An interdisciplinary team of specialists from the leading hospitals and medical schools of the Boston area, with expertise in communication disorders, clinical service delivery, and telemedicine have published an article identifying and assessing opportunities and issues around incorporating emerging technologies in the clinical management of voice-, speech-, language- and communication-disorders. The goals of their publication are to introduce to speech-language pathologists (SLPs) four evolving technologies with identified telepractice potential, to discuss how they might contribute individually and jointly to clinical voice and speech service delivery, and to weigh factors that represent substantive barriers to progress currently.
The authors begin by noting two non-technological factors that shape this discussion: first, the disparity between the high demands for SLP services vs constraints on clinician availability to meet those demands, and the gap between performance gains produced in the clinic and their low generalization to communicative improvements in daily life. Their interest is in technology developments that can improve these situations. The four areas of technology covered are: [1] artificial intelligence (AI); [2] monitoring technologies to track and report patient performance outside clinical sessions; [3] virtual reality; and [4] gamification. In AI, they highlight Eulerian visual magnification – a technology that supports real-time visual monitoring of subtle physiological changes over time that can indicate, for example, stress level rises that signal need for a break, or switch to a less demanding activity. To illustrate extra-clinical performance monitoring technologies, they describe a prototype ambulatory voice monitor that both provides real-time feedback to users themselves, and reports remotely to treating clinicians for their asynchronous attention. The authors highlight virtual reality technologies that support communication practice and rehearsal for upcoming events, such as a visit to the doctors’ offices; these can expand rehearsal opportunities, provide useful feedback, and promote scenario exploration in a low-stress environment. And finally, gamification techniques can heighten patient engagement in targeted activities by increasing focus, lengthening activity session durations, and adaptively adjusting challenge levels. Substantial obstacles to realizing these benefits exist. There is the technological need for high-speed internet connectivity for such apps. Clinical effectiveness must be established through rigorous research. Clinicians must be trained in their use’ and the case for payment must be made convincing to reimbursors.
For further reading: N. V. Mallipeddi, A. Mehtrotra, J. H. Van Stan. 2022.
Telepractice in the treatment of speech and voice disorders: What could the future look like? ASHA SIG-18 Perspectives (Telepractice), 8(2): 428-423. https://doi.org/10.1044/2022_PERSP-22-00098