title: Assessing children's speech intelligibility and oral structures, and functions via an Internet-based telehealth system.
abstract: We examined the validity and reliability of an Internet-based telehealth system for screening speech intelligibility and oro-motor structure, and function in children with speech disorders. Twenty children aged 4-9 years were assessed by a clinician in the conventional, face-to-face (FTF) manner; simultaneously, they were assessed by a second clinician via the videoconferencing system using a 128-kbit/s Internet connection. Speech intelligibility in conversation was rated and an informal assessment of oro-motor structure and function was conducted. There was a high level of agreement between the online and FTF speech intelligibility ratings, with 70% exact agreement and 100% close agreement (within ± point on a 5-point scale). The weighted kappa statistic revealed very good agreement between raters (kappa = 0.86). Data for online and FTF ratings of oro-motor function revealed overall exact agreement of 73%, close agreement of 96%, moderate or good strength of agreement for six variables (kappa = 0.48-0.74), and poor to fair agreement for six variables (kappa = 0.12-0.36). Intra- and inter-rater reliability measures (ICCs) were similar between the online and FTF assessments. Low levels of agreement for some oro-motor variables highlighted the subjectivity of this assessment. However, the overall results support the validity and reliability of Internet-based screening of speech intelligibility and oro-motor function in children with speech disorders.
authors.affiliation: Division of Speech Pathology, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia. m.waite@uq.edu.au
authors.forename: Monique C
authors.initials: MC
authors.lastname: Waite
authors.forename: Deborah G
authors.initials: DG
authors.lastname: Theodoros
authors.forename: Trevor G
authors.initials: TG
authors.lastname: Russell
authors.forename: Louise M
authors.initials: LM
authors.lastname: Cahill
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008403:Mass Screening / Q000379:methods; D019114:Remote Consultation / Q000592:standards; D015203:Reproducibility of Results; D013062:Speech Articulation Tests / Q000379:methods; D013064:Speech Disorders / Q000175:diagnosis*; D013065:Speech Intelligibility; D013066:Speech-Language Pathology / Q000379:methods*