Research by Adelphi’s Hariklia Proios, PhD, shows children can effectively teach their families to recognize stroke symptoms.
As Professor Hariklia Proios, PhD, enters her fourth year as chair of Adelphi’s Department of Communication Sciences and Disorders, she continues to stress the need for education about a particularly important health emergency: stroke. Strokes are one of the leading causes of long-term disability in America, affecting nearly 800,000 people every year. But rather than task older adults with the responsibility of detecting their own strokes, research has shown that stroke education and prevention should be a family affair—starting with children.
In 2018, along with her then colleagues at the University of Macedonia in Greece, in collaboration with the healthcare organization Angels Initiative and the Grand Heroes Foundation, Dr. Proios established FAST Heroes, an educational initiative that’s since been deployed in 38 countries worldwide. FAST Heroes uses fun, cartoony campaigns to teach children lifesaving stroke knowledge that they can pass on to their families.
Why Time is of the Essence
Stroke experts often say that “time is brain”—the longer you wait to seek treatment for a stroke, the more brain cells will die. With FAST Heroes, children are trained to act as soon as they spot common stroke symptoms. Although the program is taught primarily in classrooms, it’s designed to enhance incidental, hands-on learning about strokes. “Children learn about stroke symptoms through everyday life experiences, such as stories, music or classroom activities, and relay that information home through conversation,” Dr. Proios said. “In this way, they boost parental and grandparental awareness of stroke symptoms and encourage them to seek medical attention.”
After joining Adelphi as a professor in 2023, Dr. Proios brought FAST Heroes to her new home terrain, convincing several schools in the New York area to come on board. A research partnership with a neurologist and Yale University has also expanded FAST Heroes’ American reach to a public school district in Connecticut. “One million children around the world have been educated to date,” she said, “and this number only continues to grow.”
In September 2025, Dr. Proios and her FAST Heroes team published a reflection on their years of hard work: “The role of children in promoting stroke literacy across generations: A narrative review of the FAST Heroes initiative” (Journal of Stroke and Cerebrovascular Diseases, September 2025).
FAST Heroes has been implemented in so many settings that every published study has a different evidentiary angle. By completing a narrative review of these studies, Dr. Proios and her team would be able to paint a clear picture of what worked and what didn’t—giving researchers, educators and practitioners “the means to translate complicated evidence into a simple, coherent story that will support their decisions about program design, implementation and practical use.”
Testing the Effectiveness of FAST Heroes
So how effective are children in disseminating stroke-related knowledge? According to the narrative review, exceptionally so. Baseline stroke knowledge improved in virtually all countries that implemented FAST Heroes, with Ukraine, Romania and Poland showing improvements of up to 35 percent. In another participant group, knowledge of the country’s national emergency number shot up from 2.7 percent to 100 percent. But to understand why FAST Heroes works so well, Dr. Proios and her team examined the research along two main axes: knowledge acquisition and knowledge transfer/intergenerational learning.
FAST Heroes “has displayed noteworthy long-term knowledge retention among children,” the authors write, which “can be attributed to a combination of design elements rooted in educational psychology and communication theories.” In other words, age-appropriate educational tools, like animated videos, interactive games and mnemonic tools, were key to ensuring children would find stroke-related information both stimulating and memorable. Dr. Proios notes that children responded particularly well to FAST Heroes’ superhero campaign, which gave them a point of personal connection—for instance, thinking of a grandparent as their “hero.”
In the FAST Heroes model, children act as active health messengers within the family unit, encouraging multidirectional collaboration between generations. In one study conducted with grandparents, only 25 percent of participants could recognize at least one major stroke symptom pre-FAST Heroes, compared to 70 percent after the program’s end; two months later, that figure had increased to 83 percent. Grandparents also demonstrated “positive feelings about their grandchildren’s involvement in a health education initiative that directly impacts their well-being,” according to the authors.
That said, knowing the right number to call in a crisis is one thing, and calling it is another. Although Dr. Proios’ study doesn’t only measure action taken in cases of suspected stroke, that is the ultimate goal of FAST Heroes—one the program does appear to be meeting. “We believe crystallization of this lifesaving knowledge in young children’s long-term memories is a good predictor of actual response,” Dr. Proios said.
Frequently Asked Questions
FAST Heroes is an educational initiative that uses fun, cartoon-style campaigns to teach children lifesaving stroke knowledge they can pass on to their families. It was established in 2018 by Hariklia Proios, PhD, now professor and chair of Adelphi University’s Department of Communication Sciences and Disorders, with colleagues at the University of Macedonia in Greece, in collaboration with Angels Initiative and the Grand Heroes Foundation.
A 2025 narrative review in the Journal of Stroke and Cerebrovascular Diseases found that baseline stroke knowledge improved in virtually all countries that implemented the program, with Ukraine, Romania and Poland showing gains of up to 35 percent. In another participant group, knowledge of the national emergency number rose from 2.7 percent to 100 percent.
The authors credit design elements rooted in educational psychology and communication theories, including animated videos, interactive games and mnemonic tools. Children also respond to the superhero campaign, which gives them a personal connection, such as thinking of a grandparent as their “hero.” The review found notable long-term knowledge retention among children.
Strokes are one of the leading causes of long-term disability in America, affecting nearly 800,000 people every year. Stroke experts say “time is brain”: the longer treatment is delayed, the more brain cells die. FAST Heroes trains children to act as soon as they spot common stroke symptoms.
The program has been deployed in 38 countries, and Dr. Proios reports that one million children worldwide have been educated to date. Since joining Adelphi in 2023, she has brought it to several New York-area schools. A research partnership with a neurologist and Yale University has also extended it to a public school district in Connecticut.