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1.
Lang Speech Hear Serv Sch ; 53(2): 329-334, 2022 Apr 11.
Article in English | MEDLINE | ID: covidwho-1788338

ABSTRACT

PURPOSE: This introduction presents the LSHSS Forum: Can You See My Screen? Virtual Assessment in Speech and Language. The goals of the forum are to document reliability and validity of assessment results conducted virtually, identify characteristics of measures that are suitable for online assessment, and provide clinical and research guidance for interpreting diagnostic results obtained in virtual settings. METHOD: In this introduction, we provide an overview of the research completed by nine teams, who submitted research articles and notes on a variety of topics pertinent to the theme of telehealth assessments. Of these, seven teams investigated the validity and reliability of 14 different assessment tools, while two teams described training and experience issues. CONCLUSION: The nine studies presented in this forum will provide speech-language pathologists with insight into a range of issues regarding telehealth assessment, including the breadth of suitable assessment tools; practical strategies for assessing children with a diverse range of ages, languages, skills, and abilities; and the unexpected challenges and opportunities of conducting clinical work and research during a global pandemic.


Subject(s)
Speech-Language Pathology , Speech , Child , Child Language , Humans , Language , Reproducibility of Results , Speech-Language Pathology/methods
2.
Lang Speech Hear Serv Sch ; 53(2): 445-453, 2022 Apr 11.
Article in English | MEDLINE | ID: covidwho-1692515

ABSTRACT

PURPOSE: Due to the COVID-19 pandemic, millions of school-age children with language impairment (LI) and their speech-language pathologists (SLPs) relied on telepractice service delivery models. Unfortunately, the dearth of evidence and procedural guidance available to SLPs has made this transition challenging at best. METHOD: The current study utilized a sample of 20 young children with LI to determine the feasibility of procedures necessary for conducting vocabulary assessments via telepractice platforms and the reliability of scoring participant responses using standardized assessments. RESULTS: Study findings resulted in numerous practical suggestions for SLPs working with young children with LI via telepractice. Results suggest that these adaptations result in strong interrater reliability for scoring participant responses in an online format. CONCLUSION: Study findings suggest that conducting telepractice assessments can be a useful and reliable tool for school-based SLPs, with implications reaching beyond the pandemic era.


Subject(s)
COVID-19 , Communication Disorders , Language Development Disorders , Speech-Language Pathology , Telemedicine , Child , Child, Preschool , Feasibility Studies , Humans , Language Development Disorders/diagnosis , Pandemics , Reproducibility of Results , Speech-Language Pathology/methods , Telemedicine/methods , Vocabulary
3.
Lang Speech Hear Serv Sch ; 52(3): 769-775, 2021 07 07.
Article in English | MEDLINE | ID: covidwho-1545676

ABSTRACT

Purpose The COVID-19 pandemic has necessitated a quick shift to virtual speech-language services; however, only a small percentage of speech-language pathologists (SLPs) had previously engaged in telepractice. The purpose of this clinical tutorial is (a) to describe how the Early Language and Literacy Acquisition in Children with Hearing Loss study, a longitudinal study involving speech-language assessment with children with and without hearing loss, transitioned from in-person to virtual assessment and (b) to provide tips for optimizing virtual assessment procedures. Method We provide an overview of our decision making during the transition to virtual assessment. Additionally, we report on a pilot study that calculated test-retest reliability from in-person to virtual assessment for a subset of our preschool-age participants. Results Our pilot study revealed that most speech-language measures had high or adequate test-retest reliability when administered in a virtual environment. When low reliability occurred, generally the measures were timed. Conclusions Speech-language assessment can be conducted successfully in a virtual environment for preschool children with hearing loss. We provide suggestions for clinicians to consider when preparing for virtual assessment sessions. Supplemental Material https://doi.org/10.23641/asha.14787834.


