VR Stuttering Therapy with Gareth Walkom

Gareth Walkom 00:01

When we combine the exposure therapy with the factuality, we place those real life situations that we would usually expose them to inside the virtual scene. And this gives us many benefits from the real situation. Because of course, it's not real inside factuality, but it does feel real.

James Berges 00:30

Welcome to the Xceptional Leaders Podcast, we give you a front row seat to our conversation with new and successful entrepreneurs and thought leaders making an impact in the special education and disability communities. They share their intimate experiences so you can start, grow and expand your impact. I'm James Burgess with https://slptransitions.com/. And,

Mai Ling  00:51

And I'm Mai Ling Chan, and you can find me at https://www.mailingchan.com/. And today's episode is right in the area where I love to be, which is cutting edge tech. Gareth Walkom has done an amazing job of creating an incredible new technology in this area to support people who stutter and I just loved all of the features, including machine learning, immersive experiences, and individually unique environments.

James Berges 01:13

Yeah, it was really cool to talk to him and see how VR cannot disconnect people from society. I think we think of VR sometimes as this escapist activity where you're going into another world. But what's really cool with stuttering, people who stutter is it gives you a safe space to practice you’re stuttering and you can control the environment, so I won't give it all away. But what's really cool is you can do eye tracking, you know, their secondary parts of stuttering, head jerks, blinking things that are hard to measure as an SLP in person. But with the virtual reality headset, it makes it easier to track, get real data, and give the person a safe space to practice conversation. So for example, in a coffee shop, you can simulate that and have the person stutter and even modify the people's expressions to look angry or happy, you can modify the noise. So just so much utility to give people who stutter a platform to feel safe and take those baby steps towards anxiety that comes with stuttering, super compatible.

Mai Ling  02:16

I've been talking about it for years, I got the Oculus, right at the beginning of the pandemic. And this is a game that you put on your head. So it's like a headset for anybody who's listening and doesn't know that you put this on your head, and you are immersed, literally immersed. So it's hard to describe because it's no longer like a 3d thing. It's you are in the center. And there's depth perception. You can you feel it, you're touching things. There's haptic responses, meaning like you touch it and can be like a vibration. Just absolute incredible. And I love that someone has come into this bay, and has had the creativity, you know, to put this into, well, let's bring this into an immersive experience and all the stuff you just brought up, James is putting that person who stutters in the first person perspective, so they are experiencing presenting or they're experiencing going to the bank or, you know, whatever it is, and they really do physically feel like they're there. It's just, it's incredible.

James Berges 03:11

Yeah, honestly, I'd still need to try the Oculus. And I want to try that one where you go off on a ledge I've heard, it feels like you know, in your head that you're not going to fall, you know, you're safe. But it really feels like you're standing on the ledge of a building. And people are so afraid to take that step, even though your mind knows it's safe. So besides facing crazy anxiety like that, I could see it even useful for me or for anyone to practice public speaking, which is actually a bigger fear than dying, I think is public speaking. So it's just so exciting to do that. And then speaking of other eye tracking and making communication easier, I did want to share this really cool google commercial that came out a couple of weeks ago. And everyone should look this up. Because it's a tear jerker. I'd be lying if I said I didn't get a little choked up. But it's a commercial called a look can say a lot. So if you just type in a look can say a lot. And we'll link it up in the show notes. Also, for reference, its shows a commercial with different people giving different gestures and looks like one lady smiling without saying anything. One lady looks suspicious. And it's just showing these nonverbal examples of how much we say with their eyes. And then it flashes to someone who is basically paralyzed and cannot move, but uses eye tracking to communicate using an app that goes through Google. So she starts communicating with her granddaughters and this is really touching. And I'm happy to see these big companies like Google are highlighting accessibility to a mass audience. You know, we're in our little we're in our world, but when I saw it on YouTube go viral. Oh, cool. This is really reaching the mainstream.

Mai Ling 04:54

That's fantastic. Yeah, that's it. That's what we need to do. You know, where it's not an add on feature. It is. Its stuff is acceptable, and it's available to everyone.

