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Development of VAST™

An Evolving Program

The VAST program was developed at the Stroke Comeback Center in conjunction with a member of the Center, Winston Lindsley. Winston is a technology-minded individual with extensive video taping equipment. He, like many other apraxic clients, learned to carefully observe oral movements and to imitate the posturing and sequencing. He video taped his private speech-language pathologist speaking a series of speech exercises: automatic and serial tasks, and some language-based exercises. These preliminary tapes were viewed and used by several individuals and it was noted that they readily imitated both the oral sequencing as well as the rate and rhythm. This spawned the concept of taping scripted functional communication segments for use in the same manner. The individual with aphasia/apraxia watched the tape and attempted to imitate the script.

Several factors were derived out of initial trial tests with the technique:

  • Most individuals with apraxia/Broca’s aphasia were able to imitate and speak the script – even if they had never been previously exposed to the technique
  • Although initial scripts were recorded at an exaggerated slower pace, the individuals who were trial testing, preferred a slightly faster pace, with normal rhythm of speech, but slightly longer pauses between meaningful phrases
  • When practiced repeatedly, segments of the script became automatic

These initial results are very exciting and very promising. The fact that imitating the oral movements appears to be readily within the grasp of individuals with apraxia and nonfluent aphasia is certainly promising. The additional component of effectively using a mobile device with a relatively small screen is very exciting because it lends itself to carryover into social environments.

One question that has been raised is the issue of spontaneity of speech. Admittedly, using scripted recordings does not solve the issue of self-production of spontaneous utterances. No scripting technique can accommodate spontaneous speech. But the ability to record personalized scripts, the portability of using a mobile device, and the preliminary results of being able to over-learn the script and therefore produce speech segments spontaneously is a significant step in the right direction.

As described above, VAST was developed at the Stroke Comeback Center and initial clinical trials performed at the Center have validated the use of the technique. A natural consequence of making VAST widely available is the opportunity for expanded clinical trials and uses, which can lead to improvements and adaptive clinical uses. Thus, it is a further intent of SpeakinMotion to create a network of users who can contribute scripts, innovative uses, and adaptations, all with the goal of promoting improved communication for individuals with aphasia and apraxia. Please review the Participate page in the Clinical Trial section for more information about getting involved.