Subject(s)
Child Language , Education of Hearing Disabled , Educational Measurement/methods , Hearing Loss , Speech-Language Pathology/methods , Telemedicine/methods , COVID-19 , Child, Preschool , Educational Measurement/economics , Family , Humans , Pandemics , Pilot Projects , Speech-Language Pathology/economics , Surveys and Questionnaires , Telemedicine/economics
4.
Am J Speech Lang Pathol ; 30(2): 740-747, 2021 03 26.
Article in English | MEDLINE | ID: covidwho-1545668

ABSTRACT

Purpose Youth with cochlear implants (CIs) are at risk for delays in verbal short-term memory (STM)/working memory (WM), which adversely affect language, neurocognitive, and behavioral outcomes. Assessment of verbal STM/WM is critical for identifying and addressing these delays, but standard assessment procedures require face-to-face (FTF) administration. The purpose of this study was to determine the feasibility and validity of remote testing methods (teleassessment) of verbal STM/WM in youth with CIs as a method of addressing COVID-19-related restrictions on FTF test administration. Method Tests of verbal STM/WM for nonwords, digit spans, letter-number sequences, sentences, and stories were individually administered by speech-language pathologists over a teleassessment platform to 28 youth (aged 9-22 years) with CIs and 36 same-aged normal-hearing peers. Examiners, parents, and participants completed quality and satisfaction ratings with the teleassessment procedure. Teleassessment scores were compared to results of tests obtained at FTF visits an average of 1.6 years earlier. Results Quality and satisfaction ratings for teleassessment were high and in almost all cases did not differ between the CI and normal-hearing samples. Youth with CIs scored lower than normal-hearing peers on measures of verbal STM/WM, and scores for digit span and letter-number sequencing did not differbetween teleassessment and FTF methods. Correlations across teleassessment and FTF visits were strong for digit span, letter-number sequencing, and sentence memory, but were more modest for nonword repetition. Conclusion With some caveats, teleassessment of verbal STM/WM was feasible and valid for youth with CIs.


Subject(s)
Cochlear Implants/psychology , Memory, Short-Term , Speech Perception , Speech-Language Pathology/methods , Telemedicine/methods , Adolescent , COVID-19/epidemiology , Case-Control Studies , Child , Cochlear Implants/adverse effects , Feasibility Studies , Female , Humans , Male , Pandemics , SARS-CoV-2
5.
Am J Speech Lang Pathol ; 30(2): 532-550, 2021 03 26.
Article in English | MEDLINE | ID: covidwho-1545666

ABSTRACT

Purpose Our aim was to critically review recent literature on the use of telehealth for dysphagia during the COVID-19 pandemic and enhance this information in order to provide evidence- and practice-based clinical guidance during and after the pandemic. Method We conducted a rapid systematized review to identify telehealth adaptations during COVID-19, according to peer-reviewed articles published from January to August 2020. Of the 40 articles identified, 11 met the inclusion criteria. Full-text reviews were completed by three raters, followed by qualitative synthesis of the results and description of practical recommendations for the use of telehealth for dysphagia. Results Seven articles were guidelines articles, three were editorials, and one was a narrative review. One article focused on telehealth and dysphagia during COVID-19. The remaining 10 mentioned telehealth in varying degrees while focusing on dysphagia management during the pandemic. No articles discussed pediatrics in depth. The most common procedure for which telehealth was recommended was the clinical swallowing assessment (8/11), followed by therapy (7/11). Six articles characterized telehealth as a second-tier service delivery option. Only one article included brief guidance on telehealth-specific factors, such as legal safeguards, safety, privacy, infrastructure, and facilitators. Conclusions Literature published during the pandemic on telehealth for dysphagia is extremely limited and guarded in endorsing telehealth as an equivalent service delivery model. We have presented prepandemic and emerging current evidence for the safety and reliability of dysphagia telemanagement, in combination with practical guidelines to facilitate the safe adoption of telehealth during and after the pandemic.


