Telemedicine for voice, speech therapy poses challenges for effectively evaluating treatment

As an outcome of the COVID pandemic, people globally experienced how teleconferencing platforms help them stay connected with one another. However, in regards to telemedicine, not all medical care is easily translated to a remote format.

In a virtual world, voice therapy presents a unique challenge because clinicians must rely on acoustic recordings of voice to evaluate the effectiveness of their treatments. But many teleconferencing platforms distort sounds in their efforts to eliminate background noise. These findings were published in the Journal of Speech-Language and Hearing Research.

Boston University graduate researcher Hasini Weerathunge wanted to find out if popular teleconferencing platforms used for telemedicine could capture sounds accurately enough for clinicians to successfully treat and evaluate patients with voice and speech disorders. Weerathunge, a graduate student fellow at BU's Rafik B.

Hariri Institute for Computing and Computational Science and Engineering, and a PhD candidate in biomedical engineering, does research in the lab of Cara Stepp, a College of Health & Rehabilitation Sciences: Sargent College associate professor of speech, language, and hearing sciences.

"Although the COVID-19 crisis appears to be waning, telepractice popularity is here to stay," Stepp says.

Weerathunge and Stepp teamed up with other BU researchers to put five different HIPAA-compliant teleconferencing platforms to the test: Cisco Webex, Microsoft Teams, Doxy.me, VSee Messenger, and Zoom.

As the pandemic unfolded and lockdowns moved much voice and speech therapy online, "there was no consensus among [voice and speech] clinicians [who were] trying to convert to telepractice therapy, and we wanted to determine the accuracy of the acoustic measures they can get through telepractice," Weerathunge says.

Although voice therapists had sometimes conducted telepractice sessions with patients before the pandemic, evaluations of the effectiveness of treatment were always carried out in person. During that process, a patient goes into the clinic and sits in a soundproof booth outfitted for speech recordings.

The patient repeats sustained vowel sounds, like "aaa" or "ooo," or reads a short passage that reflects a wide variety of sounds and mouth movements in the English language. The recordings of the patient's voice are then evaluated by algorithms that measure acoustic properties, including the acoustic correlates of perceived pitch and loudness of the voice.