An Internet-Based Telerehabilitation System for the Assessment of Motor Speech Disorders: A Pilot Study

• Published in: American journal of speech-language pathology 2006-02, Vol.15 (1), p.45-56
• Main Authors: Hill, Anne J, Theodoros, Deborah G, Russell, Trevor G, Cahill, Louise M, Ward, Elizabeth C, Clark, Kathy M
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adults; Adventitious Impairments; Aged; Aphasia; Articulation Impairments; Communication Disorders; Computers; Dysarthria; Dysarthria - diagnosis; Dysarthria - rehabilitation; Evaluation; Feasibility Studies; Female; Grammatical agreement; Humans; Intelligibility; Internet; Language disorders; Language Impairments; Literature Reviews; Male; Measures (Individuals); Middle Aged; Neurological Impairments; Physical Disabilities; Pilot Projects; Rehabilitation; Remote Consultation; Research design; Research Methodology; Severity (of Disability); Speech Articulation Tests; Speech disorders; Speech Language Pathology; Speech perception; Speech therapy; Speech-language pathologists; Speech-Language Pathology - instrumentation; Speech-Language Pathology - methods; Studies; Teleconferencing; Video conferencing; Video Technology; Video teleconferencing; Videoconferencing
• ISSN: 1058-0360; 1558-9110
• DOI: 10.1044/1058-0360(2006/006)

Kathy M. Clark Princess Alexandra Hospital, Brisbane, Queensland, Australia Contact author: Anne J. Hill,Division of Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland 4072, Australia. Email: a.hill{at}shrs.uq.edu.au PURPOSE: This pilot study explored the feasibility and effectiveness of an Internet-based telerehabilitation application for the assessment of motor speech disorders in adults with acquired neurological impairment. METHOD: Using a counterbalanced, repeated measures research design, 2 speech-language pathologists assessed 19 speakers with dysarthria on a battery of perceptual assessments. The assessments included a 19-item version of the Frenchay Dysarthria Assessment (FDA; P. Enderby, 1983), the Assessment of Intelligibility of Dysarthric Speech (K. M. Yorkston & D. R. Beukelman, 1981), perceptual analysis of a speech sample, and an overall rating of severity of the dysarthria. One assessment was conducted in the traditional face-to-face manner, whereas the other assessment was conducted using an online, custom-built telerehabilitation application. This application enabled real-time videoconferencing at 128 kb/s and the transfer of store-and-forward audio and video data between the speaker and speech-language pathologist sites. The assessment methods were compared using the J. M. Bland and D. G. Altman (1986, 1999) limits-of-agreement method and percentage level of agreement between the 2 methods. RESULTS: Measurements of severity of dysarthria, percentage intelligibility in sentences, and most perceptual ratings made in the telerehabilitation environment were found to fall within the clinically acceptable criteria. However, several ratings on the FDA were not comparable between the environments, and explanations for these results were explored. CONCLUSIONS: The online assessment of motor speech disorders using an Internet-based telerehabilitation system is feasible. This study suggests that with additional refinement of the technology and assessment protocols, reliable assessment of motor speech disorders over the Internet is possible. Future research methods are outlined. Key Words: telepractice, rehabilitation, assessment, speech disorders CiteULike     Connotea     Del.icio.us     Digg     Facebook     Reddit     Technorati     Twitter     What's this?