Virtual Town Square Helps Stroke Survivors Practise Everyday Conversation Without Pressure

Dr Matthew Berryman practised ordering a coffee again and again, in a café that did not exist. In the virtual space he built for himself, he could talk with a barista and a salesperson, speak slowly and clearly, and use the techniques his speech therapists had taught him. No queue formed behind him, and no one waited while he searched for a word.

Berryman is a researcher, a software engineer and a stroke survivor who has dealt with word-finding difficulties himself. That café has now grown into a larger project at Adelaide University called VITAL, the Virtual Interactive platform to Treat Anomic Language. It is being developed as a virtual town square with shops, restaurants, hardware stores, hairdressers and other familiar places. People with speaking and communication difficulties can use them to practise finding words, asking questions and holding conversations. The program combines virtual reality with artificial intelligence.

Anomia is the struggle to find the word you want to say or write. It is a hallmark of aphasia, a language disorder that affects how a person uses and understands language. Aphasia arises when part of the brain is damaged, often through a stroke, a traumatic brain injury or certain types of dementia. About 140,000 people in Australia live with it.

The project is funded by an NHMRC Ideas Grant and led by Professor Maria Kambanaros. Its aim is to make communication therapy more realistic and more engaging. It will also investigate whether virtual reality can improve communication confidence, social participation, wellbeing and quality of life for people with anomia. Kambanaros says small moments can demand enormous effort for someone with aphasia, such as ordering a coffee, asking a question in a shop or chatting with a stranger. The person knows what they want to say, she says, but the words will not come, which can be stressful and isolating. VITAL is meant to offer a realistic place to rehearse such interactions repeatedly, without the fear of getting something wrong. Her stated goal goes beyond word-finding, to helping people communicate with more confidence in daily life.

The platform is being co-designed with people with aphasia, along with family members, communication partners, speech pathologists and researchers. Through interviews, group discussions and workshops, participants will help decide which places and activities belong in the virtual world, how conversations should work, and how to make the technology comfortable and accessible.

Berryman, who is the project manager, describes his own experience as the proof of concept that started it. After rehearsing in his virtual café, he went into a real one and ordered a coffee. He noticed he felt more confident, more fluent and more at ease. He calls it a small, everyday interaction, but a significant moment for him, and one that suggests how the technology might help others.

He sees the value in the gap between the clinic and the street. Strategies are learned in therapy, he says, but eventually they have to be carried into the community, where conversations are unpredictable and the pressure is greater. Virtual reality, in his words, can offer a middle ground where people practise, make mistakes, try again and build confidence before facing the same situation in real life.

The team is also exploring whether others, including stroke survivors and speech pathologists, could enter the virtual environment together, allowing real-time interactions and telehealth sessions. Kambanaros says the hope is that VITAL will feed into new, accessible approaches to communication therapy in Australia. The project is still in development, and the open question is whether the confidence Berryman describes can be shown to carry over for other people with anomia.