Empowering Expression for Users with Aphasia through Constrained Creativity

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: Neate, T., Roper, A. ORCID: 0001-6950-6294, Wilson, S. ORCID:

0000-0001-6445-654X and Marshall, J. ORCID: 0000-0002-6589-221X (2019). Empowering

Expression for Users with Aphasia through Constrained Creativity. In: Brewster, S. and

Fitzpatrick, G. (Eds.), CHI '19 Proceedings of the 2019 CHI Conference on Human Factors

in Computing Systems. (650.). New York, USA: ACM. ISBN 978-1-4503-5970-2

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Empowering

Expression

for

Users

with

Aphasia

through

Constrained

Creativity

TimothyNeate1,AbiRoper1,2,StephanieWilson1,JaneMarshall2 1

CentreforHCIDesign,City,UniversityofLondon,London,UK 2

DivisionofLanguageandCommunicationScience,City,UniversityofLondon,London,UK

{timothy.neate,abi.roper.1,s.m.wilson,j.marshall}@city.ac.uk

ABSTRACT

Creativeactivitiesallow peopleto express themselvesin

rich,nuancedways.However,beingcreativedoesnotalways

comeeasily.Forexample,peoplewithspeechandlanguage

impairments,suchasaphasia, facechallengesincreative

activitiesthatinvolvelanguage.Inthispaper,weexplorethe

conceptofconstrainedcreativityasawayofaddressingthis

challengeandenablingcreativewriting.Wereportanapp,

MakeWrite,thatsupportstheconstrainedcreationofdigital textsthroughautomatedredaction.Theappwasco-designed

withandforpeoplewithaphasiaandwassubsequently

ex-ploredinaworkshopwithagroupofpeoplewithaphasia.

Participantswerenotonlysuccessfulincraftingnovel

lan-guage,but,importantly,self-reportedthattheappwas

cru-cialinenablingthemtodoso.Werefectonthepotentialof

technology-supportedconstrainedcreativityasameansof

empoweringexpressionamongstuserswithdiverseneeds.

KEYWORDS

Constrainedcreativity;accessibility;contentcreation;

apha-sia;creativewriting;poetry;creativity;speechimpairments.

1 INTRODUCTION

“Themoreconstraintsoneimposes,themoreonefreesone’sself ofthechainswhichshacklethespirit.”—IgorStravinsky[44] Creativityreferstotheactof bringingsomethingnew

intoexistence.Itappliesacrossmyriaddomains,beginning

withtheveryprocessofthinkingandcontinuesthroughto

Timothy Neate, Abi Roper, Stephanie Wilson, Jane Marshall. This is the accepted version of the paper, hosted by the authors. Definitive version published at CHI 2019 and available at: doi.org/10.1145/3290605.3300615

theproductionofartisticartefactssuchasmusical

compo-sitions,worksofartandliterature.Beingcreativeisoften

arewardingendeavourandhasbeenshowntoaford

sig-nifcantbenefts,forexample,tomentalwellbeing[10]and

selfesteem[19].Itis,however,challengingtobecreative

andmanyindividualsdonotconsiderthemselves‘creative

people’.Tothisend,varioustechniquesexisttoprovokeand

supportcreativeacts[46].Onesuchtechniqueisconstrained creativity[43]or“thinkinginsidethebox”.Constrainingthe spacewithinwhichacreativeactisenactedafordsthe

ex-plorationofboundariesandisanefectivetoolforinitiating

novelartisticendeavour.ComposerStravinsky[44](pg.60)

describeshischallengeswithcreativityinmusical

compo-sition,statingthatitisthefreedomofnumerouschoices

thatblockshismusicalcreativity;conversely,limitingthe

possibilitiesenablesideationandfreesthecreativespirit.

Therefore, acomposer mightlimit themselvestousinga

specifcsetofnotes(asinserialism),orapaintermightlimit

themselvestoasinglebrushtechnique(asinimpressionism)

togenerateaninitial‘spark’ofanideaortocompletean

entirework.Further,constraintsmightguideandsupporta

user–asimpleexamplebeingdrawingwithastencil.

Inthiswork,weexploretheideaofapplyingconstraints

tothecreationofwrittenlanguage.Thevariousformsof

writtenlanguage,suchaspoetry,lyricsorevenlimericksare

ameansbywhichwecanconveysentimentandareaconduit

throughwhichwemayshapeideas.However,peoplewith

speechandlanguageimpairments,suchasaphasia,struggle

toengagewiththeserichformsofexpression.Whilemuch

oftheliteratureontechnologyforpeoplewithdiverseneeds

focusesonrehabilitation,wefocusonenablingcreativity.

Specifcally,weexplorehowconstrainedcreativitycanbe

employedtobroadenaccesstodigitalcreativityforpeople

livingwithaphasia.Thispapercontributesthefollowing:

– Anew approachfor digitaltechnologytofacilitate

constrainedcreativity;

– MakeWrite,anoveltoolco-designedwithpeoplewith aphasiawhichutilisesintentional,automatedconstraints

onlanguagetofostercreativity;

2 BACKGROUND ConstrainedCreativity

Constrainedcreativityreferstotheprocessofgenerating

somethingnewfromarestrictedsetofresources.These

con-straintscanbeexternalorself-imposed.Whilstconstraints

elsewheremighthavenegativeconnotations,constraining

oneselfintentionally ina creativeprocess isa technique

widely-usedtoinspirenewcreativepossibilities[43].In

im-pressionistpainting,forexample,anartistoftenusesasingle

technique–e.g.thin,smallbrushstrokestobuildupalarger

scene.AsnotedbyBiskjaerandOnarheim[4]“certain con-straintscan alsobehelpfulandeven crucialin creativity". BiskjaerandOnarheim[4]studytwodomains(artand

en-gineeringdesign)reportingthat,inadditiontoconstraints

suchasbudgetandtime,teamsalsoleverageself-imposed

constraintsto promote creativity.Stokes [43]noteshow,

whilethematerialsandprocessoftheactofcreationare

obviousconstraints,thoseassignedbytheactorinthetask

canalsoplayanimportantroleincreativity.Similarly,Lazar

etal.[25]discussmaterialityinarttherapy,arguingthat

dif-ferentmaterialshavediferentexpressivepossibilities.They

propose(viaMoon[33])thatfuidmaterialssupportafective

andsensorystates,whereasrigidmaterialslikepensmight

afordexpressionsofstructureandboundaries.

