Attitudes Toward the Use of Voice-Assisted Technologies Among People With Parkinson Disease: Findings From a Web-Based Survey

Abstract

Background Speech problems are common in people living with Parkinson disease (PD), limiting communication and ultimately affecting their quality of life. Voice-assisted technology in health and care settings has shown some potential in small-scale studies to address such problems, with a retrospective analysis of user reviews reporting anecdotal communication effects and promising usability features when using this technology for people with a range of disabilities. However, there is a need for research to establish users’ perspectives on the potential contribution of voice-assisted technology for people with PD. Objective This study aims to explore the attitudes toward the use of voice-assisted technology for people with PD. Methods A survey was approved for dissemination by a national charity, Parkinson’s UK, to be completed on the web by people living with the condition. The survey elicited respondent demographics, PD features, voice difficulties, digital skill capability, smart technology use, voice-assisted technology ownership and use, confidentiality, and privacy concerns. Data were analyzed using descriptive statistics and summative content analysis of free-text responses. Results Of 290 participants, 79.0% (n=229) indicated that they or others had noticed changes in their speech or voice because of the symptoms of their condition. Digital skills and awareness were reported on 11 digital skills such as the ability to find a website you have visited before. Most participants (n=209, 72.1%) reported being able to perform at least 10 of these 11 tasks. Similarly, of 70.7% (n=205) participants who owned a voice-assisted device, most of them (166/205, 80.9%) used it regularly, with 31.3% (52/166) reporting that they used the technology specifically to address the needs associated with their PD. Of these 166 users, 54.8% (n=91) sometimes, rarely, or never had to repeat themselves when using the technology. When asked about speech changes since they started using it, 25% (27/108) of participants noticed having to repeat themselves less and 14.8% (16/108) perceived their speech to be clearer. Of the 290 respondents, 90.7% (n=263) were not concerned, or only slightly concerned, about privacy and confidentiality. Conclusions Having been added to the homes of Western society, domestic voice assist devices are now available to assist those with communication problems. People with PD reported a high digital capability, albeit those who responded to a web-based survey. Most people have embraced voice-assisted technology, find it helpful and usable, and some have found benefit to their speech. Speech and language therapists may have a virtual ally that is already in the patient’s home to support future therapy provision.

Speech and Language Practitioners’ Experiences of Commercially Available Voice-Assisted Technology: Web-Based Survey Study

“…They highlighted the positive impacts of having a device that would provide such a source of feedback on speech production; if the device could understand a client, they were given clarification that they were speaking intelligibly. This echoes the findings of other studies, which have highlighted the successful experiences of users with speech impairment when using commercial VAT devices [ 27 , 28 , 32 ]. As highlighted by our professional SLT participants, the ability to practice speech at home and obtain real-time, impartial feedback from the devices was found to improve word production accuracy and increase clients' motivation to perform home therapy practice, both of which are SLT outcomes that might regularly be targeted in formal therapy.…”

“…A study [ 27 ] also reported similar findings, discussing that some Alexa users self-reported speech improvements, with a need for distinct pronunciation when using the device actively improving users’ speech through continuous practice. Duffy et al [ 32 ] also found self-reported speech improvements in approximately 25% of people with Parkinson disease who were using VATs but did not delve into why participants felt this might be happening. This is an exciting and ripe area for future research, which might explore the extent to which speech changes actually occur through device use, how they are maintained, and how speech outcomes being achieved through device use might be measured in SLT practice.…”

“…One recent study explicitly focused on VAT use among people with speech impairments. A survey conducted on 290 people with Parkinson disease (78% of whom were assessed to have mild to moderate speech impairment) explored their access and use of VAT, including whether they had noticed any changes to their speech because of using the device [ 32 ]. The authors found that as many as 25% of the participants reporting changes to their speech had noticed improvement, indicating a clear potential direction for future work exploring VAT as a tool to support outcomes relevant to SLT.…”

Feasibility of Incorporating Voice Technology and Virtual Assistants in Cardiovascular Care and Clinical Trials

“…Similarly, it is currently unclear how information collected from voice-based technologies can be transmitted and incorporated into existing electronic medical record systems while ensuring regulatory compliance. In studies exploring patient concerns, only a minority (~10%) reported any significant concerns regarding privacy or confidentiality [ 48 •]. In surveys of both users and nonusers of voice-based technologies, we see that users have much lower concerns regarding security, suggesting that perceptions of security and privacy may prevent the widespread adoption of voice technologies in the general population [ 49 , 50 •].…”

Anthropomorphizing Technology: A Conceptual Review of Anthropomorphism Research and How it Relates to Children’s Engagements with Digital Voice Assistants

“…In this context, children with disabilities and their caregivers will be a subpopulation of particular importance, given DVAs' (future) potential to inform, assist, assess and support these individuals with special developmental or medical needs (Sezgin et al, 2020). Preliminary research already suggests commercial off-the-shelf DVAs are popular among individuals with disabilities (e.g., (Pradhan et al, 2018;Duffy et al, 2021)), but research is still limited, especially when focusing on concrete disabilities (e.g., (Cave & Bloch, 2021)). However, apart from general socio-economic and skill-related accessibility issues (Paul et al, 2021), children with different kinds of disabilities will experience different kinds of benefits and challenges.…”