Using technology to help stroke survivors find lost words

Around 100,000 people have a stroke in the UK per year. More than a third of stroke survivors acquire the language disorder aphasia, which affects the ability to understand, talk, read and write, and can also affect a patient’s mood and cause them to feel isolated.

Photo of a young woman looking at a phone screen


Step-by-Step is a computer program designed to help people practise exercises to improve their ability to find the correct words when they are talking. Researchers at the Sheffield Clinical Trials Research Unit (CTRU) and School of Health and Related Research (ScHARR), both at the University of Sheffield, undertook the Big CACTUS study, which aimed to understand if Step-by-Step could improve the ability of people with aphasia to find words.

278 people with aphasia took part in the study, which compared the Step-by-Step program to usual care, and a third group received usual care plus a puzzle book (to control for intervention activity).


Results of the trial, published in The Lancet Neurology, show that computerised speech and language therapy significantly improved participants’ ability to say words compared with those who received the usual speech and language therapy available on the NHS. Computerised speech and language therapy also allowed more practice (28 hours on average) than usual speech and language therapy (3.8 hours on average) over the same time period.

We found that computerised speech and language therapy can help people with aphasia to learn new words for years after stroke, and may be cost-effective for people with mild and moderate word-finding difficulties. 


The trial has resulted in increased use of computer therapy options to deliver a greater dose of therapy across the UK trial sites to improve the word-finding skills of those with aphasia. Its use is recommended in National Clinical Guidelines, which should lead to further hospitals in the UK using computer therapy.

The trial has also influenced patient care further afield, with recommendations to use computer therapy included in the Stroke rehabilitation guidelines formulated by the Word Federation of Neurorehabilitation. Findings from the trial have been used in the development of aphasia software and apps like Cuespeak.

Professor Rebecca Palmer, Professor of Communication and Stroke Rehabilitation and Chief Investigator of Big Cactus, said: "It has been wonderful to see how the use of computer therapy has provided new opportunities for people with aphasia to practise speech and language therapy tasks for as long as they wish to continue improving their ability to find words."

Centres of excellence

The University's cross-faculty research centres harness our interdisciplinary expertise to solve the world's most pressing challenges.