Abstract
Telerehabilitation (telerehab) offers cost-effective services that potentially can
improve access to care for those with acquired neurologic communication disorders.
However, regulatory issues including licensure, reimbursement, and threats to privacy
and confidentiality hinder the routine implementation of telerehab services into the
clinical setting. Despite these barriers, rapid technological advances and a growing
body of research regarding the use of telerehab applications support its use. This
article reviews the evidence related to acquired neurologic speech and language disorders
in adults, focusing on studies that have been published since 2000. Research studies
have used telerehab systems to assess and treat disorders including dysarthria, apraxia
of speech, aphasia, and mild Alzheimer disease. They show that telerehab is a valid
and reliable vehicle for delivering speech and language services. The studies represent
a progression of technological advances in computing, Internet, and mobile technologies.
They range on a continuum from working synchronously (in real-time) with a speech-language
pathologist to working asynchronously (offline) with a stand-in virtual therapist.
One such system that uses a virtual therapist for the treatment of aphasia, the Web-ORLA™
(Rehabilitation Institute of Chicago, Chicago, IL) system, is described in detail.
Future directions for the advancement of telerehab for clinical practice are discussed.
Keywords
Telerehabilitation - telepractice - dysarthria - apraxia of speech - aphasia - virtual
therapist - assessment - treatment
