The effect of tele-speech therapy on treatment of stuttering

Design and evaluation of a serious video game to treat preschool children with speech sound disorders

Speech sound disorder (SSD) is one of the most common communication disorders in children, which must be diagnosed and treated in childhood to prevent its negative psychological, occupational, and social consequences in adulthood. The use of serious games is one technology that could help treat SSD. This study aims to design and evaluate the usability of a digital game for 3-6-year-old children. This developmental study was carried out in three main stages: determining information requirements, designing and developing a digital game, and evaluating the usability of the designed game. In the first stage, the consonants, syllables, words, and sentences that should be used in the game were determined through focus group sessions and a questionnaire completed by 30 speech-language pathologists (SLPs) in two Delphi rounds. In the designing and developing stage, the game design document was first written, and then sketches and wireframes were drawn based on this document. Then, the game was developed in the second phase using Java programming language. In the third stage, the usability of the designed game was evaluated by six experts and 22 SLPs using Nielsen's usability heuristics and the Post-Study System Usability Questionnaire (PSSUQ), respectively. Also, the usability of the game was evaluated by ten children. To determine the information requirements, SLPs confirmed 23 consonants, 138 syllables, 564 words, and 69 sentences to teach children the game. According to Nielsen's usability heuristics, the designed game had 23 unique usability problems with a mean severity of 2.29. "User control and freedom," with five usability problems, was the most frequently identified problem, and "error prevention," with a mean severity of 3.83, was the most severe problem. The results of the SLPs' evaluation also showed that the "interface quality" of the designed game obtained the highest score, with a mean score of 6.25 out of 7. Also, 100% of children stated that the game was designed beautifully, and 90% of children also liked the game. A serious game designed for children with SSDs achieved satisfactory results in usability evaluation. Therefore, this smartphone-based game can be easily used among these children to provide fun therapy sessions under the supervision of parents.

Clinical effectiveness of telerehabilitation in voice therapy programs for dysphonia

PURPOSE

The main aim of this study was to investigate the clinical efficacy of speech therapy, delivered via tele-practice to patients with dysphonia. A secondary aim was to verify whether a telerehabilitation-only protocol could have a clinical efficacy similar to a combined telerehabilitation and in-person approach.

METHODS

Thirty-two consecutive patients undergoing telerehabilitation for dysphonia were retrospectively considered. Patients were divided into two groups: those who received combined in-person and telerehabilitation treatment, and those who underwent telerehabilitation only.

RESULTS

Overall, patients included in this study showed a significant improvement in their VHI-10 scores after treatment (p < 0.001). Such an improvement was also significant in both combined therapy and telerehabilitation only groups (p = 0.019, and p = 0.002, respectively). A significant reduction in general degree of dysphonia (G), roughness (R), breathiness (B) and strain (S) scores (p < 0.001, p = 0.012, p < 0.001, and p < 0.001, respectively) was noticed over the whole sample after treatment. The same parameters showed a significant improvement also in the combined therapy group, while in the telerehabilitation only group, only G, B and S scores significantly improved. Mean phonation time, Jitter and Shimmer values significantly improved in the overall sample as well as in the combined therapy group. A significantly more favorable spectrographic class relative to the vowel /a/ was found after treatment in the whole sample, as well as in both combined therapy and telerehabilitation only groups (p < 0.001, p = 0.002, p = 0.004, respectively).

CONCLUSION

This study's results seem to support telerehabilitation as a potentially effective tool to administer speech therapy in dysphonic patients, both as a single modality and in combination with traditional in-person sessions. To better characterize the clinical results of telerehabilitation in dysphonia treatment, large-scale prospective investigations are mandatory.

Comparisons of Clients' and Caregivers' Satisfaction Across Conventional, Virtual, and Hybrid Speech-Language Therapy Services in Malaysia

Purpose

This study compared the satisfaction of recipients of conventional speech-language therapy (C-SLT), speech-language teletherapy (SLTT), and hybrid speech-language therapy (H-SLT), and determined sociodemographic factors that affect their satisfaction.

Patients and Methods

Participants were clients and caregivers of a speech-language clinic at a public university. Services were primarily provided by student clinicians, who were undergoing supervised clinical training. An online survey was distributed, which consisted of three sections: Background Information, Overall Satisfaction in SLT, and Satisfaction in SLTT. All participants completed the first two sections, while the third section was completed only by those who experienced SLTT or H-SLT.

