Public Funding for The British Stammering Association

**Need** Stammering typically begins between the ages of 2 and 6, and becomes chronic in adolescence for 25% of affected children. It affects 8% of children globally and 2% of teenagers and adults. Early detection of stammering in young children is crucial for effective intervention and treatment. However, currently available tools for detecting stammering are designed for speech and language therapists (SLTs), and long waiting lists to access SLTs can worsen mental health challenges. **Project Opportunity** Respira, a UK SME, aims to develop in this project a new therapeutic solution for early detection and progress evaluation of stammering in children who stammer that parents, guardians and caregivers (PGCs) can use and interpret without SLT support. With the support of a previous Innovate UK grant, Respira built BeneTalk: a digital therapeutic solution to provide accessible, effective, and ongoing support for chronic stammering. This project aims to develop a new solution, by leveraging existing BeneTalk expertise/framework/capabilities, thus expanding Respira's market share. The diagnostic and evaluation tools developed in the project will allow also Respira to assess the effectiveness of this project by using real-world data for evidence generation. The project will have a transformative effect on Respira's technical and commercial impact, increasing its TAM, and on the UK economy in terms of taxes and employment. **State-of-the-Art** There are no digital therapeutic solutions available for PGCs of children who stammer (CWS). The current standard of care is face-to-face therapy sessions with SLTs, which are limited or expensive, and without support outside the clinic or post-therapy. This project will be compatible with both the Lidcombe Programme and Palin Parent-Child Interaction Therapy, which are standard treatment practices. This will increase the adoption of this project and achieve better therapy outcomes. **Wider Impact** The project will transform the lives of CWS and PGCs by democratising access to speech therapy: It will improve mental health by addressing anxiety, depression, and other mental health conditions that affect both. Developing and commercialising this project will provide a cost-effective solution to tackle inequality due to the "postcode" lottery affecting UK speech therapy pathways. This project will enable the delivery of speech therapy in the home and reduce the need to travel to face-to-face appointments and follow-ups, which is estimated to be 1500 times greener than the standard of care. Developing such a humanitarian business benefits the UK economy due to high-skill jobs created, taxes collected, and national branding.

Up to 3% of the population stammers (British Stammering Association, 2019). This condition can have distressing symptoms that deeply affect social and professional interactions and can define the life choices of those People Who Stammer (PWS): 60% of PWS suffer from Social Anxiety Disorder (SAD) (McAllister et al., 2017). Even if it is not currently possible to cure stammering, once it is established in adulthood, there exist a series of practices that, when mastered, help PWS to gain fluency levels similar to those of people who don't stammer. For many PWS, the largest problem is not learning the techniques themselves, but turning these practices into habits, as this requires patience and support with ongoing practice. We believe that technology can help in this endeavour: BeneTalk is the first wearable device, which helps People Who Stammer (PWS) to establish and maintain fluency enhancing techniques learned in the initial therapy process. This is achieved through a novel application of digital technologies that enable the first implementation of an out-of-the-clinic therapy, supported by real-time feedback and performance history tracking. As a treatment centred on a wearable device, BeneTalk emerges as a new product linked to an innovative digital service that helps PWS to be in control of their own therapy. BeneTalk delivers a long-awaited solution to an old therapeutic problem with the potential to demonstrate significant step-changes in efficacy, speed and cost. BeneTalk acts as a virtual coach for PWS; as a therapeutic tool for speech and language therapists (SLTs); and a scientific instrument. We have filed a patent for the innovative technology behind BeneTalk as it is the first of its kind. Detailed information about BeneTalk can be found on [www.benetalk.com][0]. This project will validate BeneTalk using scientific and technical evidence, enabling the British Stammering Association (BSA) to endorse BeneTalk therapy as valid and close contact with PWS will help us to better understand commercial requirements. Consequently, BeneTalk will be in a stronger position to raise private funding and commercialise the product. This project will enable the University of Reading (UoR) to publish the results of the first out-of-the-clinic real-time feedback assisted fluency therapy. Publications will be based on an unprecedented quantity and variety of data that may redirect future fluency research. [0]: http://www.benetalk.com/

"About 1.3% of the population stammers (Reilly et al., 2009). This condition has distressing symptoms that deeply affect social and professional interactions and can define the life choices of those people who stammer (PWS): 60% of PWS suffer from social anxiety disorder (SAD) (McAllister et al., 2017). Even if it is not currently possible to cure stammering, there exist a series of practices that, when mastered, help PWS to gain fluency levels similar to that of a non-stammerer. In addition to mainstream therapist led approaches, several companies such as the Starfish, DelFerro or McGuire Program, currently run courses worldwide to help people to overcome their stammer via these learned techniques. The largest challenge to a PWS is turning these practices into habits, as this requires patience and dedication. We believe that technology can help in this endeavor: with the support of Innovate UK, we are developing a prototype of the first wearable device, RespiraBelt, that tracks breathing and speech patterns, providing real-time feedback and performance history to help PWS turn fluency promoting techniques into habits. Respira will also provide a platform to share the user's performance data with the SLT, who will supervise and customize the therapy. Finally, a discretionary pool of anonymous data will be shared with the scientific community researching stammering. Respira acts as virtual coach for PWS; as a therapeutic tool for SLTs; and a scientific instrument. We have patented the innovative technology behind the RespiraBelt as it is the first of its kind, and in December 2016 our idea was awarded the Terence Barry Grant Award from the Stammer Trust (ST). Detailed information about Respira can be found at www.respira.io and https://goo.gl/6mE4gC. The current project aims at defining the extent to which Respira can be used in a self-supervised manner, and therefore the amount of SLT involvement required for each PWS. This project is conducted by a consortium comprising of the British Stammering Association (BSA), which is in charge of designing and coordinating the experimental trial; the University of Reading (UoR), which will objectively analyze the data gathered and assess the efficacy of the different therapy methods; and Respira Ltd (RespiraLtd), which will lead the project and provide the necessary hardware, software and technical support."