James Berges 05:02

Yeah, so we'll link that commercial in the show notes as well. And another entrepreneur, hopefully, maybe we can interview her one day. Her name is Saya De Florek. So sorry if I mispronounced that. But she's from Haiti. And she's profoundly deaf. She invented an app that helps you keep track of who's talking in a conversation. Oh, this is so cool. Because I think she was pretty non-technical. Like she didn't come from a coding background, grew up deaf in Haiti, adapted as well as she could, she could read lips, she could read body language really well, to the point where teachers didn't even know she was deaf half the time. She just blended in. But one big challenge for her was keeping up with group conversations, you know, who's speaking now? And are they done speaking? And now whose turn is it? So her app communify, helps you identify in real time its speech to text. And so you can be in a Zoom meeting, or you can be in real life in a lecture. And we'll say like, Mai Ling is speaking now, or James is speaking now. And it color codes it with little thought bubbles. So you can just quickly follow along who's talking and with?

Mai Ling 06:14

Nice. Oh, I like that. Yeah, this is perfect. And it's great to bring that up. Because of you know, that the show today is all about cutting edge tech. So that's cool. What's been up with you, James lately?

James Berges 06:23

Well, I'm trying to balance private clients, I've been seeing more speech therapy clients, and I liked the variety, seeing, you know, working with adults, as well as younger kids. So it's all over the place. I like the variety. Sometimes I have to switch my brain around like, Okay, who am I working with? Now? What is their lesson plan? And then balancing that with marketing and copywriting and doing a course lot, Bill? The fun stuff? Yes. So, and also trying to battle my shiny object syndrome Mai Ling. I feel like I have 100 ideas written down of personal projects. And I have a couple that have some momentum. But I always have to battle myself of don't start another thing, like, keep your focus on a couple things. Yep. Yeah. Because it's exciting to start things. But you got to keep that momentum I find if you actually want to see it through and execute on it. So I think that could be a whole another episode we could talk about, I know you've been through that a bit. And you've

Mai Ling 07:24

I know, I'm like welcome to my brain.

James Berges 07:28

Yeah. So I'll have to ask you. How did you deal with that? But yeah, other than that, also wanted to mention that I enjoyed seeing Rachel Maydel. For those of you don't know, she's the cohost of talking with tech with Chris Bogey. And they talk about AAC (alternative augmentative communication), amazing podcast, and go listen to that one. But I've been on her team as a clinician and helping her behind the scenes a bit, but we barely ever meet in person. So in the Zoom world, you know, we've been talking for a year, this whole year over zoom. Finally, the team got together, we went to a bar, we played skee ball, we just convivial, enjoyable and got to see people I've never seen in person. So it's just it's just nice to get into the real world with your team.

Mai Ling 08:20

That's fantastic. I'm actually going to see her and Chris Bogey in May when they come to Phoenix to do presentation. So yey!

James Berges 08:27

Yeah, small world.

Mai Ling 08:29

Fantastic.

James Berges 08:30

What else is going on with the amazing?

Mai Ling 08:31

Well, when this episode launches, I'll have just presented at our Arizona State Speech and Hearing Association Conference, I'm really excited my first year, I'm an invited presenter, super nervous. So I definitely need that app, which I could run through it with. But I'm excited because I get to do this presentation, it's called going beyond the SLP degree. And that's the exact space that we're in, I'm encouraging the audience to really do some activities and deep dives, and I'm spotlighting amazing people in my previous books, to, you know, show what they've accomplished and share a little bit of their, their journey, and then my own and encouraging them to actually start the first steps of brainstorming and coming up with an idea and maybe even sharing it by the end of the of the presentation. So it's an hour and a half. And I'm really excited. So I think this is going to be very different than the other sessions that people are getting information, you know, from, I always call them like, sit and gets, this is going to be more interactive. And I'm gonna tell them that at the beginning, you know, this is not one of those where you can just, you know, lay back and get the information. So I'm really hoping people find some value from the presentation.

James Berges 09:41

I'm sure they will. That's amazing. I'm sure that people will walk away probably with business ideas or entrepreneurial things going off in their brain. And you can say, well, you know, hit me up if you came away with an idea, let me know. So exactly. Yeah, share and share in the glory.

Mai Ling 09:57

Yeah, maybe I'll come back next weekend for our next episode and Linda and share. Yeah, that would be really fun. Thanks for bringing that up.