Results

Most of the respondents were caregivers (89.7%), female (79.4%), of Malay ethnicity (80.9%), have received tertiary education (77.9%), within the low-income category (66.2%), held a job (76.5%), and resided in central West Malaysia (83.8%). Many participants experienced C-SLT (51%), followed by H-SLT (34%), and SLTT (15%). There were no significant differences in the overall satisfaction of the participants across three modes of services delivery (F[2,67] = 0.02, p = 0.95), and in the satisfaction with teletherapy between the H-SLT and SLTT groups (t = 0.90, p = 0.38). Income was the only sociodemographic factor that was correlated with the satisfaction level in teletherapy (r = 0.37, p = 0.04).

Rehabilitation After Total Laryngectomy: An Integrated Protocol Remotely Delivered During COVID-19

The aim of this paper was to evaluate the results of an integrated treatment delivered remotely to laryngectomized patients with voice prosthesis. Eighteen laryngectomized patients were treated remotely in groups co-led by a speech therapist and a psychologist ("Online Group"). The results were compared with those of 17 patients ("In-Person Group") previously studied. The two groups obtained comparable results on all parameters of the INFVo perceptual rating scale, in the DEP, ANX, PHO and HOS areas of the Symptom Check List-90-Revised questionnaire, and in the areas investigated by the WHOQOL-B questionnaire. The "In-Person Group" obtained statistically better results on the Italian Self-Evaluation of Communication Experiences after Laryngeal Cancer questionnaire. Although the in-person treatment favored the acceptance of the new voice and the development of conversational skills, telerehabilitation guaranteed an adequate level of assistance in terms of voice acquisition, prevention of anxiety and depression, and recovery of a good QoL.

Two-sided perspective on tele-speech therapy: Experiences of stuttering patients, and their parents

The purpose of this study was to investigate the benefits and challenges of the tele-speech therapy from the perspective of patients who stutter, and their parents. Semi-structured interviews were conducted with 12 patients and three parents in two rehabilitation centers. Data were analyzed using a qualitative content analysis approach proposed by Graneheim and Lundman. Seven categories were determined: accessible treatment, motivation of comfort in tele-speech therapy, challenges of tele-therapy, satisfaction, virtual competency, lower quality compared to face-to-face therapy, and uncertainty about the effectiveness of tele-speech therapy. The participants had a two-sided perspective regarding tele-speech therapy. Positive experiences included benefitting from more qualified therapists at multiple locations, faster access to treatment, and saving cost and time. Negative experiences and challenges consisted of low-quality of technology infrastructure for rehabilitation including low quality of shared images and videos, ineffective communication, insufficient sympathy, indirect communication, and technology incompetency. Findings showed that the participants were interested in the application of tele-speech therapy, as this method could increase their accessibility and provide the opportunity to choose proper therapists. The determined benefits and challenges can provide the policy-makers with beneficial information to implement tele-speech therapy.

Determining the effect of tele-rehabilitation on patients with stutter using the goal attainment scaling (GAS)

BACKGROUND

Lack of proper and timely patients' access to speech pathologists can affect the treatment and follow-up process; therefore, patients do not achieve the expected therapeutic goals. The aim of this study was to determine the effect of tele-rehabilitation on the stuttering patients using the goal attainment scaling (GAS).

METHODS

This interventional study was carried out on patients who visited the rehabilitation centers affiliated to the Jahrom Welfare Office. They underwent remote speech therapy using Skype. To evaluate the treatment outcomes of the stuttering patients, GAS was used.

RESULTS

The participants' speech and lingual skills improved using videoconferencing. The mean score of total GAS for patients was 53.08. Of 112 health goals, patients reached the expected or higher than expected levels in 78 goals.

CONCLUSIONS

Rehabilitation through video conferencing was effective for patients with stuttering, improved their speech, and decreased their stuttering. Since, application of remote rehabilitation services can provide regular access to healthcare services, it can lead to improving patient treatment provide more frequent and faster treatment follow-up.

