Finding Words: AI and Aphasia

In this episode of 'On the Tip of My Tongue,' hosts Rob Edwards and Jonathan Hirons with guest Dr. Abi Roper explore how artificial intelligence can assist people with Aphasia in finding their voices again. The discussion covers the ways AI aids in simplifying text, improving written communication, and developing speech recognition technologies. The episode features Jez Hodgkinson, who created an AI-driven app to help with word-finding and introduces Robert Baldcock, a musician using AI-based personalized voice technology. The conversation highlights both the promise and pitfalls of AI in this field, addressing issues such as AI's limitations in real-time conversations and the need for co-designing tools that are genuinely empowering for users with Aphasia.

00:00 Introduction to the Podcast
00:21 Understanding Aphasia and AI's Potential
01:03 Dr. Abi Roper on AI and Aphasia
01:42 AI's Role in Simplifying Text
02:39 Speech Recognition Challenges and Advances
04:48 Jez Hodgkinson's AI App for Word Finding
07:26 Chatbots and Human Conversation
10:41 AI's Limitations and Hallucinations
12:33 Visual Support and Multimodal Communication
14:09 Robert Baldock Personalized Synthetic Voice
17:03 Co-Designing AI Tools with People with Aphasia

Transcript

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AI Documentary - EDITED RCE

SPEAKER_02 0:02

Welcome to On the Tip of My Tongue, the podcast that explores communication, connection, and the moments when words slip away? I'm Rob Edwards, and my co-host, Jonathan Hyrans, has had aphasia since 2019. In this episode of On the Tip of My Tongue, we're diving into a fascinating and fast-evolving question. Can artificial intelligence help people with aphasia find their voices again? Aphasia affects millions of people worldwide, often after a stroke, head injury, or neurological illness. It can make speaking, reading, or understanding language incredibly difficult. But what if technology, specifically AI, could become a bridge, not a barrier?

SPEAKER_00 1:03

I'm Abby Roper, Dr. Abby Roper. I'm a speech and language therapist and a research fellow. I'm based at Sisi St George's University of London, and I do lots of research and thinking about aphasia and technology. In a lot of ways, AI has been helping people with aphasia for a long time. We've had things like automatic speech spelling correction on our phone, and that was an early example of AI. Now obviously, we've got really clever models of artificial intelligence that have much more information at their fingertips. So they can do far more clever things. For example, is help you take a very complicated long piece of text, maybe an a long email or a letter that you've received, and they can help you simplify that information and find what are the key bits so you can really get to the bottom of the understanding without feeling too tired out, if you like, because it takes a lot of energy when you have aphasia to do reading and extracting information. So simplifying information is one of the really lovely ways that it can support people with aphasia that can help you polish things that you want to say. So if you're typing something, it might correct the sentences for you, or you could say, could you make it sound a bit more professional once you've written something that's a starting point?

SPEAKER_02 2:29

Okay. That was how AI can help with the written word dealing with text. But

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SPEAKER_02 2:35

what about the spoken word? Dr. Abbey again.

SPEAKER_00 2:39

So I've done some research about speech recognition technologies, things like your Alexa devices and Siri.

SPEAKER_04 2:47

That's interesting. Sometimes with people with aphasia don't speak at all or speak very little. Now, is there a point where AI can't really help? Because uh Alexa, I assume, can't always understand what somebody is saying.

SPEAKER_00 3:04

That's quite right. Speech recognition used to be not very good, and it used to be okay if you had a very kind of normal sounding voice and you didn't really have an accent or you weren't really young or really old and you didn't ever have any problems tripping over your words. But if you had any of these other kind of ways of speaking, it w was a bit rubbish and it could be really frustrating. The latest models, because it has been used so widely now, the latest models are getting much better at recognising speech, even if somebody has a phasia. However, it's not always great if you need to pause and think about what you want to say. It thinks you finish talking, but actually you just need to pause and have a little think. And that's something that happens a lot more when you have a phasia is you need a little bit more time. But sometimes the devices can either jump in or switch off when you pause. Yeah. And you're like, wait, I haven't finished speaking yet. Speech recognition devices can do clever things like controlling other things in your house. So you can use your speech to turn off your lights or to turn your lights on. If it's difficult for you to physically get out of bed to turn your lights off before you want to go to bed, you can ask Alexa to turn the lights off for you. There's a lady who finds programming the central heating really complicated. She can now just ask her device and say, Can you turn the heating up? And it does it all for her. It does all that complicated programming stuff.

SPEAKER_04 4:40

I wish I could get someone to do my heating.

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SPEAKER_04 4:44

I can't understand it either.