Constraintsmightalsoservetosupportausermore

ex-plicitly:DahlandMoreau[12]arguethatconsumers’choices

to engage with pre-constrained craftssuch as

‘paint-by-number’,specialitycraftsandmodeltrains,aremotivated

byfeelingsofcompetence,autonomyandadesiretolearn.

Itisimportanttonoteherethateventhoughmostofthe

‘work’isdonebyanoutsideparty–i.e.thosewhodesigned

andbuiltthekit–enjoymentisstillgainedfromsuch

con-strainedcreativeactivities.Thespaceweaddressinthework

reportedinthispaperisintentionallyconstrained.Crucially,

however,weseektoenablepeopletocreateoriginal

arte-factsincontrasttothe‘paint-by-number’approachwhere

theoutcomeispre-defned.

CreativitySupportToolswhichUtilizeConstraints

Digitalcreativitysupporttoolsenablepeopletoarticulate

artisticintentindigitalform.Theextenttowhichthe

soft-wareassiststhecreativeprocessvariesbetweentools,but

thesetoolscommonlyrequireanextensivelearningprocess

inordertoproduceasophisticatedoutput.Shneiderman[42]

however,proposesthat,whenconsideringcreativesupport

tools,oneshould“Designwithlowthresholds,highceilings, andwidewalls”. Thatis, systems shouldbe designedfor non-experts,whileprovidingthefunctionalitythatexperts

need.Tothisend,muchresearchhasconsideredhowwemay

broadenaccesstothedigitalcreativeprocessthroughtools

thatundertakemuchofthecreativecostwithminimal

sacri-fceofexpressionontheuser’sbehalf.Tocreatemusic,for

example,onemustexplicitlyorimplicitlygraspacomplexset

ofheuristics(chordsequences,scalesandrhythm).Many

re-searchershaveconsideredhowtheserulesmaybemodelled

computationallytobroadenaccesstomusicalcomposition

foramateurs.BenglerandBryan-Kinns[3],forexample,

de-scribePolymetros–asystemenablingnon-musicianstobe creativebycontrollinganumberofparameterswithina

con-strainedstructure;meaningthatanumberofpeopleplaying

togetherwillalwayssoundcomplementary.Coughlanand

Johnson[11]identifyhowconstraintsmayserveto

supple-mentmusicalcreativityinanend-userdevelopmenttool,e.g.

byblocking‘unused’notestolowerthecognitiveefortto

engagewithaninstrument,similartotheconceptemployed

bythepopularappGarageband.Similarly,Benedettietal.[2] describeadrawingtoolthatallowsuserstocreatetheirown

versionsofpictures.Thetoolassiststhepaintingprocess

byprovidingcontoursthatautomaticallypaint‘within’the

linesofexistingpictures,allowinguserstoaddtheirown

creativestyle.

GenerativeandSupportedWritenCreativity

Anumberofdigitaltoolsgeneratecreativewriting.These

generallyproducepoemsandsimilartextsfroma

combi-nationofuserinput,suchasthechoiceofwords,andan

algorithmwhichdictatestheoutputpoem[18,35].Other

toolstakeaninteractiveapproach,formingthepoemfrom

liveinput.Forexample,PereiraandMaciel[37]investigate

theefectsofusersinteractingwithgenerativeliterature,

Mendelowitz[31]exploresanalgorithmicapproachtoauser

generatingpoetryfrom sketch-basedinput andMarshall

[30] usestheinputofrunningintensitytoaltertheefects

inareadpoem.Suchpoemgeneratingtoolssitona

con-tinuumwherethereisatensionbetweentheworkdoneby

theuserandtheworkdonebythemachine.Toolssuchas

Zhang’sneural-net-basedpoemgenerator usepreviously

createdpiecestogeneratenewpoems[49].Thisafordsthe

usernoagencyinthecreation.Otherpoetrygenerators(e.g,

onlinehaikugenerators)oferadegreeofcontroloverbasic elementsofthepoemwithinarigidstructure.Regardlessof

whereeachtoolsitsonthiscontinuum,notoolscurrently

existwhichgenerateandsupportcreativewritinginaform

accessibleforapersonwithaspeechandlanguage

impair-mentsuchasaphasia.

AphasiaandContentCreation

Wenowconsidercreativitywithinthecontextofaphasia.

Aphasiaisanimpairmentoflanguagecausedbydamageto

thebrain(mostoftenthroughstroke).Itcanafectallaspects

oflanguage:reading,writing,speechandcomprehension

uponeveryindividualdiferently.Forexample,somepeople

mayfndwritingmoredifcultthanspeaking,whereas

oth-ersmighthavespecifcdifcultiesinunderstandingspoken

language.Theconditionafectsaroundonethirdofstroke

survivorswithestimates thatthere are around2 million

peoplelivingwithaphasiaintheUSAalone[1].However,

despiteitsprevalence,lessthan10%ofthewiderpopulation

knowwhataphasiais[9]–illustratingitsstatusasalargely

invisiblecondition.Anageingpopulationandincreasing

oddsofsurvivingastrokeimplythatthenumberofpeople

afectedbyaphasiawillcontinuetoincrease–andagrowing

numberofindividualswillbefacedwithdiminished

oppor-tunitiestoconveytheirintellectandcreativepotentialdue

totheirlanguagebarriers.

Multipleaspectsofthecreativeprocessmayprove

chal-lengingto people withaphasia. Manycreative activities,

suchaspoetryforexample,necessitateextensivelanguage

processing.ChrisIreland,apoetwithaphasia,getsaround

thisbyengaginga‘poetryeditor’(aspeechandlanguage

therapistfriendwithoutaphasia)tohelpeditandrefneher

work[23].Ireland’swork,andrelateddiscussions[24],

re-portthebenefcialexperienceforherofcreativewriting(via

Boltonetal.[5]).Shedescribesherworkasacelebrationof

thelanguageofaphasia(completewith‘erroneous’spelling

andgrammar)andaliberatingtoolinwhichsheis

empow-eredthroughcreativity.Otherswithaphasiamaynotenjoy

similaraccesstoa‘poetryeditor’friendandmightlookto

technologyforsupport.Researchindicates,however,thatthe

languagedemandsimplicitinmanyaspectsof

technology-usepresentbarriersforpeoplewithaphasia[8,20,32,40].