Telepractice in School-Age Children Who Stutter: A Controlled Before and After Study to Evaluate the Efficacy Of MIDA-SP

The COVID-19 pandemic necessitated a general reorganization of rehabilitation services in Italy. The lockdown in Italy led to the use of telepractice for the delivery of speech therapy, including stuttering. The aim of the present work was to evaluate the effectiveness of the Multidimensional, Integrated, Differentiated, Art-Mediated Stuttering Program (MIDA-SP; Tomaiuoli et al., 2012), delivered online for school-age children who stutter. A non-randomized controlled pre- and post-treatment study included an experimental group (11 children) receiving a telepractice adaptation of MIDA-SP and a historical control group (11 children) receiving in-person MIDA-SP. Both groups had been assessed with the Stuttering Severity Instrument – Fourth Edition (SSI-4) and Overall Assessment of the Speaker's Experience of Stuttering (OASES-S) pre- and post-treatment. No statistically significant differences were found between the two modes of delivery. These findings suggest that MIDA-SP treatment delivered via telepractice is effective for school-age children who stutter.

Speech therapists' perspectives about using tele-speech therapy: a qualitative study

PURPOSE

Tele-speech therapy refers to the application of telecommunication technologies to provide speech-language pathology services at a distance and establishes communication between a specialist and a patient for assessment, intervention, or consultation. Due to the shortage of speech therapists, the use of tele-speech therapy services can be helpful, especially for those who do not have access to speech-language therapists. The aim of this study was to investigate speech therapists' perspectives about using tele-speech therapy.

METHODS

This was a qualitative study conducted in 2020. Data were collected through conducting in-depth semi-structured interviews with 12 faculty members who worked in three different medical universities. The interviews were recorded digitally and transcribed verbatim. The data were analysed by using framework analysis method and MAXQDA version 10.

RESULTS

Having analysed the data, four themes, 10 categories, and 26 subcategories emerged. The main findings included necessary requirements for implementing and using tele-speech therapy in terms of developing academic courses, guidelines, and necessary technical infrastructure, advantages of using tele-speech therapy for specialists and patients, challenges of, and opportunities for, using tele-speech therapy.

CONCLUSION

Although tele-speech therapy has several benefits for specialists and patients, challenges of using this technology should not be underestimated. There are also a number of research opportunities in this field and their results can be helpful for successful implementation of this technology in the future.Implications for rehabilitationThe clinical assessment and treatment of patients with speech-language disorders are sometimes difficult mainly due to the limited healthcare resources or the patient heath condition.Tele-speech therapy can be regarded as an alternative approach or a complementary method for face-to-face visits, especially for patients who are not able to attend clinics.Despite the advantages, the challenges of providing special groups of patients with tele-speech therapy should be taken into account.Telerehabiliation and rehabilitation research centres can support future research in the field of tele-speech therapy to present more evidence regarding the strengths and weaknesses of this technology.Implications for practiceTechnical and non-technical infrastructures should be taken into account before implementing tele-speech therapy services.Tele-speech therapy has a number of advantages for patients and specialists.Challenges of providing tele-speech therapy services, such as risk of inaccurate evaluation and difficulty in interaction with patients should not be underestimated.There are a number of research opportunities in the field of tele-speech therapy and tele-rehabilitation centres can support further research in this area.The findings of this study can facilitate utilisation of tele-speech therapy in different settings.

Comprehensive Review of Factors Influencing the Use of Telepractice in Stuttering Treatment

OBJECTIVES

Stuttering is a speech disorder characterized by the repetition of sounds, syllables, or words; prolongation of sounds; and interruptions in speech. Telepractice allows speech services to be delivered to patients regardless of their location. This review investigated factors influencing the use of telepractice in stuttering treatment.

METHODS

Articles related to the application of telepractice in stuttering were searched using the Scopus, Web of Science, PubMed, Cochrane, and ProQuest databases without consideration of any time limit. Initially, 79 articles were found and after application of the inclusion and exclusion criteria, 15 articles were selected for the review study. Data were analyzed by using the content analysis method and synthesized narratively.

RESULTS

Factors influencing the use of telepractice in stuttering treatment were categorized into individual, technical, clinical, and economic factors. Providing access to healthcare services, maintaining personal privacy, and allowing flexibility in arranging appointments were among individual factors. In terms of the technical factors, technical problems and Internet speed were addressed. Clinical factors were divided into positive and negative outcomes, and economic factors were mainly related to time and cost savings.

CONCLUSIONS

Although patients may benefit from using telepractice, the widespread adoption of this technology can be hindered by some technical and non-technical factors. Because telepractice can be employed as a complementary method to treat stuttering, more attention should be paid to the required infrastructure and factors that may negatively impact the use of this technology.