James Berges 10:03

Yeah. Well, I want to invite everyone to follow us on Instagram @xceptionalleaders. For more we post highlights and clips. So even if you don't listen to the whole episode, you can get little snack sized clips on Facebook as well. And that's about it. Yeah, share the episode, please.

Mai Ling 10:21

All right. Now, let's get to your amazing interview.

James Berges 10:23

Thank you so much. Today, I'm joined by Gareth Walkom an amazing entrepreneur who helps people who stutter like himself and find their voice with virtual reality with his program with VR. Gareth, welcome to the Xceptional Leaders podcast.

Gareth Walkom 10:44

I thank you for having me.

James Berges 10:52

Absolutely. It's my pleasure. And last time we talked about a year ago, I think it was a year ago about in the midst of the pandemic, somewhere lost track of time. But that's one thing about tech, especially in the pandemic is it's helped us connect and reach people where we wouldn't have reached them before. But on one hand, also, I feel like tech can be isolating and today we're talking about virtual reality, and stuttering, which is just so interesting to me. Because tech while it can be isolating, it can also help people connect, and it can be that bridge to real life, it can help people connect more with others. So we'll talk all about that. But first, I just wanted to catch up with you. You've been featured in BBC for your work lately. So congratulations on that. Very exciting. And for our audience, Gareth, why don't you give a little background of your story and how you ended up creating virtual reality for people who stutter?

Gareth Walkom 11:53

Yeah, sure is, however, since the age of about six, I have, I have I have as started, which has brought me many ups and downs. And I've had many difficult times with its sometimes very disfluencies, and sometimes more fluent. And this also really affects you not just through your speech, but also mentally and emotionally as well. And with my speech, I also wanted to address the speech side of things with using my with a using my expertise to start to benefit people just like me. So I studied a bachelor's degree in digital media technology, which is a course surrounding creating games for teaching, learning and training purposes. And it was also heavily involved with virtual reality mobile apps, websites and more. And then I use my expertise to create virtual reality exposure therapy for people who stutter. And then I created it's a bit further on where I studied a master's degree in medical product design, where I used an eye tracking virtual reality headset to create software that could objectively measure what people do with their eyes inside the virtual scene.

James Berges 13:28

Wow, that's amazing. It's like such an eclectic background. So a couple of things I want to dig into there. One, Did you always know you wanted to apply when you were studying engineering and digital media? Were you always keen on applying this to a clinical space? Especially stuttering? Or was that really just your interest? Because I was in a virtual reality, not Virtual Reality am I tracking lab for psychology and undergrad and I see people who went on to work at like Facebook. Now Meta, but the whole thing is to use eye tracking to sell people more products, which, you know, that could be lucrative. But how did you know you wanted to get into the clinical space?

Gareth Walkom 14:11

Yeah, it's not something that I thought about at the start. It's just something that kind of, it's just something that shapes itself and through creating this virtual reality exposure therapy for people who stutter, and with the results it gave with the promise, it shows it really made me realize that I was kind of on to something there. So I just expanded on it more and more. And I love to use technology in different ways and I love to create something that's never been done before. And with the eye tracking, I saw a really kind of eye opening another thing that I should do, where I saw that there was this really good tool that people could use. And right now in the space of speech of therapy, there's not too much going on and sending eye tracking. And with people who stutter, for example, just like myself, we can sometimes close flicker and fixate our eyes in the moment of its stutter. This is only measured in a subjective way by a speech therapist, which for the speech therapist is very difficult to do, it's very hard to write down an exact number. So what I wanted to do is I saw that eye tracking was around, I saw that the eye gaze behaviors was something that's kind of not fully understood within the stuttering community. So I wanted to see if I could address this and create a tool that speech therapists could use, that doesn't just observe where people look within shops, it can observe what exactly you are doing with, with your eyes within their speaking situation is

James Berges 16:13

Beautiful. And I want to talk more about the mechanics of it in a second. But first, let's go back and talk about what is I realized we haven't really defined what is virtual reality exposure therapy, because I know exposure therapy applies to anyone with some type of anxiety. But can you speak to our audience about what that is and what kind of disorders it's uniquely benefits with virtual reality exposure therapy,

Gareth Walkom 16:40

Or we can break it down into two different things. One is exposure therapy, where you are slowly exposing somebody into a situation that perhaps they fear. This could be anything from public speaking from fear of spiders of heights. And when we combine the exposure therapy with the virtuality, we place those real life situations that we would usually expose them to inside the virtual scene. And this gives us many benefits from the real situation, because of course, it's not real inside virtuality, but it does feel real. But on top of that, we can actually stop the situation at any time, meaning that we can step out of a situation which we would have been in real life. And we can also slowly build up to those situations inside virtuality.