SPEAKER_02 4:48

Loving the podcast? Subscribe for more episodes and support the journey. Your donations help keep the show thriving. Please go to tipofmytonguefilm.com. Thank you for being part of our community. Jez Hodgkinson has a phasia. He has a background in IT and has developed a phone app to help people like himself with the common problem of word finding.

SPEAKER_03 5:16

I came up with the answer, which was I was online chatting to somebody and I was struggling to remember a word. And like most of us in the phaser community, sometimes the word just won't come. And it's incredibly frustrating. So I was trying to remember the word and I thought, okay, AI might be able to help me. So I typed in a bunch of words, very badly typed, and it told me the answer straight away. I thought this would be really useful for me and for a proportion of the people who have this challenge. So I wrote an AI app using AI. If you don't know what you're doing, you've got no chance. The app that I've done, I would say if I hadn't had AI, it probably would have taken me months and months and months. With AI, it took me a few days. The app is incredibly simple, and the whole point of it being simple is uh people who are struggling to remember the words don't particularly want complexity. The first part of the app is just entering a number of words which you are trying to remember. Anything related. You can type the words in, or you can speak them in one of the updates I'm trying to fix, which is to allow extra time to be able to talk into it, because certainly when I'm doing it, unless I

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SPEAKER_03 6:44

remembered what the the words I'm trying to search for, uh it can take a bit too long, and you just end up swearing at it, which generally doesn't work quite so well. Uh I'll just say the words that I'm trying to remember to give me the word that I just can't think of. So goes round around theme park fast. Hit submit.

SPEAKER_00 7:06

Carousel, ferris wheel, roller coaster.

SPEAKER_03 7:09

So, and the word I was hunting for was roller coaster. The idea being it's incredibly simple, but it's one of those things that we will struggle with at times. I got it on a tablet, got it on my phone.

SPEAKER_04 7:22

I suppose the only question is the uh ease of use, I guess.

SPEAKER_03 7:27

Since I've been using it for my own self and I've spoken to other people in the group, and they thought that or they they thought, oh god, that would have really helped me. Hopefully it will it will be a way of trying to reduce some of the frustration.

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SPEAKER_02 7:42

On the subject of chatbots, can they really replace human conversation? Can you have a chat with a chatbot? Dr. Abby, what's the answer?

SPEAKER_00 7:54

The answer is you can have a very tightly scripted conversation with AI, one that you know, almost as if you're both following a very predictable set of questions and answers. And in speech and language therapy, that we know that therapy for aphasia, which works on practicing script interactions, like you can have a you can have an interaction, you say, Oh, I want to practice going to the shop to buy my local paper, and what might that look like? And I can rehearse

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SPEAKER_00 8:29

it by taking turns with a computer. And that was before AI, but that was the computer would say its bit, you'd say your bit, the computer, and it would take it in turns. But that is when you know exactly how that conversation's gonna go. In a real life conversation, we don't know what the other person's gonna say, and we can't predict, and we have to take it in turns and respond. There is now a voice feature on Chat GPT, for example, where you don't need to do any typing and you don't just say a quote and then it responds in text. You you say something to it and it chats back to you as if it's a real person having a conversation. One of the ways that I think it's difficult and that I don't think it's very helpful at the moment for people with aphasia, is that it does that thing where it interrupts you if you pause. So if I stop talking for a moment, it will jump in. It doesn't adjust or it doesn't automatically give me lots of time for speaking and thinking. Another thing that it does is it over-describes, it gives you lots of information at the same time. Or it assumes a certain kind of tone of voice that

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SPEAKER_00 9:42

might not be the sort of person that I want to have a conversation. Things are emerging really rapidly and changing really rapidly. So I think those things will improve.

SPEAKER_02 9:50

So our chatbots getting AI in general a bad name? Because it feels as if you're actually talking to somebody, but of course you're not.

SPEAKER_00 9:59

Exactly. And it's so it feels like you're being hoodwinked because it's as if you're having a conversation, but it's not convincing. So if we were looking at that same information on a web page on just like a frequently asked questions page, we would reconcile, we could go, oh yeah, it's okay, because I I know that I'm just looking through some information, but uh chatbots give us this feeling that there's a human at the other end of it, and we want to speak back to them like they are a human, but they don't give us a real experience of conversation. I think bad experiences with what is AI can uh make people feel really put off, and I think that's why it's important for us all to uh recognize that it's a tool and it's being used in lots of different things, and we can have good and bad experiences, and it's not good for everything. It won't take over all of our jobs because there's lots of things that only humans can do.

SPEAKER_02 10:57

We think perhaps we should introduce a note of caution. Not everything in the AI garden is smelling of

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SPEAKER_02 11:05

roses. On the Headway website, for instance, it warns us that search engines like Google are increasingly using AI to generate quick answers. Now, this might be great for simple queries like how to boil an egg, but it's much riskier for health-related questions. All AI tools are trained on vast amounts of online content, so they can get things wrong. Just like humans, they may put two and two together and reach five. These errors are known as AI hallucinations, and they're not always easy to spot.