Thetestingofsocialmediatoolswithpeoplewithaphasia

[39],forexample,hasshownthattheycanpresentanumber

ofbarriers[21].Thismeansthatmanycreativitysupport

tools,suchasthosedescribedpreviously,arenotavailable.

Inevitably,thisleadstochallengesforpeoplewithaphasia

hopingtoengagewiththeprocessofdigitalcreativity.

Workhasbeenundertakentocreatetechnologies

accessi-bletopeoplewithaphasia.Thesetechnologieshavemainly

focusedoneithertherehabilitationofcommunication,e.g. toretrainlostvocabulary[36],ortheuseoflanguageina

veryfunctionalcapacity.Forexample,Walleretal.[47]

in-vestigatedhowwemightassistpeoplewithaphasiatomake

conversation.Onecommonlyreportedmethodemploys

im-agestosupportcommunication[7,28,29].Otherworkseeks

tosupportmorepracticalactivitiessuchascooking[45].

Ac-cessibledigitaltechnologieshavealsoenabledrehabilitative

therapyforimprovinggestures[41]andspokenlanguage

[16,26].Contrastingworkhassoughttoclassifyaphasic

lan-guageinputcomputationally[15].Verylittlework,however,

hasfocusedonenablingcreativedigitaloutput.Whilst reha-bilitationisunquestionablyimportant,weaimtoprovidea

contrasttoexistingfunctionaltechnologiesbyconsidering

howwecanengagepeoplewithaphasiainadigitalprocess

ofcreativewriting.WedothisthroughMakeWrite,anovel toolthatutilisesconstrainedcreativitytoenablepeoplewith

aphasiatoplaywithandshapelanguage,facilitating

mean-ingfulandenjoyablecreativewriting.

3 EXPLORINGCONSTRAINEDCREATIVITY ErasurePoetry

The workreportedhere wasinspiredbythepotentialof

erasurepoetryto allowpeopleto scafoldtheircreativity bybuildingontheworkofothers.Inerasurepoetry(also

knownasblackoutpoetry),oneremovespartsfromasource

text,typicallybyredactingwithapen,to leavebehinda

newpoem(Figure1).Thiscreatespoems,orsmallpiecesof

creativewriting,relatedorunrelatedtotheoriginaltext.

Weexplorederasurepoetryinoneofourregularresearch

teamcreativitysessions.Althoughnoneofuswouldregard

ourselvesascreatives(andcertainlynotaspoets),weall

createderasurepoemswithrelativelylittleefortandalot

ofprideintheoutcome.Filledwithasenseofachievement,

wethenencouragedotherstoparticipatebyplacingpages

fromabookaroundourresearchlab,andreceivedanumber

ofadditionalpoemsinresponse.SeeFigure1.

The world, so beautiful

the car, succumbing to a vortex

offered up

Figure1:Excerptfromanerasurepoemwrittenontheday abillionairelaunchedausedcarintospace,redactedfrom

‘TheBriefWondrousLifeofOscarWao’byJunotDíaz[13].

Subsequentrefectionsuggestedtousthatapplying

con-straintstothecreationoftextcouldbeapowerfulenablerfor

peoplewithspeechandlanguageimpairments–providing

aconstrainedvocabularyspace withinwhich textscould

becreatedandovercomingthechallengeofstartingfrom

ablankslate.Wealsoidentifed,however,thattheerasure

poetryactivity,aswehadundertakenit,waslikelytobe

lin-guisticallychallengingforthosewithalanguageimpairment

–duetothenumberanddensityofwordspresentedona

typ-icalpage–butthattheremaybeanopportunityfordigital

toolstoassistthisprocess.Weundertookaco-design

activ-itytoexplorethisopportunity,leadingtothedevelopment

Co-Design

Followingourinitialexplorationoferasurepoetry,weworked

withfourco-designerswithaphasiatoprobethe

feasibil-ityofusingtechnology-assistederasurepoetryasaform

ofconstrainedcreativity.Theco-designerswereemployed

asconsultants.Allhadmild/moderatelanguagedifculties

duetoaphasiaasaconsequenceofstroke,wereatleastsix

monthspost-strokeandhadspokenEnglishfuentlyprior

totheirstroke.Theywereagedbetween44and68years

old(average=58).Weundertookthreeco-designsessions

forthispurpose;thesewereaudioandvideorecordedfor

laterreference.Theco-designersgeneratedideasinthefrst

sessionandworkedwithusinsubsequentsessionstorefne

prototypesasthedesignprogressed.Ourgoalwastoensure

thatanytechnologywouldbebothaccessibletopeoplewith

aphasiaandwouldempowerthemtocreatecreativecontent.

IdeationwithInitialPrototypes

Weworkedwiththeco-designerstoexploretheideaof

auto-matederasureasameansofdigitallyassistingconstrained

creativity–frstthroughapaper-basedsimulation("paper

grids")andthenthroughasimpleprototypeappwhich

mir-roredtheprocessinadigitalform.Wediscussedtheefcacy

ofthesemethodsduringandafterthesessionsupportedby

visualratingscales.Thesescalesprovidevisualcuesin

addi-tiontonumbers(e.g.a‘thumbsup’or‘thumbsdown’atthe

endsofaLikertScale,similarto[17])tosupportpeopleto

expresstheirthoughtsandquantifytheirsentiments.

PaperGrids.Wefrstsimulatedtheconceptof‘automated’ redactionusingpapergrids.Co-designersweregivenasource

textlaidoutinagridpatternonA3paperandoverlayswith

holescutout.Theoverlays‘redacted’themajorityofwords

fromthesource.Co-designerswereabletoredactvarying

amountsoftextbymovingtheoverlaysandbyselecting

alter-nativeoverlays(Figure2).Thegoalwastoexplorewhether

reducingthecognitiveburdenof redactionwouldenable

peoplewithaphasiatoborrowwordsfromasourcetextto

createtheirownexpressiveoutputs.

Afterpracticeapplyingoverlaystothepapergrids,allof

theco-designerswithaphasiawereabletocreatewritten

textswithwhichtheyweresatisfed.Indeed,this‘automated’

redactionofalargebodyoftextmadetheselectionofwords

moreachievable.However,achallengewiththewordsets

elicitedby theoverlayswasthatbyspotlightingjustone

wordatatime,elementsoftextswhichnaturallyconsistof

twoorthreewordphraseswerelost–sometimesleaving

theemergentsubsetof wordsfragmentedandlacking in

potentialforcomposingnewphrases.

