Transforming NHS Speech and Language Therapy (SLT) pathways in TBI rehabilitation by empowering caregivers with a novel AI digital therapeutic platform: Prototype development and feasibility studies

Need ABI affects over 350,000 people/year in the UK [1]. Traumatic Brain Injury (TBI), a subset of ABI, results in around 160,000 hospitalisations/year [2], disproportionately affecting younger individuals who often face lifelong cognitive and communication challenges [3]. Approximately 60-70% of individuals with ABI would benefit from SLT [8], enhancing rehabilitation outcomes, improving quality of life, and reducing long-term mental health issues [7]. TBI caregivers face considerable challenges, often lacking tailored resources and support [4]. Unlike stroke rehabilitation, TBI caregivers—especially those caring for younger patients—frequently encounter a "wilderness" of limited guidance [5], increasing their stress and negatively impacting patient rehabilitation outcomes [6]. Additionally, NHS rehabilitation pathways for ABI generally lack integrated digital diagnostics and management tools, particularly after hospital discharge. Opportunity Building on the success of SuperPenguin—adopted by 25 NHS Trusts to support caregivers of children who stammer—we aim to transform NHS pathways for ABI and TBI rehabilitation by leveraging the existing SuperPenguin infrastructure to empower caregivers. This will enable rapid prototyping, testing, and validation, building on our progress to date. Key features of SuperPenguin to be repurposed for empowering ABI/TBI caregivers include: AI personalised content delivery framework (see Figure 1). AI engine for rapid clinician-curated content development. Integration with NHS Trust resources. Collection of real-world data via assessments. Caregiver/family ecosystem. Figure 1: AI personalised content delivery framework. Objectives Currently at TRL3, we aim to develop two prototypes focused on TBI, with general support for ABI: Prototype-1: Personalised educational support for caregivers, advancing to TRL6. Prototype-2: Self-diagnostics and long-term management support for caregivers and patients, advancing to TRL5. We will evaluate the technical and commercial feasibility of these prototypes in enhancing ABI/TBI rehabilitation within NHS pathways. Prototypes will adapt to different stages of the pathway as patient needs evolve, focusing on, but not limited to: SLCN (Aphasia, Cognitive-Communication, Dysarthria and Dysphagia) Group support and social skills Multimodal communication Since SLCN often co-occur in ABI/TBI, the project must address these conditions together. Development-to-date SuperPenguin-App (by BeneTalk-LTD): Integrated into 25 NHS Trusts, delivering personalised educational support to caregivers, with a potential 30% reduction in SLT needs. A study with 91 parents showed a statistically significant positive impact [13](Figure 2) Relevance: SuperPenguin codebase will be used for Prototype 1. Figure-2: SuperPenguin Evidence [13] BeneTalk-App (by BeneTalk-LTD): Supports adults post-therapy for chronic stammering. Preliminary studies showed 10-hours of usage equals 10-hours of traditional therapy [12] (Figure-3) Relevance: BeneTalk codebase will be used for Prototype 2. For instance, BeneTalk s real-time speech rate algorithms may be useful for dysarthria. Figure-3: BeneTalk-app Evidence [12] Competitor Evaluation: Lack of TBI caregiver support: more comprehensive solutions are still needed. Needs-Analysis: NHS services interviews: Consulted South West Yorkshire NHS Trust (SWYFT) and Health Innovation East Midlands (HIEM) to identify gaps in ABI/TBI services. Expert input: Dr Mark Jayes, a leading expert in ABI/TBI rehabilitation, has pledged support for the project. PPI development Endorsements from the Stroke Association, Brain Charity, Headway UK, and UKABIF [9,10,11], will help establish an ABI/TBI Patient Advisory Group (PAG). Further PPI development is included in WP2 (Question-Q2).