The Knowledge and Use of Speech Therapy Mobile Applications: Speech-Language Pathologists’ Perspectives in Malaysia

Technology incorporation in speech therapy has been growing over the years. Mobile applications are among the adoptions that facilitate delivering speech therapy services. The situation in Malaysia is discouraging because there are not enough speech-language pathologists (SLPs) to serve the growing number of populations. Despite the abundance of available speech therapy mobile applications in the market, there is a lack of information focusing on the SLP’s knowledge and usage perspectives, especially in Malaysia. The objectives of this study are to describe the knowledge and usage perspectives of speech therapy mobile applications among SLPs in Malaysia and to analyze the instructional features and functional features relationships within the perspectives of SLPs. Surveys are established in three parts, with demographic questions in Part A, Likert scale responses for statements in Part B, and open-ended questions in Part C. This study is co-designed to relate to the results from an initial study that adopted PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and features analysis. The data from the initial study includes a review of 161 apps out of 1797 that have been identified. Five instructional features and nine functional features are presented. There are 35 SLPs participating in the survey. Their responses demonstrate evidence of SLPs’ knowledge and usage of speech therapy mobile applications. We will propose a conceptual framework for the features of speech therapy mobile applications, using people with aphasia as a point of reference for users with speech and language disorders

The Knowledge and Use of Speech Therapy Mobile Applications: Speech-Language Pathologists’ Perspectives in Malaysia

Technology incorporation in speech therapy has been growing over the years. Mobile applications are among the adoptions that facilitate delivering speech therapy services. The situation in Malaysia is discouraging because there are not enough speech-language pathologists (SLPs) to serve the growing number of populations. Despite the abundance of available speech therapy mobile applications in the market, there is a lack of information focusing on the SLP’s knowledge and usage perspectives, especially in Malaysia. The objectives of this study are to describe the knowledge and usage perspectives of speech therapy mobile applications among SLPs in Malaysia and to analyze the instructional features and functional features relationships within the perspectives of SLPs. Surveys are established in three parts, with demographic questions in Part A, Likert scale responses for statements in Part B, and open-ended questions in Part C. This study is co-designed to relate to the results from an initial study that adopted PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and features analysis. The data from the initial study includes a review of 161 apps out of 1797 that have been identified. Five instructional features and nine functional features are presented. There are 35 SLPs participating in the survey. Their responses demonstrate evidence of SLPs’ knowledge and usage of speech therapy mobile applications. We will propose a conceptual framework for the features of speech therapy mobile applications, using people with aphasia as a point of reference for users with speech and language disorders

A Virtual Conversational Agent for Teens with Autism: Experimental Results and Design Lessons

We present the design of an online social skills development interface for teenagers with autism spectrum disorder (ASD). The interface is intended to enable private conversation practice anywhere, anytime using a web-browser. Users converse informally with a virtual agent, receiving feedback on nonverbal cues in real-time, and summary feedback. The prototype was developed in consultation with an expert UX designer, two psychologists, and a pediatrician. Using the data from 47 individuals, feedback and dialogue generation were automated using a hidden Markov model and a schema-driven dialogue manager capable of handling multi-topic conversations. We conducted a study with nine high-functioning ASD teenagers. Through a thematic analysis of post-experiment interviews, identified several key design considerations, notably: 1) Users should be fully briefed at the outset about the purpose and limitations of the system, to avoid unrealistic expectations. 2) An interface should incorporate positive acknowledgment of behavior change. 3) Realistic appearance of a virtual agent and responsiveness are important in engaging users. 4) Conversation personalization, for instance in prompting laconic users for more input and reciprocal questions, would help the teenagers engage for longer terms and increase the system's utility

Fog Computing in Medical Internet-of-Things: Architecture, Implementation, and Applications