Overthecourseoftheactivity,itnaturallyevolvedintoa

collaborativeexercise.Wenotedtherewasincreasing

engage-mentwiththepoetryactivityandthatpeoplebeganto‘rif ’

Figure2:Wordblockingexerciseanalogoustoautomatically redactingtexts(self-imposedconstraints).Left,apapergrid

is placed over aspaced gridof words.Right, this gridis turnedupside-downandadiferentsetofwordsemerge.

ideasofeachothertocreatesomethingnewwithlanguage.

Forexample,oneco-designernoted:“Maybeifeachperson doesachunkandthengeteveryonetogetherforthepoem”. Bytakingitinturnstogeneratelinesusingthepapergrids,

thegroupproducedaseriesofcreativetexts,forexample,a

shortHaiku-soundingpoementitled‘TheHemlockGrief’: The Hemlock Grief

The change subsides

Her tree only sank

It’s almost dark

InitialAutomatedRedactionPrototype. Wenextexplored automatedredactionthroughasoftwareprototypebuiltin

theProcessingprogramminglanguage.Thisprototypeused thesameconceptofblockingoutsectionsfromagridof

words,butdidsowithblockinggridswhichblocked out

wordswithanuser-defnedprobability(between10%and

90%inincrementsof10).Thisprototypewasdemonstrated

byoneoftheresearchersandprojectedontoascreeninthe

labduringthesession,withdirectionfromtheco-designers.

Theredactionwasrepeateduntilapreferredsetofwords

wasidentifed.Theselectedwordswerethenwrittenout

andrearrangedbythegrouptocreateanewtext.

Theiterativeapproachofrenderingmultipleredactionsof

thetextsupportedbythisprorotpewasreceivedpositively.

Thisapproachmadeeachsetofwordslessprecious,

mean-ingthatmultipleiterationscouldbeviewedquicklyuntila

preferredsetofwordswasavailable.Thismadeforaneasier

processofbeingcreativewithlanguage.Oneco-designer

statedthattheblockingofthewordsenabledthemtocreate

atextthattheywerehappywith,likeningittoacrossword

anddescribingitasa“surprisinglyrewardingexperience”.

Fromtheseinitialexploratoryactivities,wedrewseveral

conclusionsforthedevelopmentofanappthatwouldutilise

constrainedcreativityto supportpeople increative

writ-ing:thatallowingfortheretentionofmore grammatical

structurefromthesourcetextmightsupportwriting(e.g.by

supportingselectionofsmallchunksoftextinsteadof

possiblebuttheappshouldencompassafairpowerdynamic;

andthatfacilitatingmultipleiterationsofredactionsofthe

sourcetextalloweduserstogeneratecreativelanguage.

Co-DesignofMakeWrite

Wenextconductedtwoco-designsessionstoiteratively

de-signanappthatusesautomatedredactiontoenablepeople

toplayandexperimentwithwordsandproducecreative

output.Thegoalswere tobuildonthefndingsfromthe

ideationsessionandtodeliveranaphasia-friendly,

accessi-bleapp.Wedecidedthattheappshouldhavethreestages:

onetoallowtheuserstochoosethesourcetexttheywantto

redact(‘Choose’);onewheretheyapplythecomputer-aided

redaction(‘Erase’);andafnalstagetoarrangethetext

(‘Ar-range’).Theco-designprocessemployedtechniquessuch

asSWIM(SomeoneWhoisnotMe)[48]viaco-created

per-sonas[6,34]andvisualratingscales(asabove)tofacilitate

ideagenerationandfeedbackforthesethreestages.

ChoosingtheSourceText.Althoughasourcetextmight bedrawnfromanywhere(e.g.awebsite,bookorpoem),for

thesakeofthesimplicity,wechosetolimittheprototype

apptosixshortcreativetexts(poemsandshortstories).We

consideredhowthesourcetextsmightbepresentedforusers

tomakeachoice–exploringanumberofmeanstoidentify

eachsourcetext,includingplainwordlabelsandword-clouds

generatedfromthetexts.Theco-designersadvisedthata

picturewithatextlabelwouldsupportthemtounderstand

themainthemeofeachtext:“Youcanputsomepicturein. Thatwouldhelp.Picturewillmakemanywords”.

AutomaticRedactionoftheSelectedSourceText. Wewanted togiveuserscontroloverhowmuchtextisredacted.Based

onfeedbackintheco-designsessionsregardingthenumber

ofwordsthatwouldbeappropriate,theamountof

redac-tionwaschangedtohaveanupperlimitof10%retention

ofthesourcetext(i.e.atleast90%redaction).Furthermore,

informedbythefndingsofthefrstco-designsession,we

wantedtoretainsomeelementsofthesourcetextstructure

asco-designersfounditchallengingtolinkisolatedwords.

Therefore,weexploreduseofa‘textgrouping’functionto

allowuserstospecifythatsomeofthewordsshouldbein

chunksofeithertwoorthreeadjacentwords.Thiswas

re-ceivedpositively. Finally,afterexploring aninitialvisual

design,allUIelementsweremadelargerandarrangedto

afordeasierinteractionforpeoplewithaphasia(i.e.taking

intoaccountnon-dominanthanduseandtheconsequent

needforinteractiontargetswhichrequirelessaccuracy).

ArrangingtheText.Forthefnalpartoftheprocess,we wantedtooferaninterfacethatenablesuserstoorganise

theselectedwordsubsetastheywish.Herewewereinspired

byfridgepoetry(aformofVocabularyclept[27]),aformof

constrainedcreativitywherepeoplearrangeafnitesetof

wordstocreatevaryingoutputs.Afterexploringaninitial

designwiththeco-designers,itbecameclearthatto‘clean

up’anyunwantedwords,thisphaseshouldprovideasimple

waytodeleteselectedwords.Co-designersalsoindicated

thatthereshouldbeanoptiontoaddwords.Tosupportthis,

wecreatedabuttontoallowuserstoelicitone

randomly-selectedadditionalwordatatimefromthepoolofpreviously

rejectedwordsinthesourcetext.Wetookthedecisionto

avoidtheoptionofwordentryviakeyboardinput–which

mightexcludethoseuserswithtypingdifculties–toensure

thatalluserswishingtoaddnewwordscoulddosoonan

equalfooting.ThevisualdesignoftheArrangescreen(e.g. thesizeofthewordsandtheirpadding)andtheinteraction

(multiple fngers) were designedwithinput fromthe

co-designers.