James Berges 17:47

I love it. It reminds me, you know, when I was working in school, there was some older students in high school who stuttered in different situations. And that's one thing we know about stuttering is, it's very context dependent situation dependent. For example, She was very outgoing and vivacious had lots of friends had no problems socializing with new people, during lunch, but when it came time to read aloud in front of the class, she froze up and, you know, had a lot of anxiety and blocks mentally and physically. So, you know, I almost was doing exposure therapy without realizing it. Without virtual reality, you know, we would just practice, well, what's the minimum thing you can do without completely shutting down because you don't want to overwhelm people, right? You don't want to throw them so far out of their comfort zone that they freak out. And, you know, let's say they're a fear of spiders, you're not going to dump spiders on them. Like, I've seen reality shows where they do that on Mari and I don't think that's very effective. But yeah, that's what I love about, you know, virtual reality. I think the misconception is that you're in this separate world, which you are, but it acts as a bridge to practice these things in a controlled environment. So, Gareth, tell me like what are some of the variables we can control? How many different environments can someone practice? And what are the different met not metrics, but different levers we can pull to increase anxiety or lower anxiety, things like that.

Gareth Walkom 19:23

So when we think about virtual reality, we can separate it into two pillars. One is video virtual reality where we have where we will record a video which could be a 180 as headway video or 360s as Tegrity video, and we then place it inside to the virtual reality of viewer. This is a really good methods because it's very realistic because it is a The video, but it has many drawbacks where many people feel motion sickness with this method, and also where you can't change anything within the video itself unless if you have a prerecorded video of that thing that you want to change. We then go into to the other pillar, which is 3d models and 3d animations 3d avatars, this method is, is somewhat less realistic, but not too much. It comes in many shapes and forms, you can start with a very cartoony feel. And you can also go up to a very realistic feel. With these 3d models, these 3d avatars you can create them to or whatever you like. Meaning that you can shape them in real time, you can change the speaking situation, you can adjust it to your needs. And just like he was saying earlier, with his your friends comfort zone, it was probably a bit too much for him or her to step into that speaking situation. Now what we want to do in virtual reality exposure therapy is we want to slowly build up into that speaking situation. And a prime example of, of the, of the situation that she had is typically the video Virtual Reality situation where she's placed inside a standard situation, and she can't really adjust it to her needs. But then within the 3d modeling situation, we can adjust it to the individual's needs, we can change the amount of people that they're speaking with, we can change what the people look like how the people are reacting, their positive negative reactions, we can change the sounds around them. For example, inside a coffee shop, we could be in a queue to order a coffee. Within this queue, we then get to the front's we then speak with the person who was asking us what we wants. With this speaking situation, we are addressing the conversation itself. But it's not just the conversation that we are addressing within the speaking situation. It's the people around us is the cube behind us. It's the noises around us, the noise of the people, the noise of the music, the coffee machine making a really loud noise. And it's these things that we can really adjust to shape to the individual seeds. And because its 3d models, we can start to create anything we like. So we can have a coffee shop, we could have a classroom, we could have auditorium, a chop interview scene, the possibilities are really endless. Wow, that's great.

James Berges Advertisement 20:11

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Mai Ling 23:41

Now let's get back to our amazing interview.

James Berges 23:44

It's really cool to think about your creativity almost seems like a limit. I'm sure there are some limits. The first thing that pops in my mind is how does the scripting work? For example, you brought up if you go to the front of a coffee shop, who's prompting that interaction? Is it pre written? Or is it a speech therapist also plugged into the program in real time? Can you walk us through how that works?

