al., 2014; Colantonio et al., 2016; Durham, 2012; Fabiano & Sharrad, 2017; Sabatello, 2014, Soeker, 2016). Aphasia – defined as ”a loss or impairment of verbal communication, which occurs as a consequence of brain dysfunction” – is one common consequence in the communicative domain (Brady et al., 2016, p. 79). It often means long-term communicative changes with severe influence over engagement in activities and maintenance of relationships (Lanyon, Rose, & Worrall, 2013). To achieve communicative support for persons with aphasia, we bring together expertise in computer game technology, education, special needs education, and philosophy. Together with end users we develop the application and test its effectiveness. In this paper, we (i) provide an overview of the theoretical background and the development hitherto, and (ii) discuss issues or dilemmas relating to the app and the fulfilment of its purpose.

In short, Dialogica is an application developed through the game development engine Unity, designed for mobile devices with larger screens, and is based on computer game technology, theory in dialogic education, and argumentation theory. The main usage of the app is when the participants are in the same physical room and it is then intended to support participants in expressing themselves in different virtual environments through personal avatars, animations and chats. Dialogica allows for conversations’ argumentative structures to be represented visually through so-called ”conversation trees”. In order to support participants with verbal language loss, the app also incorporates a text-to-speech function.

The project depends on close collaboration with end users, with which iterated workshops and facilitated dialogues using prototypes will be conducted. Through these workshops, we receive feedback used for further development of the prototype. In the end stage of the project, we will compare dialogues with and without Dialogica using an adapted version of the structured observational scale called the Argumentation Tool (Reznitskaya & Wilkinson, 2017), in order to measure the extent to which the application facilitates communicative participation for the participants. However, because of the pandemic, we have not yet been able to test the prototypes developed so far. Other issues that we will attend to in greater length in this paper is the level of applicability of the app in settings others than dialogues facilitated by experienced facilitators, how the app could support the participants’ awareness of improvements in communicative participation, and possible threats to internal validity when using the final app in experimental studies.

Central references

Brady, M. C., Kelly, H., Godwin, J., Enderby, P., & Campbell, P. (2016). Speech and language therapy for aphasia following stroke. Cochrane Database of Systematic Reviews, 24(958), 314. http://doi.org/10.1002/14651858.CD000425.pub4  

Cancelliere, C., Kristman, V., Cassidy, J. D., Hincaplé, C., Côte, P., Boyle, E., . . . Borg, J. (2014). Review article: Systematic review of return to work after mild traumatic brain injury: Results of the international collaboration on mild traumatic brain injury prognosis (ICoMP). Archives of Physical Medicine and Rehabilitation, 95(3), 201–209.

Colantonio, A., Salehi, S., Kristman, V., Cassidy, J. D., Carter, A., Vartanian, O., . . . Vernich, L. (2016). Return to work after work-related traumatic brain injury. NeuroRehabilitation, 39(3), 389–399.

Durham, C. Y. (2012). Empowering people with ABI to acquire better insight into brain injury: An application of educational principles (Doctoral thesis). RMIT University, Melbourne, Australia. Retrieved from https://researchbank.rmit.edu.au/eserv/rmit:160046/Durham.pdf 

Fabiano, R., & Sharrad, S. (2017). Rehabilitation considerations following mild traumatic brain injury. Journal of Nurse Life Care Planning, 17(1), 26–34. 

Lanyon, L. E., Rose, M. L., & Worrall, L. (2013). The efficacy of outpatient and community-based aphasia group interventions: A systematic review. International Journal of Speech-Language Pathology, 15(4), 359–374.

Reznitskaya, A., & Wilkinson, I. A. G. (2017). The Most Reasonable Answer: Helping students to build better arguments together. Cambridge: Cambridge Education Press

Sabatello, M. (2014). “If you can’t do it now, you’re out the door:” Employees with traumatic brain injury – A case study. Work, 48(3), 373–379. 

Soeker, S. (2016). A pilot study on the operationalization of the model of occupational self efficacy. Work, 53(3), 523–534.