CapturingtheContent.Finally,wediscussedwiththe co-designershowtheyandotherpeoplemightwanttoshare

thecreatedtexts.Allco-designersexpressedadesiretoshare

thetextswithcloseindividualssuchasfamilyandfriends,

butthereweresome reservationsaboutwidersharingto

socialmedia.Hence,ratherthananautomatic‘publishto

socialmedia’option,weoptedtoimplementtheoptionfor

theusertosaveanimageofthetexttheyhadcreated,and

thiscouldlaterbesharedhowevertheymightchoose.

4 OVERVIEWOFMakeWrite

Wenowdescribetheresultantco-designedapp.MakeWrite

isaprototypeappthatenablesuserstotakeasourcetext,

automaticallyredactitaccordingtoselectedparameters,and

thenarrangetheredactedtextinsuchawayastocreatea

newformofwrittenexpression.MakeWritehasthree con-secutivestages,eachdedicatedtoonespecifctask:Choose,

EraseandArrange(Figure3).

The‘Choose’Stage

ThefrstscreenofMakeWriteinvitestheusertochoosea sourcetextfromaselectionofsixshortcreativetexts.

The‘Erase’Stage

Oncetextisloadedfromtheoriginalsource,theusermay

beginredactingwordstofndagroupthattheylike.

Auto-maticredactionisinitiatedbypressingtheyellow‘Refresh’

button(Figure4).Thepercentageofredactioncanbealtered

throughuseofaslider(set,bydefault,sothatonly5%of

textwillremainafterredaction).Userscanchoosetoretain

between0%and10%ofthesourcetext.Thewordgrouping

featureenableschunksofeither1,2or3wordsatatimetobe

generatedbypressingtheappropriatebutton.Here,ifaword

appears,inaccordancewiththepercentageredaction

Figure3:MakeWrite:a)the‘ChooseStage’,b)the‘EraseStage’,c)the‘ArrangeStage’.

userisfreetomanipulatepercentageredactionandgrouping

constraintsuntiltheyarriveatagroupofwordstheywould

liketouseasastartingpointfortheircreativetext.

The‘Arrange’Stage

Theelicitedwordsarethenpresentedonagreycanvasarea

withinthe‘Arrange’screen.Userscandragandrearrangethe

wordswithmultiplefngerstoformanewtextcomposition.

Awordcanbe deletedby movingitto the‘Draghere to

delete’region.Usersmayalsoaddwordsfromthepreviously

‘rejected’setofwordsfromthe‘choose’stage.Pressingthe

‘Newword’buttonwillspawnarandomly-selectedword

intothegreyregionbelowthebutton.

Figure4:Variationsofredaction:topleftandtoprightshow thevariationinwordretention(10%and20%respectively).

Bottomleftandbottomrightshowthevariationintheword grouping(2wordsand3wordspergrouprespectively).

5 ‘POETRY’CREATIONWORKSHOP

ToexploreuseofMakeWritewithinareal-worldsetting,we conductedacreativewritingworkshopatadrop-insession

forpeoplewithaphasia1.Thedrop-insessionisaweekly

eventwherepeoplewithaphasiainthelocalcommunitycan

accesscommunicationsupportfromspeechandlanguage

therapists (SLTs), speechand language therapy students

(SSLTs)andpeerswithaphasia.Thoseattendingweremade

1

Weinitiallyreferredtothesessionasapoetryworkshop.Overtime, how-ever,wehavecometoconsidertheterm‘creativewriting’amoreftting descriptoroftheactivity.

awareinadvancethatthesessionwouldincludeapoetry

ac-tivitywithresearchersandweregiventheoptiontoopt-out

oftheactivityinfavouroftheirregularsessionactivities.

Theaimofthisworkshopwastounderstandthe

efec-tivenessofMakeWriteforenablingpeoplewithaphasiato createnewtexts(referredtoas‘poems’asashorthandwithin

thecontextoftheworkshop).Owingtothenatureofthe

drop-insession,wecouldnotcontrolforaphasiaseverity.

Giventheapphadnotbeencreatedwithexplicitinputfrom

userswithsevereaphasiaweexpectedavarietyofoutcomes

whenputtingittothetestwithinthisbroadercontext.The

workshopwasrunbyahumancomputerinteraction(HCI)

researcher,threeprofessionalSLTsandoneSSLT.TheSSLT

andtwooftheSLTshadnotbeenpartoftheco-designteam.

Procedure

Atthebeginningoftheworkshop,participantswere

sup-portedtoaccesstheinformationandconsentprocedureby

theSLTsandSSLT.Thiswasfollowedbycompletionofan

aphasiaaccessibleinterviewtogatherdemographic

infor-mation(reportedinTable1).Tocapturedetailsofaphasia,

participantswereaskedto self-reporttheirperceived

dif-fcultieswithreading,writing,speakingandlistening,by

refectingontheirabilitytocompleteaseriesoftaskswhich

rangedfrommoretolesscomplex.Forexample,to

under-standaperson’swritingability,weaskedparticipantswhich

(ifany)ofthefollowingtheyfeltabletoproduce:longtexts

(likeastory);aletteroremailtoafriend;simplesentences;

somesinglewords;theirname.Wealsoaskedthemto

re-portanyphysicalimpairments.Datacapturewassupported

byuseofaphasia-accessibleformsandvaryingdegreesof

facilitationfromthe(S)SLTs.

MakeWritewasthendemonstratedwiththeiPadscreen projectedontoalargedisplay.Thiswasundertakenbyone

oftheSLTswhohasextensiveexperienceinusingdigital

technologiesalongside people withaphasia. Participants

thendividedintofveself-selectinggroupstouseMakeWrite

askedtoworktogethertocreatepoems.Wherenecessary,

theuseoftheappwassupportedbyanSLTorSSLTfacilitator.

Whenparticipantshadfnishedcreatingtheirpoems,they

weresupportedtocompleteafeedbackquestionnairewhich

includedrating theiragreement/disagreementto thekey

statement"IwroteapoemwiththeappthatIcouldnothave writtenwithoutit"(seeTable3).

Weadoptedthisworkshop-basedapproachtoinvestigate

usageofMakeWritebecauseSLTsontheresearchteam ex-pressedtheviewthatitwasnotreasonabletoask

partic-ipantstoengageinunsupportedcreativewriting(indeed,

thischallengewastheoriginalmotivationfortheapp).For

thisreason,aformalcomparativeevaluationbetweenthe

creativewritingoutcomesachievablewithorwithoutthe

appwasrejectedinfavourofparticipants’self-evaluationof

theirMakeWrite’poems’againsttheirabilitytowritepoetry withouttheapp.

