Purdue SLHS Telehealth Webinar Series Fall 2020 Webinar 3: Telehealth Adapta2ons for Adult Popula2ons Speakers: Bauer Malandraki, Gutmann, Huber, Hubertz, Malandraki, Wetzel 1 Presenters Jaime Bauer Malandraki, MS, CCC-SLP, BCS-S (she/her/hers) Michelle Gutmann, PhD, CCC-SLP (she/her/hers) Jessica E. Huber, PhD, CCC-SLP (she/her/hers) Jillian Hubertz, AuD, CCC-A (she/her/hers) Georgia A. Malandraki, PhD, CCC-SLP, BCS-S (she/her/hers) Dawn Wetzel, MAT, CCC-SLP (she/her/hers) Moderator Georgia A. Malandraki, PhD, CCC-SLP, BCS-S (she/her/hers) TELEHEALTH IN ADULT POPULATIONS DURING AND BEYOND COVID-19: THE PURDUE SLHS PERSPECTIVE CEU Requirements To receive ASHA CEUs, there are two things we will need you to do in order to collect the full .10 amount. Please note there will not be any parGal credit given for this course. 1. The first component is to aIend this webinar in its enGrety tonight. a. Your aIendance will be tracked through the system and only those who are present through the whole webinar, will be eligible for credit. b. The moderator will designate the end of the webinar. 2. Secondly, we will need you to fill out a Learning Outcome Assessment form. a. This electronic form/quesGonnaire will be emailed to you the day aOer the webinar event. b. You will need to submit your form quesGonnaire, within the soOware system, no later than 15 calendar days aOer this event which will be Friday December 18 . A confirmaGon email will be sent to you once we have verified your aIendance and received your form. If you have any quesGons about your CEU redempGon, please contact our administrator Teasha McKinley at [email protected]. 2
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• Telehealth screenings for adults • Telehealth for adult dysphagia services • Telehealth for adult transgender voice services • Telehealth for adult language and AAC services • Telehealth for adult audiology services • Principles for adult motor speech tele-services
Outline
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Image by Rachel Arkenberg - from Malandraki et al., accepted, AJSLP
§ Considerations with COVID-19 § Masking wearing impact on communication
§ Mask wearing and hearing aid retention
RESEARCH EVIDENCE AND PRACTICAL GUIDELINES FOR ADULT MOTOR
SPEECH DISORDERS
• Thank you to Jordanna Sevitz, a doctoral student in Michelle Troche’s lab at Teachers College, Columbia University, and Brianna Kiefer, my doctoral student, for investigating the literature supporting the use of telemedicine in motor speech disorders and for testing the feasibility of objective measures via telemedicine – watch for the upcoming paper which is provisionally accepted in AJSLP (telemedicine special issue)
• Most of the literature supporting the use of telemedicine in motor speech disorders was conducted under controlled research conditions with specialized equipment and custom software
• The trick is to translate these studies to the real clinical environment
RESEARCH EVIDENCE AND PRACTICAL GUIDELINES FOR ADULT MOTOR
SPEECH DISORDERS
• Important to consider using both objective and perceptual measures – critical with telemedicine due to limitations of teleconferencing software
• Difficult to reliably perceive vocal intensity, vocal quality, and potentially intelligibility
(mixed outcomes)1-3
• Studies have shown perceptual ratings of overall speech severity and articulatory precision to be reliable1-2
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1Constantinescu, G., et al. (2010). Assessing disordered speech and voice in Parkinson’s disease: A telerehabilitation application. International Journal of Language & Communication Disorders, 45(6), 630–644. https://doi.org/10.3109/13682820903470569. 2Hill, A. J., Theodoros, D., G., ussell, T. G., RCahill, L. M., Ward, E. C., & 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. 3Utianski, R. L., Sandoval, S., Berisha, V., Lansford, K. L., & Liss, J. M. (2019). The effects of speech compression algorithms on the intelligibility of two individuals with dysarthric speech. American Journal of Speech-Language Pathology, 28(1), 195-203.
RESEARCH EVIDENCE AND PRACTICAL GUIDELINES FOR ADULT MOTOR
SPEECH DISORDERS • What types of objective measures are possible?
• Fundamental frequency (mean and range), speech rate, utterance length, pause patterns, DDK rates and regularity
• Important to develop a simple protocol and to use the same protocol with all patients
• Due to issues with teleconferencing software, measurements of vocal intensity are not valid in most interfaces • However, SpeechVive, Inc. has a software that can be used with the SpeechVive
device that controls gain and can be used to obtain measures of vocal intensity – available for free right now and can be used with telemedicine