Gareth Walkom 24:09

Yeah. With this methods, it's really important that people can have the customization that they need. And this is because if you think about a speaking situation, the speaking situations are never the same. We aren't always speaking with exactly the same person over and over again. And the things that we say with that person aren't the same, the environment, mental factors aren't the same. So what we do is we provide a toolbox which is controlled by a speech therapist. This is controllable through a dashboard on a laptop or PC, where they can see what the client can see inside virtuality and they can change everything about the speaking situation in real time. You can also purchase purchases on an autopilot mode, where things are programmed before the person goes inside it. And they just, they just go through the different tasks when they need, or they control it to when they want to progress in the speaking situation, or whatever they need to do.

James Berges 25:22

Hmm, interesting. So like, choose your own adventure where you can have more control with the speech pathologist or less or more randomized. You know, that sounds like a really cool tool for speech therapist to be in that driver's seat. And as a speech pathologist, myself, I'm thinking, What about prompting for techniques such as, you know, easy on sets are these relaxation, stuttering modification techniques that help people who stutter, get through those moments of tension, are they prompting in real time?

Gareth Walkom 25:55

Yeah, so this is all dependent on how the speech therapists would usually prompt it in in real life. Now, a speech therapist can do this in many ways, they could be making a hand signal they could be, it could be saying something, they could be creating some kind of an indication, for example, where a light comes on, and then that the mind is the person that they have to do something. If we then think about virtual reality, we can then also place these different signals into virtuality to. So we can place the different cues, the prompts that we need. But we can also we, we can also adapt them to be something different. We could do something where, for example, something changes color, or where the lights dim or bits, just some kind of indication where the clients knows, okay, this indication means that I have to remember to do this. But of course, in a real life, speaking situation, the speech therapist won't always be there. So we want to create this, this, we want to create this method, where the clients can slowly do these things on their own. But of course, we can start off with these views.

James Berges 27:20

Yeah, it's really amazing in thinking about tele practice to have, maybe these things can be combined and I'm also thinking about chatbot technology and self-guided courses, all these trends that are sort of converging. They were already converging, but then the pandemic made them accelerate even faster. So it'd be interesting to see. Now, virtual reality I feel like has been talked about since sci fi books, you know, as early as I don't know how long ago the 70s? Maybe before that. Now you have talks of the metaverse and virtual reality for all kinds of things. But I'm wondering, as someone on the front lines at this cutting edge, how far are we from artificial intelligence programs combined with virtual reality? Where the person who stutters can take control? And it's really self-guided? And what are the limitations that we still have to face with virtual reality?

Gareth Walkom 28:18

So mercurial as he is still has a long way to go until we're ready for the metaverse. There's a lot that we need to do and prepare for the need to enforce guidelines. We need to have better hardware, faster machines. And these things are actually being created right now. Because of the investments that we've seen from many different big companies such as Meta is really shown. The future of virtuality is really strong and the metaverse is coming. It's, it will be really interesting to see how this plays out. Because there will be probably different metaverse where you can jump in and out of the different ones and move to and from different things. But it's really we do need the technology and software to improve a bit more before we are there. If we look at things such as artificial intelligence. Artificial Intelligence is all around us. It's, it's in many different bits of technology that we own and you can go as low as the simplest things within artificial intelligence because it's such a broad term. If we look at things such as machine learning, these things are already being used right now. Within for example, speech. If you look at what's a Googler doing with the project you folio and project relates where they using machine learning within the assistance that they use, this creates models based on an individual's voice and it trains the assistant to better understand what they're saying. So for example, people with people with speech disabilities, or voice disabilities, such as ALS, or Newton, or motor neuron disease can use those applications better. So the technology is really lying around in different areas, we just have to really combine it together. And wait a tiny bit more. Probably a couple more years, I'd say. Maybe for four or five years until things are really moving. Until I'm until we can start to ay, ay, choose the metaphors for what we think it is.

James Berges 30:58

Yeah, well, the future is wild, everyone. In speech synthesis, it's getting better, right? But we're not quite there, even with non-disordered speech, but uh, let alone with someone with ALS or someone who stutters. That voice recognition isn't quite their natural language understanding, but it's getting better every day, thanks to Google Amazon. And yeah,

Gareth Walkom 31:22

Yeah, exactly. It's um, so with the, the speech as synthesis side of things. With some speech and voice disabilities, it's much easier to implement. Now, in terms of much easier, I don't mean that it's easy, but it's just not really difficult compared to some other speech and voice disabilities. If you look at ALS, for example, typically, the difference trends in the speech are very similar. If you look at the different words and the different sounds that the people are saying, but if you look at different speech disabilities, such as stuttering, such as aphasia, this can be very varied. And because of the way that it's varied, it means that it is much harder to model, whereas this will come a bit later on the speech thing, on the speech as sentences as a side of things.