DataCollectionandAnalysis.EachiPadrecordedall inter-actionsbothasvideoandaudioandalsoasevent-basedlog

data.Asmentionedabove,aftertheusagephase,participants

reportedtheirexperienceofMakeWritethrougha question-nairewithvisualratingscales(facilitatedbySLTandSSLTs

outsideoftheappdesignteam).Additionalvideoandaudio

recordingsoftheworkshopwereusedtotriangulate

fnd-ingsfromtheprimarydatasources.Logandinteractiondata

wassummarisedusingdescriptivestatistics.Qualitativeand

quantitativedatafromuserevaluationformswerecollated,

summarisedandreviewedforemergingthemes.

Participants

Fifteenpeopleattendedthedrop-insession;allwereofered

theopportunitytotakepartinthecreativewriting

work-shop.Twopeopleoptednottodosoandengagedinother

tasks.Wereportdatafromtheremaining13participants,

identifedasA–M(Table1).Therewere4femaleand9male

participantswithanaverageageof60.7years(SD=10.7;min

=48;max=85).Participantsreportedvaryingdegreesof

lan-guagedifcultiesasaresultoftheiraphasia–refectingthe

typicaldiversityofthebroaderusergroupwithaphasia.Five

participantsreportedsomedegreeofdifcultywithreading,

ninewithwriting,sixwithspeakingandfourwith

under-standingspeech.Oneparticipant(p.I)reportednoidentifed

difcultiesfromthepresentedlistofoptions–indicating

thatsheexperiencedmoresubtlebutnonetheless

impact-fulefectsuponherlanguage.Anotherparticipant(p.M),in

contrast,reporteddifcultiesacrossallfourdomains.All

butfourparticipantsreportedadditionalphysical

impair-ments.Theseweremostlyone-sidedweaknessorparalysis

asaresultofastroke(hemiplegia/hemiparesis),meaning

thatseveralparticipantshadmobilityissuesand/orlimited

useoftheirdominantrighthand.Groupconfgurationsfor

theself-selectinggroupsareidentifedinTable2.

Results:EraseStage

WordRedactionandGroupingParameters.When interact-ingwiththe‘Erase’partoftheapp,participantsusedthe

wordredactionand/orgroupingfeaturestosetparameters

on78.89%ofoccasionswherewordsweretakentothe

‘Ar-range’stage.Interactionwiththegroupingfeaturebuttons

wasmorecommon(68.97%)thanwiththewordredaction

slider(58.62%).Followinguseofthegroupingfeature,the

averagewordgroupsizeincreasedtoanaverageof2.35.The

averageamountoftextremainingfollowinguseofthe

redac-tionsliderwas6.88%.Mostoften,participantsincreasedthe

valuefromitsdefault5%value(70.59%ofthetime).

Results:ArrangeStage

MovementofWords.Asaproxyforengagementwiththe textarrangementactivityatthisstage,weconsiderthe

move-mentofwords.Weloggedeachtimeausermovedtheirfnger.

Somegroupsmovedthewordsconsiderablymorefrequently

thanothers,e.g.,Group2onlytouched72words,whereas

Group3touched149words.

Figure5:Kineticvideoheat-mapofthearrangestage,with interfacesuperimposedforreference:Group2(left)mostly usedthewordschosenfromthe‘Erase’stage.Group3(right) regularlyspawnedandthenmovedwordstothedeletearea.

WordSpawningandDeletion.Acrossthe5groups,428 wordsweredeletedand440wordswerespawned–anetof

12extrawords(428- 440).Thiswasaresultofverydiferent

usagebehavioursbetweenthegroups(withnetdeletionsof

wordsrangingfrom-79(Group1)to165(Group5).Some

groupsdeletedconsiderablymorewordsthanothers.

Anal-ysisofvideoheat-mapssuggestedtwomainvariationsin

userbehaviouratthisstage(Figure5).Thisvarianceisalso

refectedinthewordspawnanddeletiondata.Thiscontrasts

toGroup1andGroup3whousedthewordsgeneratedin the‘Erase’stagemoreoften.

Results:OutputsofProcess

ID M/F Age DifcultiesReading DifcultiesWriting DifcultiesSpeaking DifcultiesUnderstanding

Writes

Now

Wrote

Before

A m 67 - Longtexts Using more than a few - No Yes

words

B m 56 - - Speakingforalongtime - NA NA

C m 73 Books Longtextsandletters - - No No

D m 59 - Longtexts Speakingforalongtime - No No

E f 59 Booksandmagazines Longtexts Speakingforalongtime - Yes Yes

F m 85 - Longtexts - - Yes Yes

G m NA NA NA NA NA NA NA

H m 61 Books Longtexts Speaking for a long or - No Yes

shorttime

I f NA - - - - NA NA

J f 56 - - - Somephoneconversations Yes No

K m 53 - Longtexts - Somephoneconversations No No

L m 48 Books Longtextandletters - Phoneconversations No No

M f 51 Books,magazines,short Long texts, letters, Speaking for a long or Radio,TV,phoneandin-person Yes Yes instructions,menus simplesentences shorttime conversations

Table1:Self-reportedparticipantdetails:m=male;f=female;NA=notanswered;- =nodifcultiesidentifed

amongstlistofprovidedoptions.‘Writesnow/before’referringtoparticipant’spoetrywritingpre/poststroke.

(mm:ss.ms)pergroup.Overthecourseofthistime,atotal

of28textswerecreated.Figure6presentsfourofthetexts,

givinganindicationofthevariationinlengthandcontent.

OutputTextscreated. Table2providesanumerical sum-maryoftextsproducedwithinthe‘Arrange’stage.The

aver-agenumberoftextsproducedpergroupwas5.6.Theaverage

numberofwordswas11.3.Wordswerespreadovera

mini-mumof1andamaximumof7lines.Groupsspentanaverage

of7:08.90minutescreatingeachtext.