SPEAKER_00 11:44

So we've already talked about the fact that the one thing, and it really wants to do that well. And so if you ask it something and it doesn't really know, it's like a really confident person in a job interview. It'll make something up the first thing that comes to its mind and goes, I know that I should say something here, so I'm gonna say it, even if I it's not true. What that actually means is that the information that it gives you doesn't come from real evidence. It doesn't come from real information. It knows it should give you an answer here, but it can't find that answer. So it goes, this is the nearest best thing, this would fit. Normally I should give a reference for this here, or something that sounds a bit like this should go in that slot. And so that can be really troublesome when you are looking for like factual information. And the BBC have recently done a study on this and find found out that AI can be a bit of an unreliable source for news details and things like this. When we're trying to ask a system to do something that it's not really trained to do, like you've got the overconfident person in the job interview. Well, it's really important to do what we mentioned before, which is you always double-check the information, especially if it's something that's important to you.

SPEAKER_02 12:49

AI isn't just about words. For many people, visual support like images, icons, or gestures, helps bridge the gap. AI-driven tools can now generate pictures or symbols in real time to match what someone is trying to say. For example, if you type or say coffee, the app might instantly show you a steaming mug or even offer related words like cup, milk, or morning. This kind of multimodal communication allows people to express themselves even when speech is difficult. It's not replacing words, it's expanding how we can share meaning. Of course, technology alone isn't the solution.

SPEAKER_04 13:36

On one of our podcasts, we had a guy who's a musician who's got very poor, no, sorry, no, he's got no speech at all. Because he used to be on radio, he's there's this um this is called speak unique. And what it does is it catches all his words from previous things he's done on radio and puts it together for speech for himself. When it speaks for him, it's in his voice, and I think that's so clever.

SPEAKER_02 14:25

The guy Jonathan refers to is Robert Baldock, a composer and new media artist who in 2017 suffered a severe ischemic stroke, which left him with acute aphasia and severe verbal dyspraxia. Effectively, no speech at all. Here's Robert using his personalized synthetic voice to talk about the company's Speak Unique that created it.

SPEAKER_01 14:51

My particular form of aphasia and dyspraxia of speech is acute and lacks speaking, word-finding, and writing incredibly difficult and often frustrating. I've found i apps such as ChatGPT really useful for constructing texts. It works particularly well as a collaborative tool used between myself and my personal assistant. My work as an electronic musician is often technically complex. Communicating and outlining how and why works are made can take a long time, requiring my personal assistant to have a good understanding of the software and audiovisual programming tools I use, as well as my motives and inspirations for making my work. My language processing systems such as ChatGPT have accelerated this process massively, and my experience of it has been generally positive. By writing about my work, communicating with friends and family, or making applications for opportunities, I generate as many key prompts as I can. I do this by writing single words, cutting and pasting sections from previous texts, and by sharing drawings, gestures and signs with my personal assistant. The more prompts I offer, the more authentic and satisfactory the outcomes. My personalized Speak Unique voice was created using artificial intelligence, based on samples of recordings lifted from radio shows and podcasts I have presented in the past. SpeakUnique is a voice bank research project, based within Edinburgh University, created to help people without the ability to speak and to sound like themselves again by providing their own voice for use in a communication aid. They work with people with a range of medical conditions that affect speech.

SPEAKER_02 16:29

We've said before in previous podcasts, our voices express our personality, our identity. Me without my voice can feel like it's not me anymore. So technology that can go some way to restoring your real voice, however imperfectly, has to be genuinely empowering. Robert again.

SPEAKER_01 16:52

It might not sound like a big deal, but having a voice that sounds more like my own has allowed me to express myself more authentically and with confidence. However, the subject of AI, it's a hornet's nest, and I do have concerns about safeguarding the value of creative work. I do not use AI to generate my own creative output as a musician. A big deal indeed.

SPEAKER_02 17:13

Of course, technology alone isn't the solution. For AI to truly help, it has to be designed with people with aphasia and not just for them. Accessibility means more than clear buttons or large fonts. It means understanding frustration, pacing, and the emotional impact of communication barriers. Many research teams are now co-designing AI tools with people who have aphasia, testing interfaces, refining feedback, and making sure the technology feels empowering, not overwhelming. Now, if you want more help and information about strokes and aphasia, please go to stroke.org.uk. Say aphasia, that's SAY aphasia or one word.org, or the aphasia page of NHS.uk. Enjoying the podcast. Subscribe for more episodes and support the journey. Please go to tipofmyfilm.com in the description. Thank you. This has been a Buffalo Lounge production. Please follow Buffalo Lounge on all the socials.