Subject(s)
Deglutition Disorders/therapy , Speech-Language Pathology/methods , Telemedicine/methods , Adult , COVID-19/epidemiology , Child, Preschool , Deglutition Disorders/diagnosis , Deglutition Disorders/rehabilitation , Humans , Pandemics , Pediatrics/methods , SARS-CoV-2
6.
Am J Speech Lang Pathol ; 30(2): 503-516, 2021 03 26.
Article in English | MEDLINE | ID: covidwho-1545665

ABSTRACT

Purpose COVID-19 has shifted models of health care delivery, requiring the rapid adoption of telehealth, despite limited evidence and few resources to guide speech-language pathologists. Management of dysarthria presents specific challenges in the telehealth modality. Evaluations of dysarthria typically rely heavily on perceptual judgments, which are difficult to obtain via telehealth given a variety of technological factors such as inconsistencies in mouth-to-microphone distance, changes to acoustic properties based on device settings, and possible interruptions in connection that may cause video freezing. These factors limit the validity, reliability, and clinicians' certainty of perceptual speech ratings via telehealth. Thus, objective measures to supplement the assessment of dysarthria are essential. Method This tutorial outlines how to obtain objective measures in real time and from recordings of motor speech evaluations to support traditional perceptual ratings in telehealth evaluations of dysarthria. Objective measures include pause patterns, utterance length, speech rate, diadochokinetic rates, and overall speech severity. We demonstrate, through clinical case vignettes, how these measures were completed following three clinical telehealth evaluations of dysarthria conducted via Zoom during the COVID-19 pandemic. This tutorial describes how each of these objective measures were utilized, in combination with subjective perceptual analysis, to determine deviant speech characteristics and their etiology, develop a patient-specific treatment plan, and track change over time. Conclusion Utilizing objective measures as an adjunct to perceptual ratings for telehealth dysarthria evaluations is feasible under real-world pandemic conditions and can be used to enhance the quality and utility of these evaluations.


Subject(s)
Dysarthria/therapy , Speech-Language Pathology/methods , Telemedicine/methods , COVID-19/epidemiology , Humans , Pandemics , SARS-CoV-2 , Speech Intelligibility , Telemedicine/standards
7.
Am J Speech Lang Pathol ; 30(2): 598-608, 2021 Mar 26.
Article in English | MEDLINE | ID: covidwho-1545664

ABSTRACT

Purpose The COVID-19 pandemic has drastically increased the use of telehealth. Prior studies of telehealth clinical swallowing evaluations provide positive evidence for telemanagement of swallowing. However, the reliability of these measures in clinical practice, as opposed to well-controlled research conditions, remains unknown. This study aimed to investigate the reliability of outcome measures derived from clinical swallowing tele-evaluations in real-world clinical practice (e.g., variability in devices and Internet connectivity, lack of in-person clinician assistance, or remote patient/caregiver training). Method Seven raters asynchronously judged clinical swallowing tele-evaluations of 12 movement disorders patients. Outcomes included the Timed Water Swallow Test (TWST), Test of Masticating and Swallowing Solids (TOMASS), and common observations of oral intake. Statistical analyses were performed to examine inter- and intrarater reliability, as well as qualitative analyses exploring patient and clinician-specific factors impacting reliability. Results Forty-four trials were included for reliability analyses. All rater dyads demonstrated "good" to "excellent" interrater reliability for measures of the TWST (intraclass correlation coefficients [ICCs] ≥ .93) and observations of oral intake (≥ 77% agreement). The majority of TOMASS outcomes demonstrated "good" to "excellent" interrater reliability (ICCs ≥ .84), with the exception of the number of bites (ICCs = .43-.99) and swallows (ICCs = .21-.85). Immediate and delayed intrarater reliability were "excellent" for most raters across all tasks, ranging between ICCs of .63 and 1.00. Exploratory factors potentially impacting reliability included infrequent instances of suboptimal video quality, reduced camera stability, camera distance, and obstruction of the patient's mouth during tasks. Conclusions Subjective observations of oral intake and objective measures taken from the TWST and the TOMASS can be reliably measured via telehealth in clinical practice. Our results provide support for the feasibility and reliability of telehealth for outpatient clinical swallowing evaluations during COVID-19 and beyond. Supplemental Material https://doi.org/10.23641/asha.13661378.


