Pervasive AI-based smart speakers such as Amazon Alexa and Google Home have been maligned on privacy grounds, but new research suggests they may be invaluable in helping sufferers of Parkinson’s disease counter voice changes.

The affliction’s progressive degeneration – which gives Parkinson’s patients a soft, monotone and hoarse sounding voice due to changes in muscle function – is found in 89 per cent of patients, and the vocal chord changes that it causes are one of the first clinical signs of the condition.

It typically causes patients to withdraw from conversations because they cannot modulate their voice enough to be heard, or heard clearly – and many sufferers report decreased social confidence as a result.

Such loss of speech might have been expected to make it difficult for Parkinson’s patients to interact effectively with voice-assisted smart speakers – but, Monash University senior lecturer in the Department of Human Centred Computing, Dr Roisin McNaney told Information Age, anecdotal reports to the contrary led to a formal research stream that produced surprising results.

Building on earlier work with Parkinson’s sufferers with researchers at Northern Ireland’s Ulster University, the team surveyed 290 Parkinson’s sufferers and found that 90 per cent owned a voice-assisted device, with 71 per cent using it regularly.

“It was quite surprising to us that they were using this successfully,” McNaney explained, noting that 80 per cent of the participants had “moderate speech difficulties”.

“Some had quite serious speech difficulties,” she explained, “and when we asked one of them ‘what do you do when Alexa doesn’t understand you?’ she just said ‘I speak again, louder and clearer’.”

Because they have been designed using AI that allows them to interpret a broad range of voices and accents, it turns out, the voice assistants had inadvertently become a form of speech therapist: Parkinson’s patients can try over and over to communicate with them until they have adjusted their speech, and speaking volume, to be understood.

“It is quite a non-confrontational way to practice speech,” McNaney said. “Sometimes the wife or husband isn’t so patient, but this technology gives you an unlimited number of attempts.”

Indeed, 31 per cent of respondents said they were using the voice assistants specifically to address the needs associated with their Parkinson’s disease – and many reported that using the devices to improve the clarity of their voice was producing significant improvements.

“We found remarkable success with using the technology just out of the box,” McNaney said, noting newly-published findings including reports that a quarter of participants said they were repeating themselves less; 54.8 per cent “sometimes, rarely, or never” had to repeat themselves using the voice assistants; and 14.8 per cent perceived their speech to be clearer.

“Others were even saying that their spouse or loved one was asking themselves to repeat themselves less,” she added, “which is interesting because it suggests the changes were persisting even when they weren’t using the device.”

Future work will explore the role of voice-powered smart assistants in other contexts, while McNaney said the research team is also looking at designing Alexa ‘skills’ specifically designed to help Parkinson’s patients practice and improve their speech.

The new in-home therapist

Despite widespread concern that voice assistants were serving as de facto listening devices, the test group was unfazed – with 90.7 per cent of respondents saying they were not concerned, or only slightly concerned, about privacy and confidentiality.

That bodes well for the exploding market for inexpensive voice assistants that are rapidly becoming front-line tools to help healthcare providers communicate with, monitor, and support all kinds of patients at home.

Lenovo, for one, last year launched a healthcare-specific Virtual Care solution while Amazon is exploring ways its readily-available Alexa virtual assistant can be used in chronic disease care.

Startups are pouncing on the opportunities, with firms like WeFight also exploring the companions’ use in supporting cancer and chronic disease.

AI algorithms are even being used to analyse ‘vocal biomarkers’ that allow them to pick up on disease-specific voice changes: Canadian startup Winterlight Labs, for one, claims that its technology analyses 500 different features from speech and can diagnose Alzheimer’s from two minutes of speech with 91 per cent accuracy.

Such uses will continue to emerge as the increasingly popular devices become ubiquitous – particularly in Australia, which has outpaced the world as we buy millions of the anthropomorphised devices in a market that Telsyte believes will grow from $1.26b in 2019 to $4.8b by 2024.

And while it’s still early days for research into their use, a panel of healthcare experts this year concluded that the assistants’ versatility will continue to carve out a niche in certain areas.

While voice assistants may not currently be able to “provide frustration-free user experience nor outperform or replace humans in health care,” they noted, eventually “[they will] be able to provide solid medical advice based on patients’ personal health information and to have human-like conversations.”