Engagement with a virtual clinician encourages gesture usage in speakers with aphasia

Aphasia is an acquired communication disorder that affects the ability to speak and understand spoken language. The use of gestures during speech is an important nonverbal means of communication that may facilitate speech production. The purpose of this project was to determine whether verbal interaction with a virtual clinician that produced gestures facilitated the use of meaningful gestures in the affected and unaffected upper extremity of individuals with aphasia. Individuals with aphasia engaged in several communication tasks following instructions from a virtual clinician that first did not use gestures, then exhibited gestures, and then again did not use gestures. Upper extremity and head motion of the patient were recorded and analyzed off-line. A taxonomy of gestures was created to identify whether each gesture was communicative or noncommunicative. Frequency of appearance of each type of gesture was calculated. Magnitude of upper extremity motions and trunk motion were analyzed to explore whether immersion in the virtual environment impacted the responses to the virtual clinician. We hypothesized that active engagement with a virtual clinician that produces natural gestures will support the emergence of more upper extremity and coordinated postural actions in patients with aphasia. Our results suggest that individuals with aphasia produced larger gestures after the clinician produced gestures, and they became more engaged with the virtual clinician over time. The results support the use of virtual clinicians for speech rehabilitation purposes.