About a third of people who have had a stroke have aphasia, making it difficult to speak, understand, read and write. There is evidence that people can continue to improve their language ability for several years. However, speech and language therapy is rarely available on the NHS for more than three to six months. As a result, many people are not always able to achieve their potential.

Dr Jane Mortley is the director of Steps Consulting Ltd who developed the StepByStep© software for people with aphasia to self manage their speech and language practice. Rebecca Palmer from the Stroke and TaCT themes of CLAHRC SY spent two days with Jane observing how the software could be used to enable continued speech and language practice.

The step-by-step approach was identified and defined during this visit. 
It has three components incorporating key evidence based features of successful aphasia therapy:

1. 'Light touch' input from
a speech therapist to set
the software up with steps
required by the individual
with aphasia
2. Intensive independent
practice by the individual
using the software 
(20 minutes at least 3 times a
week is recommended)
3. Volunteer visits to support
use of the software and
carry out activities to
promote use of the new

Members of the South Yorkshire CLAHRC received NIHR Research for Patient Benefit funding to support evaluation of the step-by-step approach to extend opportunities for people with aphasia. Results of this project were shared with Steps Consulting Ltd to contribute to further software improvements. Following positive results from the pilot study, we have begun implementation of the step-by-step approach into Speech and Language Therapy services at Sheffield Teaching Hospitals. Our collaboration with Steps Consulting Ltd continues as we investigate use of their telehealth system for reviewing patients' progress remotely and carrying out remote speech and language therapy consultations to assist with the efficient delivery of this service.

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