Stroke Victims Get New ‘Voice’ Via Computer Communication Device

For three or four hours each week at Baltimore’s Kernan Hospital, it is almost like happier days in the past for Clifford and Phyllis Leager.

They have fun, they squeal with delight, and there is laughter. They are like two youngsters, playing a game on a special computer that has no keyboard but still helps Leager, a stroke survivor who can no longer speak or write, communicate with his wife.

“He’ll ask a question, and I take the ‘mouse’ and answer it,” says Phyllis Leager, 54. “But the communication is all over when we come home, where there is no computer. We have to play a guessing game then.”

Using the mouse, a 2-inch-by-4-inch plastic box that rolls on a ball attached to the underside, Leager can move an arrow on the computer screen that opens up categories such as people, food, clothing, appliances and buildings.

To open up the categories and get to symbols or pictures that represent ideas the 71-year-old former railroad brakeman wants to express, he pushes a button on the mouse. Then the challenge gets under way. The pictures can be moved around to form sentences.

“It’s like having a dictionary on the computer,” Phyllis Leager says. “In the beginning it was laborious until Clifford learned how to use it and how it works, but now he loves it. I can tell by his expression.”

Stroke patients at the Kernan Rehabilitation Unit who have been left with severe aphasia--the inability to understand or produce language in any form--are the first in Maryland to use this new computer program, called Computerized Visual Communication.

C-VIC, as the program is commonly called, was developed by Dr. Michael Weinrich, a University of Maryland Medical Center neurologist who also directs the Kernan Rehabilitation Unit, and Dr. Richard Steele, a physician at the Veterans Administration Medical Center in Palo Alto. About 20 patients worldwide who would otherwise not be able to communicate are now using the program, Weinrich says.

The program has been patented, and Weinrich is trying to get a company to distribute it commercially. He also hopes to use grant money to bring more of these special computers to Kernan and to find a way to make them more available to patients.

“It’s an imperfect means of communication, but it’s a lot better than nothing,” the neurologist says. “Life can be very frustrating for people who have severe communication problems. This can help reduce their own stress and the stress on their families.”

In the past, computers have not been very successful with these patients, he says.

“The same cognitive deficits that prevent them from understanding language also get in the way of using computers that are designed for use by ordinary people,” he explains.

About 80,000 Americans each year become aphasic, and of those about 20,000 lose their ability to communicate effectively.

The computer program is seen as a boon for patients who cannot benefit from conventional speech therapy after a stroke, which in most cases is caused by blood clots that hit the brain.

The program can benefit not only patients but also researchers who are studying the effects of severe strokes.

“One of the most interesting aspects of the computer program is that it allows us for the first time to assess the cognitive ability of patients whose communication skills are severely impaired,” says Dr. Rita S. Berndt, associate professor of neurology and director of the aphasia research program at the University of Maryland Medical Center.