Telehealth Technology Applications in Speech-Language Pathology

Keck, Casey; Doarn, Charles R.

doi:10.1089/tmj.2013.0295

Cited by 93 publications

(96 citation statements)

References 33 publications

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“…Thus, the main advantages of synchronous (ie, real-time interaction by videoconferencing) and asynchronous (ie, intensive, independent training, storage, and analyses of audio and video data) technology can be combined. 20,21 For example, an aphasic patient is provided with a structured language intervention by asynchronous technology, while an SL pathologist is enabled to monitor real time by videoconferencing. Also, the possibility of only asynchronous language training is possible, with an SL pathology monitor or analyze the results asynchronously.…”

Section: Telemedicine In Aphasiamentioning

confidence: 99%

“…1,21 However, to lower the threshold for using telemedicine, its applications should be adapted to users' needs. 41 Large user groups with common interests and needs may also be identified along the telemedicine taxonomy and serve as an argument for further development of telemedicine applications and new business models by reimbursement companies.…”

Section: Health Care Institutions and Patients (Supported By Patient mentioning

confidence: 99%

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Asynchronous telemedicine applications in rehabilitation of acquired speech-language disorders in neurologic patients

Beijer¹,

Rietveld²

2015

SHTT

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Abstract:In this time of an aging population in the Western world and a concomitant need for cost reduction, there is an obvious need for innovative health care delivery. One of the consequences is that a growing number of telemedicine applications are emerging in different health care domains. Also in the area of speech-language (SL) disorders, particularly neurogenic disorders, telemedicine is rapidly gaining interest. In this paper, we place applications for neurogenic SL disorders in a telemedicine taxonomy in order to establish common features along the dimensions of functionality, application, and technology, and their components. Thus, we aim at identifying common features in a wide variety of telemedicine applications and to establish common interests of stakeholders in health care for classified groups of telemedicine applications. This may facilitate decision-making with regard to expansion of innovative products, and give directions to measures needed for upscaling and structural embedding of feasible and effective SL telemedicine applications in health care. Common interests of stakeholders in health care, established using telemedicine taxonomy, is a key factor in decision-making with regard to which telemedicine applications should be given priority for genuine utilization. Priorities of health care institutions, patients, and reimbursement companies are also leading for researchers aiming at solid scientific evidence for the beneficial effects of target applications. That is, although research results tend to indicate the potential of telemedicine in the area of SL pathology, the alleged benefits of most applications have not been confirmed according to the accepted standards for clinical outcome testing as yet. Methodologic obstacles and the lack of adequate speech materials and suitable outcome measures for efficacy and effectiveness testing partially account for this. From the perspective of scientific evidence, the benefits of asynchronous SL telemedicine applications concern data storage and data analyses. To facilitate implementation of telemedicine, there is a call for development of information and communication technology infrastructures that allow feasible applications which meet requirements with regard to licensure and medical privacy laws. For applications with evidence for beneficial effects, we are challenged to develop new business models that apply to a new health care environment.

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Section: Telemedicine In Aphasiamentioning

confidence: 99%

Section: Health Care Institutions and Patients (Supported By Patient mentioning

confidence: 99%

Asynchronous telemedicine applications in rehabilitation of acquired speech-language disorders in neurologic patients

Beijer¹,

Rietveld²

2015

SHTT

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“…A growing body of evidence is available in speech-language pathology to support the use of telepractice, in which therapy services are provided at a distance (Keck & Doarn, 2014;Theodoros, 2008). Speech pathology services in general appear to be well-suited to telepractice delivery due to the audio-visual nature of the patient-clinician interaction in most consultations.…”

Section: Alternative Methods Of Service Delivery: Telepracticementioning

confidence: 99%

“…One possible service delivery mode is telepractice, in which services are provided at a distance (American Speech-Language-Hearing Association, 2014). A growing body of evidence is available to support the use of telepractice in speech pathology (Keck & Doarn, 2014). Speech pathology services in general appear to be well-suited to telepractice delivery due to the audio-visual nature of the patient-clinician interaction in most consultations.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of intensive voice therapy for patients with vocal fold nodules

