Marja-Liisa Mailend, PhD, recently joined the team of institute scientists at Moss Rehabilitation Research Institute (MRRI), where she completed her postdoctoral fellowship. We talked with Dr. Mailend about her appointment as director of the Speech and Language Recovery Lab and her studies in neurogenic communication disorders such as aphasia and apraxia of speech.

What are your background and training?

I am from Estonia, a small country in Northern Europe with lots of forests, a beautiful shoreline, and a population that is not much bigger than Philadelphia. I received my bachelor's and master's degrees in speech-language pathology from the University of Tartu. It is the oldest university in Estonia—established in 1632—and the most prestigious one.

My interest in pursuing a career in science emerged from an experience I had during my master’s program. I joined a research team studying the efficacy of Estonian primary schools. The project focused on child development in a very comprehensive way including aspects of speech and language development. Being new to science and the youngest member of the team, I found the experience very inspiring. I developed an interest in research and scientific thinking. It led me to pursue a PhD.  

I received my PhD in Speech, Language, and Hearing Sciences at the University of Arizona, where I had the opportunity to work with Dr. Edwin Maas, Dr. Pelagie Beeson, Dr. Kenneth Forster, and many other exceptional researchers. After graduating, I trained as a postdoctoral fellow at MRRI under the mentorship of institute scientists Erica Middleton, PhD, director of the Language and Learning Laboratory, and Laurel Buxbaum, PsyD, associate director of MRRI, and director of the Cognition and Action Laboratory. They were a perfect mentoring team for me, allowing me to combine my interests in language and cognitive-motor control, and explore new angles of both.

What is your role as director of the Speech and Language Recovery Lab?

After finishing my postdoctoral studies, I returned to MRRI as the director of the Speech and Language Recovery Laboratory. It is an exciting time for me as I am currently in the process of setting up this new lab, which will focus on aphasia (a language impairment that disrupts a person’s ability to produce and understand language) and apraxia of speech (an impairment of planning the movements that produce speech). The primary goal of my lab is to contribute to the evidence-based assessments and treatment programs for maximizing recovery in these disorders.  

Can you explain some of your current studies?

One focus in my lab is a phenomenon called speech entrainment—speaking in synchrony with another speaker. We know for a while now that people are remarkably good at imitating another speaker in real-time. More recently, we learned that many people with aphasia, even severe aphasia, can produce fluent speech under the entrainment condition. We are currently investigating what causes this improvement in speech production and how we can use this technique as a treatment. In other words, could training with speech entrainment lead to long-term benefits?

What are your research methods?

I am interested in how the human mind works. That is a complicated subject to study because it cannot be directly observed. Behavioral experiments are among the best tools that scientists have for exploring the types of questions. These are studies where we observe the behavior of our research participants under tightly controlled conditions that vary from one another in one critical aspect that is of interest in the study. In my studies, the participants may be asked to produce different types of words. We make inferences about the speech production system by examining different groups of people (e.g., people with aphasia and neurologically healthy people) with regards to the types of errors that they make or how long they take to initiate speech under these different conditions. More recently, I have become interested in lesion-symptom mapping, a technique that aims to establish which brain areas are associated with a specific impairment.

Why did you decide to return to MRRI as an institute scientist?  

There is so much to love about working at MRRI. I enjoy working with my colleagues. The institute is the perfect size to support a very collegial environment. Everyone at MRRI—research assistants, administrative support, clinicians and, scientists—are fabulous at what they do. They enjoy their work and working with one another, and are interested in what is going on in the neighboring lab. MRRI also has great resources (MRRI Research Registry where current and former MossRehab patients sign up to participate in research studies, association with the rehabilitation hospital, and the opportunity to interact with clinicians) that support my work. In so many ways, it is an ideal place to do my kind of research.

Who will benefit from your research?  

One of the main goals of my lab is contributing to the evidence base for accurate diagnosis and effective treatment approaches to maximize communication after stroke. I hope that people with communication disorders benefit from my research, and it will improve the tools and guidelines available to clinicians for speech and language therapy. Finally, research is a community effort. Other scientists inspire my research. I hope that our work, in turn, will be useful to my scientific community in the same way.

What have been your early research findings?

I conducted a series of studies that examined the underlying nature of apraxia of speech. Unlike aphasia, which impairs expression and understanding of language, people with apraxia of speech know the words they want to say but cannot translate the message into speech movements. Their impairments are not the result of muscle weakness or paralysis but instead the impairment of planning and programming of speech movements. There are several hypotheses about what exactly goes wrong in the planning and programming phase. One is that the motor programs that guide speech articulation are damaged. An alternative view suggests that the motor programs are intact, but access to the programs is impaired. As a result, it is difficult for people to select the appropriate movements at the intended time. My research has supported the latter view. These findings may prove to be clinically relevant by giving a different focus to the treatment approaches for remediating apraxia of speech.

What inspires you?

Speaking is so effortless to most of us that we never stop to think what a central role it has in our lives until something goes wrong. My research allows me to interact with so many incredible people for whom speaking is very hard. They have shared their experience with me and helped me understand how the communication difficulties changed their lives. I understand that I study something precious and nobody should have to do without it. That inspires and motivates. My colleagues provide me with inspiration for ideas. I find it very inspiring to learn from different fields. I like working at MRRI where I am close to other scientists working on a similar problem from different angles or domains. Another field may be making headways in one part where I am struggling. I can bring certain aspects of their findings into my studies and take a step forward. I find that to be a source of inspiration too.  

What is something your co-workers might not know about you?

There is probably plenty of that—I am not that chatty. But with a demanding career and a fun little three-year-old at home, there is only so much in my private life at the moment that is worthwhile sharing, although I talk a lot about my little son. Many events with him offer such wonderful insights into the development of the human mind, which most of my co-workers appreciate as I do. I like to boast that I learned to ski before I learned to walk, even though it may not be technically quite true. But I do love to ski, all types of it: nordic, downhill, even water. I love to be outside (so much so that is probably common knowledge about me). I cannot wait to visit the theatre again, and lately, I have been thinking about taking up windsurfing or maybe kayaking.

What is your life motto?

I don’t have one. Being maximally adaptable without losing who I am is what I strive for. That requires rethinking the guiding principles as well every now and then.