Subject(s)
Deglutition Disorders/therapy , Deglutition/physiology , Speech-Language Pathology/methods , Telemedicine/methods , Aged , Aged, 80 and over , COVID-19/epidemiology , Deglutition Disorders/etiology , Female , Humans , Lewy Body Disease/complications , Male , Middle Aged , Multiple System Atrophy/complications , Pandemics , Parkinson Disease/complications , Prospective Studies , SARS-CoV-2 , Telemedicine/standards
8.
PLoS One ; 16(4): e0250308, 2021.
Article in English | MEDLINE | ID: covidwho-1206196

ABSTRACT

OBJECTIVE: To evaluate the evidence of aerosol generation across tasks involved in voice and speech assessment and intervention, to inform better management and to reduce transmission risk of such diseases as COVID-19 in healthcare settings and the wider community. DESIGN: Systematic literature review. DATA SOURCES AND ELIGIBILITY: Medline, Embase, Scopus, Web of Science, CINAHL, PubMed Central and grey literature through ProQuest, The Centre for Evidence-Based Medicine, COVID-Evidence and speech pathology national bodies were searched up until August 13th, 2020 for articles examining the aerosol-generating activities in clinical voice and speech assessment and intervention within speech pathology. RESULTS: Of the 8288 results found, 39 studies were included for data extraction and analysis. Included articles were classified into one of three categories: research studies, review articles or clinical guidelines. Data extraction followed appropriate protocols depending on the classification of each article (e.g. PRISMA for review articles). Articles were assessed for risk of bias and certainty of evidence using the GRADE system. Six behaviours were identified as aerosol generating. These were classified into three categories: vegetative acts (coughing, breathing), verbal communication activities of daily living (speaking, loud voicing), and performance-based tasks (singing, sustained phonation). Certainty of evidence ranged from very low to moderate with variation in research design and variables. CONCLUSIONS: This body of literature helped to both identify and categorise the aerosol-generating behaviours involved in speech pathology clinical practice and confirm the low level of evidence throughout the speech pathology literature pertaining to aerosol generation. As many aerosol-generating behaviours are common human behaviours, these findings can be applied across healthcare and community settings. SYSTEMATIC REVIEW REGISTRATION: Registration number CRD42020186902 with PROSPERO International Prospective Register for Systematic Reviews.


Subject(s)
Aerosols/adverse effects , COVID-19/transmission , Verbal Behavior/physiology , Aerosols/metabolism , COVID-19/metabolism , Cough/physiopathology , Phonation/physiology , SARS-CoV-2/pathogenicity , Singing/physiology , Speech/physiology , Speech-Language Pathology/methods
9.
Int J Pediatr Otorhinolaryngol ; 138: 110318, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-714003

ABSTRACT

OBJECTIVE: To study whether providing Speech and Language Pathology (SLP) interventions by telepractice (TP) could effectively improve speech performance in children with cleft palate (CCP). METHODS: Forty-three CCP were treated with TP intervention in 45 min sessions, 2 times per week for a period of one month. Children ages ranged 4-12 years (X = 7.04; SD = 2.59). All children presented with velopharyngeal insufficiency (VPI) and compensatory articulation (CA) after palatal repair. TP was provided in small groups (5-6 children) following the principles of the Whole Language Model (WLM). Severity of CA was evaluated by a standardized scale at the onset and at the end of the TP period. RESULTS: At the onset of the TP intervention period, 84% of the patients demonstrated severe CA. At the end of the TP period there was a significant improvement in severity of CA (p < 0.001). CONCLUSION: The results of this study suggests that TP can be a safe and reliable tool for improving CA. Considering that the COVID-19 pandemic will radically modify the delivery of Health Care services in the long term, alternate modes of service delivery should be studied and implemented.


Subject(s)
Betacoronavirus , Cleft Palate , Coronavirus Infections , Pandemics , Pneumonia, Viral , Speech Therapy , Speech-Language Pathology , COVID-19 , Child , Child, Preschool , Cleft Palate/complications , Humans , SARS-CoV-2 , Speech Therapy/methods , Speech-Language Pathology/methods , Velopharyngeal Insufficiency/etiology , Velopharyngeal Insufficiency/physiopathology
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