Fu¹

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The primary aetiologic factor for vocal fold nodules has been proposed to be cumulative perpendicular impact stress between the vocal folds over time, which increases with voice use (Titze, 1994). Many people with vocal fold nodules work in high vocal demand occupations, therefore, it is essential that they recover vocal function so that their ability to perform their jobs is not compromised (Karkos & McCormick, 2009). A number of studies have reported positive improvements in vocal fold nodules following various types of behavioural voice therapy, and as such, voice therapy is recommended as a first-line treatment .The majority of the intervention studies for patients with vocal fold nodules have examined treatment outcomes following traditional voice therapy models, typically delivered once a week over a period of multiple weeks. To date, no studies have systematically examined the impact of using an intensive, massed practice therapy approach. In that the rehabilitation process for vocal fold nodules requires the learning, maintenance and transfer of new behaviours, it is possible that a more condensed voice therapy protocol may yield equal or even greater benefit. Therefore, the primary aim of this thesis was to explore the efficacy of intensive voice therapy (eight sessions within 3 weeks) as compared with traditional voice therapy (one session per week for 8 weeks).Both the short and long term effects of the different treatments on perceptual, acoustic, and physiological outcomes were examined.Although it has been established that voice therapy is often effective, in many caseloads, rates of therapy completion are poor and this creates a challenge for clinicians (Portone-Maira, Wise, Johns, & Hapner, 2011). Traditional, face-to-face (FTF) voice therapy has shown dropout rates as high as 65% (Hapner, Portone-Maira, & Johns, 2009). Various factors contributing to nonattendance include travel time, inflexible work conditions, and inability to access due to physical barriers. Non-attendance not only affects treatment success, but also results in unnecessary extensions to treatment, and repeated examinations without sufficient behavioural change to effect improvement. Ultimately, there may be a loss of revenue or even employment if patients are unable to meet the vocal requirements of their occupations (Portone, et al., 2008;Portone-Maira et al., 2011). Consequently, there is a need to explore ways to help maximise attendance and ultimately enhance outcomes for people with vocal fold nodules. To this end, the secondary aim of this thesis iii was to examine the feasibility and outcomes of delivering intensive voice therapy via telepractice, as an alternative service delivery model for patients with vocal fold nodules.To address aim one, 53 female patients (56% professional voice users) with bilateral vocal fold nodules were recruited. Participants were matched in pairs according to their age, occupation, and severity of dysphonia and assigned to either of two treatment groups: traditional therapy of eigh...

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“…• cognitive communication disorders (151) • adult voice disorders (149)(150)(151)(153)(154)(155) • dysphagia (swallowing impairment) (149,151,156) • literacy impairment (157)…”

Section: Efficacy and Adoption Of Speech Pathology Telepracticementioning

confidence: 99%

Speech and language screening for children with medical complexity: A comparison of telepractice and in-person methods

Taylor¹

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Effective communication is vital for healthy development and successful educational and vocational outcomes. For children with medical complexity (CMC), the interaction between medical complexity and a speech and language impairment may put them at particular risk for adverse effects. It is important that these children are promptly assessed and diagnosed so that intervention can be started early. Medical complexity is rare in childhood, thus CMC usually access speech pathology services through tertiary facilities where staff have specialist experience and resources, and work as part of a coordinated tertiary team. Unfortunately these facilities are typically located in metropolitan centres, which may compromise service accessibility for CMC living in rural and remote locations.A potential solution to improve service accessibility is remote speech and language screening using telepractice. Telepractice screening allows the speech-language pathologist (SLP) to distinguish those children who need further assessment at the tertiary hospital from those with normal speech and language. This model is increasingly used for the delivery of tertiary medical services, however, there is little research to support the use of telepractice for paediatric speech and language screening, and very few studies have included CMC. Thus, the overall purpose of this research project was to investigate the role of telepractice for remote speech and language screening of CMC. To achieve this aim, two studies were carried out.The first study was an international survey of tertiary SLPs that aimed to describe access difficulties experienced by CMC, and to investigate the rate of telepractice adoption among SLPs who work with CMC. The survey was administered in 2011 (n = 46) and repeated in 2015 (n = 47). This survey identified widespread access difficulties experienced by CMC, highlighting a need for alternative service delivery models such as telepractice. Telepractice adoption among tertiary SLPs more than doubled between 2011 and 2015 (p < 0.05), and in 2015 the rates of telepractice adoption were higher (40%) than previously reported for the general speech pathology profession. Tertiary SLPs were willing to use telepractice with their CMC patients, and considered a wide range of patient groups and service types to be appropriate for telepractice delivery. However, some SLPs were reluctant to use telepractice for direct services such as screening, and a number of barriers to telepractice adoption were identified, including inability poor audio and image quality, lack of experience with telepractice, concerns about behaviour management and use of hands-on techniques, and concerns about the caregiver's inability to assist during telepractice sessions.ii The second study was an exploratory method comparison study that aimed to investigate the feasibility, validity, and acceptability of speech and language screening via telepractice for CMC.This study compared in-person speech and language screening with two telepractice screening ...

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Telehealth Technology Applications in Speech-Language Pathology

Cited by 93 publications

References 33 publications

Asynchronous telemedicine applications in rehabilitation of acquired speech-language disorders in neurologic patients

Asynchronous telemedicine applications in rehabilitation of acquired speech-language disorders in neurologic patients

Efficacy of intensive voice therapy for patients with vocal fold nodules

Speech and language screening for children with medical complexity: A comparison of telepractice and in-person methods

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