James Berges 32:26

Hmmm and then I tracking I know, we glossed over that a little bit, but that's a core part of with VR is and with people who stutter is tracking eye movements and silent blocks, how far along are we with that?

Gareth Walkom 32:42

It's so so with the eye tracking, it's a, it's an extension. So this is something that's typically researchers can use. And the main software that speech therapists can use this is the typical virtual reality headsets, such as the Oculus quest to for researchers or for people who want to track the eye tracking, we use special virtual reality headsets with eye tracking, but also with other sensors as well. So these have things such as face cameras, they have heart rate sensors, a owl a rhythm, that can measure cognitive load. So we've got all of these different sensors and different data points, which are really analyzing all of your parts of speech and body movements and so on. These are currently in our tools right now. So we are actually testing these with speech therapists and researchers. So yeah, like it's currently out there, and it's been tested, we are seeing the, the benefits from it, and we're getting lots of good progress. And it's showing that it really does work and pretty is having an effects. So yeah, like it won't be long until more and more people can start to use our software.

James Berges 34:19

Amazing. I'm so excited. Please don't use AI overlords for evil Gareth. I mentioned these tools, you know, you can track your eyes and I've even heard of therapy robots where it tracks your emotional expression and it can you know it that can be great to adapt to children, let's say who want to talk to an animated figure rather than an adult. And that can track if you're sad or happy but I can also see that being used to sell you crap you don't need or.

Gareth Walkom 34:49

Yeah. Yeah. And with these different senses, so. So like you said, we can start to track the emotional states and this is really interesting because with the different senses such as cognitive load, this is a number from zero to 100. 100 being the most, the most amount of brain power that you can use. But typically, the more brainpower doesn't mean that we are in a good states, if you look at the way that we currently measure performance, within exposure therapy, we measure this along with distress. So with the more distress, it doesn't mean that we have the most performance, typically, the higher the, the highest performance is along the middle of the distress, where we feel like we aren't fully comfortable, but we are in a state where we are a tiny bit distress. And within this area, we start to learn more, and we start to perform better. Now if we capture that, that section with the cognitive load, we can start to realize if somebody is finding a speaking situation too difficult, so if they are getting too anxious, or if they're starting to have a burnouts, we can then decrease the speaking situation and the challenges within those speaking situations, and bring the person back to the center where we want them to perform the best.

James Berges 36:28

Wow, these are really just tools to help mine read in a way not mind read, but yeah, to help augment what we're already doing. Because yeah, like, as you said, that that magic space between too far out of your comfort zone, you have too much arousal, you're overwhelmed, or you're on the other end of the spectrum, tired, you need some caffeine, you're not learning anything. So finding that sweet spot, and this will help us get there. So that's amazing. So Gareth, we're just about out of time, I could talk about this forever. But can you Is there anything else? Is there anything else that we didn't talk about that you want to let the people know?

Gareth Walkom 37:06

I think if there is anyone who would like to try our software to, then please get in touch we on social media, on Facebook and LinkedIn, you can find us from the from the air with VR page, and on add on Instagram and Twitter. It's @withvrapp. So if you want to get in touch, if you want to reach out, find out what we're doing, test out what we're doing as well. You can even you can you can even start without a virtual reality headsets. So you can really test the speaking situations that we are using, and work with us together where we can create something that's truly works not just for one person, not just for one type of person, but for many things.

James Berges 38:00

I love it. Such a great mission, Gareth. So thank you so much. I appreciate you taking the time to talk with us. Thank you.

Mai Ling 38:09

We hope you enjoyed this episode and invite you to leave us a review on Apple podcasts and Spotify and share the show with people you think will find value from it. This helps the show a lot for have a great guest referral, reach out to us at xleaders@gmail.com.

James Berges 38:25

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