9th June 2014: Startup of the week: Neuro Hero

For this 'Startup of the week' post, I caught up with Ireland based, Aviva Cohen , founder of Neuro Hero.

[Disclosure: I have no commercial ties with Neuro Hero]

1. What is Neuro Hero?
Neuro Hero creates apps to support people living with cognitive or speech and language difficulties that often follow stroke, brain injury and a range of other conditions. Our apps provide home based rehabilitation and opportunities for caregivers, family and friends to learn communication skills. We develop low cost products with health care professionals and test our apps with the people they are designed to support. 

Our Talk Around IT apps help people to improve their word finding skills. There are four versions; each one is based on a widely practised speech and language therapy technique called Semantic Feature Analysis (SFA). In addition to the benefits of doing these rehabilitative exercises, family and friends can learn how to ask the right questions and provide useful prompts to help their loved one. Talk Around IT apps are available on Apple iPad, Apple OSX, Android and Windows PC’s. 
Our One Skill Video app helps friends and family learn how to interact with a loved one who is living with communication difficulties. Each video is less than three minutes long and includes three elements: it shows how a conversation can go wrong, how to have a more productive conversation and it helps you to remember the important points. It is available for Apple IOS and Android Devices.

2. Could you explain the essence of Neuro Hero, i.e. it's core values? 
The problem
‘Our ability to interact with our family, friends and community in a meaningful way is essential to our sense of well-being and general health. When this ability is reduced by conditions such as stroke, brain injury or dementia, the impact can be immense’ (Seeman:1996). 
Feelings of isolation may lead to depression. This often has a negative impact on our ability to perform the general activities of daily living such as washing, dressing and shopping for food (Chemerinski et al,2001). Therefore, it is essential that therapy for people with cognitive or neurological difficulties should include ways to enhance social companionship. (Hilari and Northcott:2009).
Neuro Hero’s approach
We are determined to enhance the potential for interaction and social companionship through our work. We aim to include family and friends in the process of rehabilitation. We want to help them to learn essential skills that can make communication easier. We are committed to working side by side with people who are living with communication disorders as well as their families and friends.
Why Neuro Hero can help
The theory of Neuroplasticity suggests that our brains have the ability to change their structure and function in response to changes in our environment (Kolb et al:2008). When you provide the right challenges after a brain injury, it may be possible to stimulate recovery (Chapey:2008). We aim to provide challenges that have the potential to improve quality of life through rehabilitative exercises and social interaction.

3. How did you know where to begin? 
I didn’t! When my husband had his stroke, I knew how to do research, so I did that. I sat by his bed all day reading whatever I could get his doctors and therapists to give me. 

When the children slept I spent my time on Google. I phoned consultants and researchers all over the world and I was amazed by their generosity. I was a stranger at the end of a phone, at first I didn’t even know what questions to ask. I put my natural shyness on hold and made call after call. This was my beginning and I just kept going. 

4. What's the business model you're operating under? 
Neuro Hero is both a social enterprise and a limited company. As a social enterprise we are proud to have received two prestigious awards. In May of 2012 we received the Arthur Guinness Fund Award. This supports emerging social entrepreneurs to develop their projects by providing the resources they need to make a difference. In October of 2012 we received the Impact Award from Social Entrepreneurs Ireland. This award helps high potential social entrepreneurs to refine their solution, become effective leaders and increase their impact.

As a limited company we generate revenue from the sale of apps and from software licencing. For us the bottom line represents how many lives we can impact for the better. We need to generate sufficient revenue to continue to produce products so that we can achieve this. Our ethos is to invest our revenue into new products and new ways to help people whose lives have been rewritten by cognitive impairment. 

5. Why isn't anyone else doing what you're doing?
There are some other apps that deliver speech and language therapy in the home. The experts who have been working with our Talk Around IT apps agree that we stand apart because of the clarity of our design and the beauty of our images which are essential when delivering effective rehabilitation for adults. The other feature they highlight as different, is the opportunity we provide for family and friends to interact with their loved one. This has two positive outcomes: it helps to address the social isolation that so often accompanies speech and language difficulties. In addition, it teaches friends and family how to ask the right questions to help their loved one ‘find’ his or her words. 

We created our One Skill Videos after numerous speech and language therapists expressed the wish that they could find short, accessible videos. They were looking for videos that demonstrate  useful skills to improve interactions e.g. how to speak in simple sentences or recognise that people may need time to respond. We created nine videos, available as a free app. The response we receive is often emotional and always rewarding. This is a review written by a women who is living with Aphasia: 

“Helps so much in educating others to help me more and perhaps repair relationships who didn’t understand or believe was brain injury. I can’t wait to see the rest of the apps. I have been hoping for something like this- so people would not patronize me, put words in my mouth or keep ending up with bills I didn’t want or should have to pay. Tired of the taken advantage of and hopefully this being passed around inner circle will help with their disgusting behaviour. Very excited! I literally am getting a voice again that doesn’t get “episodes” & again has clout to pull.’: (by Andrea) 

6. Was there one moment which compelled you to begin the journey of working on Neuro Hero? 
On June 5th 2006 our lives changed utterly. That morning my husband, Steve, and I practiced karate as we did every day. Our five year old daughter was counting for us in Japanese (more or less) and our baby girl was laughing at the spectacle. By that evening a stroke had stolen away Steve’s cognition, his movement and his speech. After six months in hospitals and rehab centres we took Steve home; he was less able than our baby who was now almost one and a half. In addition to numerous challenges Steve was diagnosed with severe expressive Aphasia. His condition attracted some attention as he had the dubious honour of being one of the most severe cases his medical team had treated.