In the era when the market segment of Internet of Things (IoT) tops the chart in various business reports, it is apparently envisioned that the field of medicine expects to gain a large benefit from the explosion of wearables and internet-connected sensors that surround us to acquire and communicate unprecedented data on symptoms, medication, food intake, and daily-life activities impacting one's health and wellness. However, IoT-driven healthcare would have to overcome many barriers, such as: 1) There is an increasing demand for data storage on cloud servers where the analysis of the medical big data becomes increasingly complex, 2) The data, when communicated, are vulnerable to security and privacy issues, 3) The communication of the continuously collected data is not only costly but also energy hungry, 4) Operating and maintaining the sensors directly from the cloud servers are non-trial tasks. This book chapter defined Fog Computing in the context of medical IoT. Conceptually, Fog Computing is a service-oriented intermediate layer in IoT, providing the interfaces between the sensors and cloud servers for facilitating connectivity, data transfer, and queryable local database. The centerpiece of Fog computing is a low-power, intelligent, wireless, embedded computing node that carries out signal conditioning and data analytics on raw data collected from wearables or other medical sensors and offers efficient means to serve telehealth interventions. We implemented and tested an fog computing system using the Intel Edison and Raspberry Pi that allows acquisition, computing, storage and communication of the various medical data such as pathological speech data of individuals with speech disorders, Phonocardiogram (PCG) signal for heart rate estimation, and Electrocardiogram (ECG)-based Q, R, S detection.Comment: 29 pages, 30 figures, 5 tables. Keywords: Big Data, Body Area Network, Body Sensor Network, Edge Computing, Fog Computing, Medical Cyberphysical Systems, Medical Internet-of-Things, Telecare, Tele-treatment, Wearable Devices, Chapter in Handbook of Large-Scale Distributed Computing in Smart Healthcare (2017), Springe

Emotions in context: examining pervasive affective sensing systems, applications, and analyses

Pervasive sensing has opened up new opportunities for measuring our feelings and understanding our behavior by monitoring our affective states while mobile. This review paper surveys pervasive affect sensing by examining and considering three major elements of affective pervasive systems, namely; “sensing”, “analysis”, and “application”. Sensing investigates the different sensing modalities that are used in existing real-time affective applications, Analysis explores different approaches to emotion recognition and visualization based on different types of collected data, and Application investigates different leading areas of affective applications. For each of the three aspects, the paper includes an extensive survey of the literature and finally outlines some of challenges and future research opportunities of affective sensing in the context of pervasive computing

Speech-Language Pathologists\u27 Practices and Attitudes Toward App Use in Therapy

Numerous national surveys have established that Americans of all ages are using mobile technologies (e.g. cell phones, smartphones, and tablets) more than ever before (Pew Research Center, 2018; American Academy of Pediatrics, 2016a; American Academy of Pediatrics, 2016b; Reid-Chassiakos et al., 2016; Tsetsi & Rains, 2016; Kabali et al., 2015). In the same vein, Morris, Jones, and Sweatman (2016) found that Americans with visual, hearing, motor, learning, and speech disabilities area also engaging with apps on smartphone and tablet technologies for vocational, educational, and social purposes. Developers of the iOS and Android operating systems have prioritized user-friendly design and accessibility features to improve access of mobile technologies to the greatest number of users (“Android Accessibility Help,” 2017; Apple, 2017). Rehabilitation professionals are interested in changing or modifying behaviors to help their clients meet therapy goals and access high quality of life outcomes. Multiple resources have supported that people form new behaviors and habits related to use of their smartphones (Peters, 2009; Wood & Neal, 2008; Oulasvirta, Rattenbury, Ma, & Raita, 2012); therefore, smartphone apps could possibly assist rehabilitation professionals when providing treatment to people with disabilities. Other survey-based studies of Occupational Therapists (OTs) (Kyaio, 2015) and Speech-Language Pathologists (SLPs) (Zajc, Istenic-Starcic, Lebenicnik, & Gacnik, 2018) have confirmed that app-based interventions and therapy tools have already infiltrated the field of rehabilitation (Peters, 2009; Wood & Neal, 2008; Oulasvirta et al., 2012), despite the lack of evidence establishing the efficacy of many app-based interventions (Newmann, 2017; Papadakis, Kalogiannakis, & Zaranis, 2017b; Schoen-Simmons, Paul, & Shic, 2016; Erickson, 2015; Stone-MacDonald, 2014). Collectively, these studies highlight the urgency of integrating evidence-based practice (EBP) into an SLP’s service delivery decisions related to app use, especially now that apps and mobile technologies are being developed and available for purchase by the public at unprecedented rates. The purpose of this study was to survey practicing, certified SLPs in the U.S.A. to examine current attitudes and opinions toward the use of apps for purposes related to speech-language therapy. This survey was conducted utilizing the Qualtrics survey platform to maximize data security, access data, and perform data analysis. The web-based survey consisted of 48 questions which were designed to (1) examine common trends in demographic features of SLPs who use apps in therapy, (2) examine the purposes for which apps were used and which skills SLPs targeted when using apps in therapy, (3) examine the variety of barriers which SLPs may face when using apps or mobile technologies in therapy, and (4) examine the factors which SLPs consider when purchasing apps. There were 228 SLPs who participated in the study. All had their certificate of clinical competence (CCC-SLP) or were currently in their clinical fellowship year (CFY-SLP) and practiced in the United States of America. Results of the study indicate that therapists of varying demographic features who see patients across pediatric and adult settings are using apps to target therapy goals. Clinical implications and directions for future research are discussed

