Design and Implementation of an Interactive Website for Pediatric Voice Therapy-The Concept of In-Between Care: A Telehealth Model.

Purpose: This article describes the design and implementation of a web-based portal developed to provide supported home practice between weekly voice therapy sessions delivered through telehealth to children with voice disorders. This in-between care consisted of supported home practice that was remotely monitored by speech-language pathologists (SLPs). Methods: A web-based voice therapy portal (VTP) was developed as a platform so participants could complete voice therapy home practice by an interdisciplinary team of SLPs (specialized in pediatric voice therapy), telehealth specialists, biomedical informaticians, and interface designers. The VTP was subsequently field tested in a group of children with voice disorders, participating in a larger telehealth study. Results: Building the VTP for supported home practice for pediatric voice therapy was challenging, but successful. Key interactive features of the final site included 11 vocal hygiene questions, traditional voice therapy exercises grouped into levels, audio/visual voice therapy demonstrations, a store-and-retrieval system for voice samples, message/chat function, written guidelines for weekly therapy exercises, and questionnaires for parents to complete after each therapy session. Ten participants (9-14 years of age) diagnosed with a voice disorder were enrolled for eight weekly telehealth voice therapy sessions with follow-up in-between care provided using the VTP. Conclusion: The development and implementation of the VTP as a novel platform for the delivery of voice therapy home practice sessions were effective. We found that a versatile individual, who can work with all project staff (speak the language of both SLPs and information technologists), is essential to the development process. Once the website was established, participants and SLPs effectively utilized the web-based VTP. They found it feasible and useful for needed in-between care and reinforcement of therapeutic exercises.

Telehealth technology applications in speech-language pathology.

INTRODUCTION: Speech-language pathologists are anxious to adopt telehealth technologies but have encountered barriers such as limited reimbursement, state licensure laws, and medical information privacy laws. Moreover, speech-language pathologists are confronted with the hurdle of evolving face-to-face clinical practices into effective telehealth practice adapted to the current national infrastructure. Factors such as costs, availability of resources, and diagnostic/intervention and patient needs should be considered when selecting the telehealth infrastructure for service delivery. Understanding the new role of technology in the diagnosis and treatment of communication disorders is vital for the expansion of telehealth as a standard of care. The purpose of this article is to overview the current technologic infrastructure and procedures for telehealth applications in speech-language pathology (SLP) and the innate challenges and opportunities. MATERIALS AND METHODS: A literature search was conducted for telehealth publications in the field of SLP. Given the rapid rate at which technology advances, only peer-reviewed articles published over the past 5 years (2008-2013) were included. RESULTS: The majority of articles reviewed used hybrid methodologies to maintain traditional SLP service standards. General technological components for telehealth activities included computers, Web cameras, headsets with an embedded microphone, and Internet connectivity. CONCLUSIONS: Advanced technology has limitations in the application of telehealth. Technological adversities were not reported as the cause of discontinuation of telehealth services by the practitioner or the individual. Audio and visual disturbances were primarily associated with videoconferencing. Supplemental asynchronous technology was widely reported as a solution to real-time instabilities.