About a year after Steve’s stroke, we became aware that he felt excluded when friends and family came over. Despite his communication deficits he made it very clear that he would no longer allow visitors to our home. This became abundantly obvious when one of Steve’s friends travelled from Belgium to visit him. After a brief “hello” Steve stood up, took his friend by the hand and backed him out the front door repeating “bye bye” as he went. After that we all shared in the isolation he had been experiencing. I quickly realised that social isolation is a common problem for people living with communication difficulties and their families. I started searching for a comprehensive, integrated, therapeutic solution to this problem. The resources that I found were either limited and expensive or required support from a therapist or a training course.  Eventually, Steve allowed two cheerful, young speech and language therapists to visit us. Slowly, with their help, he began to re-enter the world. 

From the beginning I had been asking questions, sitting in on every speech and language therapy session and reading every training manual and paper that I could lay my hands on. I was determined to come up with ways to help Steve continue to make progress at home and to share this with other families.

7. What have reactions to Neuro Hero? Do different people perceive it differently? 
I have been amazed by the positive reactions from everyone we speak to or interact with. I have been delighted by the support we have received from members of the public, Irish government ministers and respected organisations. We have also built fantastic relationships with caring and support organisations who have helped us along the way. 

I did receive one negative email from a member of the public who thought that €20 was too much to pay for unlimited access to home based speech and language therapy. I wrote to explain the financial realities and then, even he accepted that our apps deliver excellent value. 

I have lived through more than one tragedy and people often tell me that I must be a “very unlucky person”. On the contrary, I feel that I am lucky to be surrounded by such positivity. I have been the beneficiary of incredible support both publicly and privately. In those moments of personal darkness, I sit and think about the wonderful reactions we have had and the potential that our work has to benefit others and I don’t feel “unlucky” at all. 

8. Given that Silicon Valley is the world's innovation hub, it's inspiring to see an Irish start up ahead of the rest of the world. Do you see more ground breaking innovations in Digital Health coming from outside Silicon Valley? 
In September of 2011, Neuro Hero, won a place on the LaunchPad accelerator program for digital start-ups in Dublin, Ireland. 

I remember my first meeting in the National Digital Research Centre (NDRC); I spoke to one of their project directors Mark Kearns. I showed him the project I had been working on, he liked it but didn’t see any potential for revenue; “what else do you have?” he asked. I began to explain numerous ideas I had been working through. With the gifts of lateral thinking and insight typical of NDRC, Mark started to unpick one of my ideas: an app to help people with speech and language difficulties. “This sounds more like something we can work with,” he said, and he advised me to download an application form for LaunchPad, a three-month accelerator programme for technology based start-ps in the heart of Dublin.  I found a talented app developer and together we filled in forms, pitched our ideas, and won a place on the LaunchPad programme. It began in September 2011 and it has been a phenomenal experience. We have been mentored by experts; talked to by entrepreneurs in every field; trained by professionals; and really looked after by an intensely knowledgeable and compassionate staff.

I now have an incredible team around me and we are still here in NDRC’s wonderful old building, a former oast house that had been used as the Guinness Store House. I don’t believe that we could have had a better start anywhere in the world.  

9. Two years from now, in 2016, what would success for Neuro Hero look like? What are the barriers to success? 
Two years from now I would like to know that people around the world are benefiting from our work. 

We are in the process of localising our apps and we hope to have our Spanish language version of Talk Around IT available by November. By 2016 we plan to have launched in four other languages.  In addition, we have been working on apps in other fields such as occupational therapy. We will launch the first of these by the end of this year. 

We are also dedicated to raising awareness of Aphasia and fostering a better understanding of those living with cognitive challenges. The impact we make through our awareness campaigns will never be measurable but it may help to change attitudes and that can be immensely powerful.    

When my husband had his stroke our two daughters were under seven and I found very few resources to help me explain what had happened to their Daddy. This is another project I intend to create along with therapist from numerous fields. I want to build resources for families who need guidance when faced with a life changing illness or event.   

Our greatest barrier to success is this: we need find ways to let more people know that our free and low cost apps can help them and their families. We need to connect with more hospitals and rehabilitation centres around the world in order to deliver effective rehabilitation and education that does not require the presence of a therapist.    

10. If people feel inspired by your journey, and want to do something with Technology to improve Global Health, what would your words of wisdom be? 
It doesn’t matter where you begin your journey or what your previous experience has been, you can make a difference. 

When I started I was a lecturer in philosophy, a communications consultant and a martial arts instructor. My advice is to use the skills you have and learn how to adapt them so that you can bring a fresh approach to each problem. I try to draw from what I know: I am guided by the great philosophers who write about authenticity and ethics. I use the communications skills I taught in areas such as time management and making presentations. More than 20 years of practicing karate have given me the strength to pick myself up time and again. When you come across something new you have to let go of your pride, start at the beginning and study until you understand. 

If your motivation is strong enough you can find everything you need to make the changes that will bring your vision to life.  

Neuro Hero is on Twitter and click here for the Neuro Hero website.