Cross validation of bi-modal health-related stress assessment

This study explores the feasibility of objective and ubiquitous stress assessment. 25 post-traumatic stress disorder patients participated in a controlled storytelling (ST) study and an ecologically valid reliving (RL) study. The two studies were meant to represent an early and a late therapy session, and each consisted of a "happy" and a "stress triggering" part. Two instruments were chosen to assess the stress level of the patients at various point in time during therapy: (i) speech, used as an objective and ubiquitous stress indicator and (ii) the subjective unit of distress (SUD), a clinically validated Likert scale. In total, 13 statistical parameters were derived from each of five speech features: amplitude, zero-crossings, power, high-frequency power, and pitch. To model the emotional state of the patients, 28 parameters were selected from this set by means of a linear regression model and, subsequently, compressed into 11 principal components. The SUD and speech model were cross-validated, using 3 machine learning algorithms. Between 90% (2 SUD levels) and 39% (10 SUD levels) correct classification was achieved. The two sessions could be discriminated in 89% (for ST) and 77% (for RL) of the cases. This report fills a gap between laboratory and clinical studies, and its results emphasize the usefulness of Computer Aided Diagnostics (CAD) for mental health care

The experiences and perspectives of overseas trained speech and language therapists working in the United Kingdom

There is a growing body of research which has investigated the experience of the migrant health worker. However, only one of these studies has included speech and language therapists thus far, and then only with extremely small numbers. The aim of this study was to explore the experiences and perspectives of migrant speech and language therapists living in the UK. Twenty-three overseas qualified speech and language therapists living in the UK completed an online survey consisting of 36 questions (31 closed question, 5 open-ended questions). The majority of participants came from Australia or the USA and moved to the UK early in their careers. Participants reported a range of benefits from working in another country and more specifically working in the UK. The findings were consistent with other research on migrant health workers regarding known pull factors of travel, finance, and career. This study suggests additional advantages to working in the UK were realised once participants had started working in the UK, such as the UK job lifestyle. Finally, the migrant speech and language therapists were similar in profile to other migrant health workers in terms of age and country of origin previously reported in the literature

CreaTable Content and Tangible Interaction in Aphasia

Multimedia digital content (combining pictures, text and music) is ubiquitous. The process of creating such content using existing tools typically requires complex, language-laden interactions which pose a challenge for users with aphasia (a language impairment following brain injury). Tangible interactions offer a potential means to address this challenge, however, there has been little work exploring their potential for this purpose. In this paper, we present CreaTable – a platform that enables us to explore tangible interaction as a means of supporting digital content creation for people with aphasia. We report details of the co-design of CreaTable and findings from a digital creativity workshop. Workshop findings indicated that CreaTable enabled people with aphasia to create something they would not otherwise have been able to. We report how users’ aphasia profiles affected their experience, describe tensions in collaborative content creation and provide insight into more accessible content creation using tangibles