Group(Participants) Num. Words Lines Time

Group1(B,L,M) 7 5.9 2.3 04:22.1 Group2(C,D,E) 4 11.5 2.5 06:34.2 Group3(F,G,H,I) 7 10 2.1 10:40.6

Group4(A) 4 4.5 1.3 04:53.0

Group5(I,J,K) 6 25 6.2 09:14.7

Averages 5.6 11.3 2.9 07:08.9

Table 2: Descriptive statistics of texts created by

groupsasaresultofthe‘Arrange’stage

QestionnaireData.ThequantitativeLikertdatafromthe questionnairestatements(S1- S8)areshowninTable3.At

leasthalfofallrespondentseitheragreedorstronglyagreed

witheachstatement(56outofatotalof99responses),

indi-catingagenerallypositiveresponsetowardsMakeWrite;20 (of99)responseswereneutraland23wereindisagreement

orstrongdisagreement.S1,S2andS3elicitedthehighest

levelsofoverallagreementandS4,S5 andS6elicitedthe

greatestdisagreement.Eightof13participantsagreedthat

theyhadmadesomethingnewwiththeapp(S1).However,

twoparticipantseitherdisagreed(p.H)orstronglydisagreed

(p.C)withthis.ParticipantH,inhiswrittencomments,

ex-pressedthatthereweretoomanywordsforhimtowork

with“3wordsenough!”.Eightof13and9of13participants respectivelyagreedthatMakeWriteenabledthemtowritea ‘poem’thattheycouldnothavewrittenwithoutitandthat

theyhadenjoyedusingtheapp.Oneparticipantnotedthat

helikedtoreducethecomplexity–i.e.cutdownthenumber

ofwords–toworksomethingintoaanewform“Ienjoyed makingchoicetomakesomethingsimple"(p.L)

Fourof12participantsdisagreedwithstatementS4:“Ifelt thepoemIcreatedwasmyownwork”.Thoseindisagreement generallycitedoneoftworeasons:eitherthatthewords

camefromtheoriginaltextandthereforeitwasnottheirs–

“fromthebook!”(p.A)or,thatbyworkinginagroup,theyfelt thattheothermembersoftheteamdidmostofthework,for

examplep.C–“teamhelped”.Someparticipantsexpressed adesiretoaddtheirownwords,forexamplep.B:“Nonot myownworkI wouldliketotypemyownwords".Fiveof 12participantsdisagreedwithstatementS5:“Ifeltproudof mypoem”.Someparticipants,whofeltthattheprocessof redactingandarrangingthetextwassomethingthatthey

did,wereveryenthusiasticabouttheprocess–“Itwasme" (p.B).Howeverothers,again, feltthatasthewordswere

sourcedfromapre-existingtext,theworkwasnotasmuch

theirs.Finally, 4 of 12disagreed withstatement S6: “My poemallowedmetoexpressathoughtorfeeling”.Participant Bwrote:“Noitwasntthewordsiwouldhaveuse”.

AdditionalComments.Several participantsnoted some improvementsthatcouldmaketheappmoresuitable for

them,forexample,bychangingthecontentavailableduring

Figure6:Fourdiferingexamplesoftextsfromthegroups:a)fromGroup3;b)Group2;c)Group4;d)Group5.Textsa)and b)takeanalmostHaiku-typeform.c)takesamoreminimalistapproach,whereinp.Amostlyusedafewwordstocreate

sentenceshefoundamusing,andd)wastypicalofGroup5,whooftenuseda(comparably)largenumberofwordsintheir creativetexts.

Strongly Strongly

Statement(S) Disagree Neutral Agree

Disagree Agree

1)Imadesomethingnewwiththeapp

2)IwroteapoemwiththeappthatIcouldnothavewrittenwithoutit

3)Ienjoyedusingtheapp

4)IfeltthatthepoemIcreatedwasmyownwork

5)Ifeltproudofmypoem

6)Mypoemallowedmetoexpressathoughtorfeeling

7)Theappwaseasytouse

8)Iwouldliketousetheappagain

1 1 3 3 5

1 0 4 2 6

1 2 1 4 5

3 1 1 3 4

2 3 0 3 4

4 0 3 0 5

2 1 3 3 3

1 0 5 1 5

Table3:Likertscaleresultsfromtheworkshop.S1-S3elicited13participantresponses;S4-S8elicited12.

Forexample,football”(p.K).Additionally,participantsnoted thatitwouldbeusefuliftheappwasabletoreadoutthe

morechallengingwords:“Itwouldhelptoreadoutdifcult words"(p.M);“Itshouldtalk"(p.B).Finally,participantswith moresevereaphasiaindicatedthatthecomplexityofthe

originaltextsintheappwastoogreatandthat,ideally,it

shouldbesimpleror thattheywouldrequiremoretime:

“writtenwordsaredifcult.1-2or3wordsatonceisthemost thatIcanimagine" – “confusing.Toomanywords.Abstract words"(p.H).

DiscussionofResults

Thediversityoftheparticipantgroupintheworkshopcan

beconsideredrepresentativeoftheuserpopulationofpeople

withaphasia.However,theconsequentheterogeneityofthe

resultsmakesitchallengingtoidentifyagroupconsensus

andhencetoinferspecifcimplicationsforindividualaphasia

profles.Theresultshave,however,provideduswithvaluable

insightsintodesigningforthisdiversepopulationandwe

areabletoidentifyimportantoverallthemes.

Signifcantly,theresultsindicatethatMakeWriteenabled avarietyofuserswithaphasiatocreatenewtext

composi-tions.Severaloutcomessupportthis:fromthefactthateach

groupwasabletoproduceanumberofnewtextsduring

theworkshop,throughtothenumberofparticipantswho

agreedwithstatementS2onthequestionnaire(“Iwrotea

poemwiththeappthatIcouldnothavewrittenwithoutit”).At agrouplevel,thevariationinthenumberofwordsspawned

anddeletedisindicativeofthewaythatthediferentgroups

workedtocreatethetexts.Thebehavioursnotedfromthe

logs(Figure5)suggestthatsomegroupsutilisedthe

con-strainedredactiontechniquefully,whereasothersuseditas

theinitial‘spark’toelicitabasictext.Tomakethetexttheir

own,theythenoptedforamore‘bruteforce’approachby

spawningandrejectingwords.

Thereisevidencethatmostparticipantsenjoyedusing

theapp(S3,Table3).Some,however,experienceddifculty.

