I. Project Summary
Successful social interactions and strong social connection are critical to well-being and quality of life.
The significant need for more research on social connectedness and its impact on health has been
acknowledged recently by calls to elevate the wide-spread problem of social disconnection to a public
health crisis. Many individuals with neuromotor speech impairment, such as people with amyotrophic
lateral sclerosis (ALS), experience restrictions in communicative participation (reduced engagement in
day-to-day communication) that places them at risk for social disconnection. The impact of speech
impairment on communicative participation has been understudied, even though such information is
essential for developing interventions that target improving social connection. The problem has not
been addressed, in part, because of barriers to research participation experienced by individuals with
neuromotor impairments. Recently developed mobile platforms now make this important research
convenient and feasible by improving accessibility. The long-term goal of this work is to facilitate the
communicative participation and social connection, and therefore improve quality of life, of individuals
with neurodegenerative diseases such as ALS. Sixty people with ALS and thirty healthy controls will
participate in this project that employs an innovative mobile health (mHealth) approach that leverages
the ubiquity of smartphone ownership with existing mobile technology deployed for medical research.
Participants will use their own smartphone to acquire actively generated data (surveys and speech
recordings) and passively acquired data (call logs, text logs, and GPS). The mHealth approach is
uniquely suited to the research questions and to people with ALS, given that it is convenient, minimally
invasive, and can provide remote and frequent data collection. This approach will be used to identify
the atypical speech characteristics that limit communicative participation in people with ALS (Aim 1). It
will further determine the validity of passive smartphone data (communication logs and GPS) as
quantitative indicators of communicative participation in people with and without ALS (Aim 2). The
goals of this work are to (1) identify the attributes of impaired speech that limit communicative
participation in people with ALS, (2) address the need for objective indices for monitoring
communicative participation, and (3) remove previous barriers to monitoring communicative
participation using mHealth monitoring technology. Completion of these specific aims will yield novel
tools for monitoring social connection and provide a better understanding of the communicative
participation challenges experienced by individuals with neuromotor speech impairment. This
knowledge is critical for maximizing social connection, and therefore health and quality of life outcomes,
for individuals with neurodegenerative diseases such as ALS.