Access to Pediatric Voice Therapy: A Telehealth Solution

描述(由申请人提供)：患有发音障碍(发音困难)的儿童在社会和教育方面处于明显的不利地位，获得适当的诊断和治疗服务可能很困难。儿童发音困难与社交退缩和抑郁有关，这会对社会、情感、教育和职业结果产生负面影响。语音(语音)和视频数据的安全互联网传输正在成为增加患者获得专门的联合保健服务的有效手段，但儿童语音障碍的治疗还不在其中。鉴于需要获得高度专业化的临床技能，有文件证明个人发声治疗适合成人的这种护理模式，将远程保健的概念扩展到儿童发声障碍的治疗是一个新颖的步骤，尽管这是合乎逻辑的。这项研究的目的是确定使用远程健康解决方案通过安全的电话会议和基于Web的系统提供儿科语音治疗的可行性。我们还将收集初步疗效数据，并仔细评估患者、家庭和儿科语音护理专家使用远程保健的情况。激励性的假设是，通过远程医疗对儿科语音护理进行知情、可行和个性化的方法是可能的，并将改善患者获得高质量护理的机会，并带来更多自我管理和临床监测的机会。此应用程序符合为PAR-08-269列出的文档标准。它旨在支持以患者为中心的护理和跨环境提供护理(例如，基于医院的到家服务)。本次调查旨在为更大的R01应用程序收集初步数据。从长远来看，我们的目标是证明这种服务提供模式可以标准化，并用于持续提供高水平的护理，评估治疗结果，并减少儿童发声障碍的慢性性质。随着时间的推移，它可以应用于其他儿童沟通障碍。我们预计，远程保健方法还将减轻家庭在获取、旅行和 家庭日程安排和日程安排疗法的复杂性。我们计划通过以下具体目标来实现本应用的目标：1)。使用远程健康方法在10名儿童中测试个性化语音治疗的试点计划。评估同步互联网和基于网络的音频/视频数据传输的质量和稳定性以及衡量治疗进展将是这一目标的主要组成部分；以及2)。探讨使用远程保健进行儿科发声治疗所带来的个人和人际利益以及相关障碍。结果衡量标准将包括满意度、合规性和成本。我们还将寻求确定通过互联网提供声音治疗需要进行哪些调整。我们的发现将为这种类型的患者护理提供与所需技术设备、互联网操作的可靠性和Web门户访问相关的系统能力和可靠性的证据。在这个项目结束时，我们将能够向传统医疗保健和远程医疗专业人员通报我们的患者使用技术作为其护理的基本成分的能力。我们将拥有必要的初步数据，以开发一项基于结果的大型疗效研究，比较这一重要人群的面对面(FTF)和远程医疗(TH)选择。

DESCRIPTION (provided by applicant): Children with voice disorders (dysphonia) are at a distinct social and educational disadvantage and access to adequate services for diagnosis and treatment can be difficult. Childhood dysphonia is associated with social withdrawal and depression that can negatively influence social, emotional, educational and occupational outcomes. Secure Internet transmission of voice (speech) and visual data is emerging as an effective means by which to increase patient access to specialized allied health services but treatment of childhood voice disorders is not yet among them. Given the need for access to highly specialized clinical skills, the documented suitability of individual voice therapy to this model of care in adults, extending the telehealth concept to treatment of pediatric voice disorders is a novel, albeit logical step. The purpose of this study is to determine the feasibilit of using a telehealth solution for delivering pediatric voice therapy via secure teleconferencing and Web-based systems. We will also gather preliminary efficacy data and carefully evaluate the use of telehealth by patients, families and pediatric voice care specialists. The motivating hypothesis is that an informed, feasible and personalized approach to pediatric voice care via telehealth is possible and will result in improved patient access to quality care and result in greater opportunity for self management and clinical monitoring. This application responds to the documented criteria listed for PAR-08-269. It aims to support patient centered care and the delivery of care across settings (e.g., hospital based service to home). This investigation is intended to collect preliminary data for a larger R01 application. Long-term we aim to prove that this model of service delivery can be standardized and used to consistently deliver a high level of care, evaluate treatment outcomes and reduce the chronic nature of childhood voice disorders. In time its application to other childhood communication disorders can be made. We expect that a telehealth approach will also relieve a family's burden related to access, travel and the complex nature of family schedules and scheduling therapy. We plan to accomplish the objectives of this application by the following specific aims: 1). Test a pilot program of personalized voice therapy in ten children using a telehealth approach. Assessing the quality and stability of synchronous Internet and Web-based audio/video data transmission and measuring progress in therapy will be the principal components of this aim; and 2). Explore the personal and interpersonal benefits and obstacles surrounding delivery of pediatric voice therapy using telehealth. Outcome measures will include satisfaction, compliance, and cost. We will also seek to identify what adaptations are needed to deliver voice therapy via the Internet. Our findings will provide proof of systems capability and reliability relative to the needed technical equipment, reliability of Internet operations and Web-portal access for this type of patient care. At the conclusion of this project we will be able to inform traditional healthcare an telehealth professionals about the ability of our patients to the use technology as an essential ingredient of their care. We will have the necessary preliminary data to develop a large outcomes based efficacy study that compares face to face (FTF) and telehealth (TH) options for this important population.