An Internet-based telerehabilitation system for the assessment of motor speech disorders: A pilot study

Hill, A. J., Theodoros, D. G., Russell, T. G., Cahill, L. M., Ward, E. C. and Clark, K. M. (2006) An Internet-based telerehabilitation system for the assessment of motor speech disorders: A pilot study. American Journal of Speech-language Pathology, 15 1: 45-56.


Author Hill, A. J.
Theodoros, D. G.
Russell, T. G.
Cahill, L. M.
Ward, E. C.
Clark, K. M.
Title An Internet-based telerehabilitation system for the assessment of motor speech disorders: A pilot study
Journal name American Journal of Speech-language Pathology   Check publisher's open access policy
ISSN 1058-0360
Publication date 2006
Sub-type Article (original research)
DOI 10.1044/1058-0360(2006/006)
Volume 15
Issue 1
Start page 45
End page 56
Total pages 12
Editor Holt, J.
Place of publication Rockville
Publisher American Speech-Language-Hearing Association
Collection year 2006
Language eng
Subject C1
321024 Rehabilitation and Therapy - Occupational and Physical
730303 Occupational, speech and physiotherapy
Abstract 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.
Keyword Telepractice
Rehabilitation
Assessment
Speech Disorders
Applied Linguistics
Closed-head-injury
Brain-injury
Reliability
Telehealth
Agreement
Hypernasality
Technology
Therapy
Ratings
Q-Index Code C1

 
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