ParticipantsCandHexpresseddisagreementwiththe

state-mentsthattheyhadbeenabletomakesomethingnew(S1)

andthattheyhadfoundtheappeasytouse(S7).Itis

interest-ingtonotethatthesetwoparticipantsself-reported

difcul-tiesinbothreadingbooksandwritingtexts(Table1).This

mayindicatethat,forsomeusers,acombinationofreading

andwritingdifcultiesmightinhibittheiruse.However,this

combinationofdifcultiesdidnotappeartohaveanegative

impactontheexperienceforotherparticipants.Participants

E,LandM,forexample,eachindicatedstrongagreement

withthesameS1andS7,inspiteofalsoreporting

difcul-tieswithreadingandwriting.Furthermore,participantM,

theonlyusertoreportextensivedifcultiesacrossallfour

domainsoflanguage,nonethelessreportedenjoymentand

ofdifcultieswithlanguagecanuseMakeWritesuccessfully butfurtherresearchisrequiredtounpackthesefndings.

Asmightbeexpected,participantsidentifedseveral

addi-tionalfeaturesthatmightenhanceMakeWriteforthemselves orothers.Theseincludedmoresimplistictextcontentatthe

‘Choose’stage;fewerwordsatthe‘Arrange’stage;andthe

capacitytoread-aloudtext.Suchfeedbackcaninformthe

designofotherappsforconstrainedcreativitywhichwill

meettheneedsofavarietyofusers.Finally,theenvironment

–agroupworkshop–workedformost,butdidnotforsome.

Some,withmoresevereaphasia,reportedfndingthepace

toofast.Beyondthis,manynotedthattheywouldliketo

experimentwiththeappintheirowntime.Futureresearch

shouldexploretheuseofMakeWriteoverthelongerterm.

6 REFLECTIONSANDWIDERIMPLICATIONS

UseofAutomatedConstraintsforCreativity.Thework re-portedherefocusesonprovidingsomeautomatedsupport

forconstrainedcreativityinthecontextofcreativewriting.

Thiscomplements–butdivergesfrom–previousworkon

creativitysupportwithconstraints.Previousworkhas

con-sideredconfningtheuserwithinasetofparameters(e.g.

drawingwithinlines[2]orkeeping inthesamekey[3]),

buthasnotsoughttousetheseconstraintsdynamicallyfor

contentandideageneration.MakeWriteencouragesusersto manipulateandshapetheconstraints,beforeallowingfor

morefree-formexpression.Webelievethisdesignconcept,

integratedintoanaccessible,co-designedappaswehave

here,showsconsiderablepromise.

OwnershipofCreativeWriting. Wediscoveredsome ten-sion relatingto theownership of the textscreated with

MakeWrite.Someworkshopparticipantsthoughtthe ‘creativ-ity’camefromtheoriginalsourcetextortheappitself,and

notfromthem.Benedettietal.[2]notesimilarfndingswhen

testinganapptoassistpeopletomakepaintings.Likeour

results,thiswasattributedtothesource(theoriginal

paint-ingintheircase)andalsolikelyattributedtothealgorithm

‘doingsomeofthework’,whichreducedusers’perceived

senseofaccomplishment.

Suchtensionsmightbeaddressedinanumberofways.

Onecouldconsiderallowingmorecontroloftheparameters

withintheappor,alternatively,morechoicein selecting

asourcetext(orindeeduser-generatedcontent).Itcanbe

arguedthatthesource of thecontent isan intrinsicpart ofthisclassofart-form,andrefectstheartisticintent.For

someerasurepoetry,thesourceofthecontentisintended

tomakeastatement.Forexample,NiinaPollari[38]uses

anerasurepoetryapproachtoartisticallysubvertanofcial

governmentnaturalisationapplicationformtobecomeaUS

citizen.WhilesuchcapabilitiesarepossiblewithMakeWrite, thebroaderissueofsourcetextswasnotexploredwithinthe

workshop.Finally,onemightre-imaginethewaythatthe

appispresentedtotheuser.Itisclearthatmanyviewedthe

appasanenjoyablechallenge.Gamifcation[14]technology,

forexample,mightmotivatepeopletoengageindiferent

ways,fosterchallenge[22]andthereforedeliverasenseof

heightenedaccomplishmentinthefnalresult.

BroaderApplications. Inthispaperwehavearguedthat peoplewithaphasiacanbeenabledtoproducecreative

dig-italwritingthroughmeansofautomatedconstrained

cre-ativity.Duetothebarriersthatpeoplewithaphasiaface,we

focusedourexplorationonthedomainoflanguage.However,

theideasproposedmayalsobeconsideredasaparadigmfor

wideruse.Themodelisofasteppedprocesswhereauser

choosesapieceofsourcecontent,manipulatesitthrough

automatedredactionandthendynamicallyarrangesthe

re-sultantoutput.Asimilarprocesscouldreducethecognitive

demandofcreativeactivitiesinothermodalities–sound,

videoor picturesforexample.Loweringthecognitive

re-quirementsofwritingandothercreativeactivitieswould

openthemuptoabroaderrangeofusers–acrossawider

agespanandawidercognitiverange–andwouldinclude

thosewithsituationaldisabilitieswhichtemporarilyimpact

upontheircognitiveresources.

7 CONCLUSION

Asourengagementswithcreativitybecomeincreasingly

dig-ital,itisvitaltoconsiderthedesignoftechnologythatcan

supporteveryonetobecreative,suchthatthedomainof artis-ticexpressionisaccessibletoall.Littletechnologypresently

supportscognitivelydiversegroupsinfulfllingtheir

cre-ativepotential,includingthosewithspeechandlanguage

impairmentssuchasaphasia.Weaddressthisbyproposing

anapproachthatusesautomatedanddynamicconstrained

creativity.Throughco-designwithpeoplewithaphasia,we

developedMakeWrite,aprototypeappforcreativewriting basedonthisconcept.MakeWriteenablespeoplewith apha-siatocreatemeaningful,elegantandsometimeshumorous

creativewriting.Webelievethatthisapproach,andthe

in-sightwehavegainedfromapplyingit,ofersrealpotential

fordesigningtechnologyfordiverseuserstoenablemore

equalaccesstodigitalcreativity.

8 ACKNOWLEDGEMENTS

Wewouldliketothanktheco-designersfortheir

involve-mentin developingthisprototypeandthosewho

partici-patedintheworkshop,includingSallyMcVickerandHeather

Tyasfortheirguidanceandassistance.Thisworkwas

car-ried out as part of the INCAProject, funded by EPSRC EP/P025587/1incollaborationwiththeStrokeAssociation

andDyscover.Finally,thankstotheanonymousreviewers

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