Using telerehabilitation to assess apraxia of speech in adults

Hill, Anne Jane, Theodoros, Deborah, Russell, Trevor and Ward, Elizabeth (2009) Using telerehabilitation to assess apraxia of speech in adults. International Journal of Language and Communication Disorders, 44 5: 731-747. doi:10.1080/13682820802350537

Author Hill, Anne Jane
Theodoros, Deborah
Russell, Trevor
Ward, Elizabeth
Title Using telerehabilitation to assess apraxia of speech in adults
Journal name International Journal of Language and Communication Disorders   Check publisher's open access policy
ISSN 1368-2822
Publication date 2009-09
Year available 2010
Sub-type Article (original research)
DOI 10.1080/13682820802350537
Volume 44
Issue 5
Start page 731
End page 747
Total pages 17
Editor K. Hilari
N. Botting
Place of publication Oxford, United Kingdom
Publisher Informa Healthcare
Collection year 2010
Language eng
Subject C1
920107 Hearing, Vision, Speech and Their Disorders
110321 Rehabilitation and Therapy (excl. Physiotherapy)
Formatted abstract
Background: Telerehabilitation is the remote delivery of rehabilitation services via information technology and telecommunication systems. There have been a number of studies that have used videoconferencing to assess speech and language skills in people with acquired neurogenic communication disorders. However, few studies have focused on cases of apraxia of speech. In order to perform accurately differential diagnosis via the telerehabilitation medium, it is important that validation of the assessment of apraxia of speech be established as part of the overall evidence base for telerehabilitation communication assessment protocols.

Aims: To determine if valid and reliable assessment of apraxia of speech using a standardized assessment tool was feasible via telerehabilitation.

Methods & Procedures: Eleven participants with an acquired apraxia of speech were assessed simultaneously via telerehabilitation and face‐to‐face methods on the Apraxia Battery for Adults — 2 (ABA‐2). A custom‐built telerehabilitation system developed at the University of Queensland enabled real‐time telerehabilitation assessment over a 128 kbit/s internet connection. Data analysis included tests of significant difference between raw scores using the Wilcoxon signed rank statistic and analysis of the degree of agreement between the two methods using weighted Kappa statistics. Inter‐ and intra‐rater reliabilities were also examined for the telerehabilitation‐led assessments.

Outcomes & Results:
Results revealed no significant differences between the subtest scores of the ABA‐2 obtained in the telerehabilitation and face‐to‐face test environments (p = 0.06–0.68). Weighted Kappa statistics indicated moderate to very good agreement (0.59–1.00) between the two environments for the subtests of the ABA‐2. The reliability study was hampered by small sample size; however, the data were suggestive of reasonable reliability. Participants reported high overall satisfaction, comfort level, and audio and visual quality in the telerehabilitation environment. The speech‐language pathologists (SLP) reported some difficulties assessing participants with severe apraxia of speech via the telerehabilitation system.

Conclusions & Implications: This study suggests that valid assessment of apraxia of speech using the ABA‐2 over the internet is feasible. The reliability study on the telerehabilitation assessments was encouraging with results suggesting that telerehabilitation assessment using the ABA‐2 could be reliable. Findings from the participant satisfaction questionnaire were favourable. However, comments from the SLP suggested that participants exhibiting severe apraxia of speech might be better suited to face‐to‐face assessment. These findings may have implications for the development of evidence‐based guidelines for the use of telerehabilitation in the assessment of apraxia of speech. The authors propose that future research should include larger sample sizes with a range of participant severity levels and be conducted over higher bandwidth connections to explore further the validity and reliability of telerehabilitation assessment of apraxia of speech.
Keyword Telerehabilitation
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Health and Rehabilitation Sciences Publications
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Citation counts: TR Web of Science Citation Count  Cited 20 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 21 times in Scopus Article | Citations
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Created: Tue, 08 Dec 2009, 15:35:38 EST by Kathleen Reinhardt on behalf of School of Health & Rehabilitation Sciences