Improving Efficacy of Voice Therapy Concepts via Telepractice and Mobile App Technology

7.项目摘要/摘要 由于新冠肺炎的流行，远程实践得到了快速增长。到目前为止，同步远程练习(即， 在实时视频会议中)一直是异步远程实践(即 稍后存储和访问的信息)最小限度地仅用于记录同步相遇。 对声音治疗概念的描述在文献中极少可用，没有标准的报告 框架，没有临床疗效或疗效数据。因此，拟议的研究将解决这些障碍。 首先，将开发一种异步方法，通过以下方式影响面对面和远程实践服务 在客户的环境中提供反复学习的机会。该方法包括生态瞬时 通过灵活的日常语音治疗实践应用程序、服务器和Web门户进行干预(EMI) 编程以满足客户的需求，提供性能反馈，并随时间推移绘制结果图表。 其次，声音疗法的概念将被测试，以提高我们对这些概念的了解，从而促进 成功的以客户为中心的语音问题预防和治疗结果。参加会议的人员 这项研究将对那些嗓音问题患病率较高的教师，在影响医疗系统的时候 需要治疗，并在课堂交流中对学生的学习能力产生负面影响 嗓音有问题。第三，将使用康复治疗规范系统(RTSS)框架 描述发声疗法的概念。这些概念包括：训练多个声音，以满足所有客户的 声音需求，通过声音产生系统的解剖学和生理学来定义声音质量， 将语音目标泛化为层次化的语音任务，并使用“新”或“其他/旧”的语音来帮助客户 成为自己的临床医生。嗓音健康的实习教师和有发声抱怨的专业教师 将被随机分为四种通过远程练习提供的声音治疗条件之一。两组教师 需要对预防和治疗的概念进行评估。条件2，它完全表示 提出的声音治疗概念将优于其他三种情况，这三种情况并不完全代表 概念，通过证明客户报告的声音的主要结果衡量标准有更大的下降 残障指数-10和发声疲劳指数的因子1和2。声学测量的次要结果， 博格人类别比率-10个发声和精神努力量表，以及发声治疗满意度调查也将 调查过了。通过推进异步远程实践和通过以下方式，结果将在实践层面上有用 提高嗓音治疗理念的疗效。此外，研究结果还将为今后的研究奠定基础 参与开发语音-语言病理的其他领域的EMI平台，并测试其他 促进以客户为中心的成功结果的声音治疗理念。

7. PROJECT SUMMARY/ABSTRACT Due to the COVID-19 pandemic, telepractice has grown rapidly. To date, synchronous telepractice (i.e., in real-time videoconferencing) has been the focus of most research with asynchronous telepractice (i.e. information stored and accessed later) being used minimally only to record synchronous encounters. Descriptions of voice therapy concepts are minimally available in the literature with no standard reporting framework and no clinical efficacy or effectiveness data. Thus, the proposed study will address these barriers. First, an asynchronous method will be developed that will impact both in-person and telepractice services by offering repeated learning opportunities in the client’s environment. The method includes ecological momentary intervention (EMI) through a daily voice therapy practice app, server, and web portal that is flexible in its programming to meet the needs of the client, offers performance feedback, and charts results over time. Second, voice therapy concepts will be tested improving our knowledge about such concepts that facilitate successful client-centered outcomes for both prevention and treatment of voice problems. The participants in the study will be teachers who have a high prevalence of voice problems, impact the healthcare system when treatment is needed, and negatively affect students’ learning abilities in the classroom when communicating with a voice problem. Third, the Rehabilitation Treatment Specification System (RTSS) framework will be used to describe the voice therapy concepts. The concepts include: training multiple voices to meet all the clients’ vocal needs, defining voice qualities by the anatomy and physiology of the voice production system, generalizing voice targets into hierarchical speech tasks, and using “new” vs “other/old” voice to help the client become their own clinician. Vocally healthy student teachers and professional teachers with voice complaints will be randomized into one of four voice therapy conditions delivered via telepractice. Both groups of teachers are needed to assess the concepts for prevention and treatment. Condition 2, which fully represents the proposed voice therapy concepts, will be superior to the other three conditions, which do not fully represent the concepts, by demonstrating a greater decrease in client-reported primary outcome measures of the Voice Handicap Index-10 and factor 1 and 2 of the Vocal Fatigue Index. Secondary outcomes of acoustic measures, Borg Category Ratio-10 scales for vocal and mental effort, and voice therapy satisfaction surveys will also be investigated. The results will be useful at a practical level by advancing asynchronous telepractice and by improving efficacy of voice therapy concepts. In addition, the results will lay the groundwork for future studies involving development of EMI platforms in other areas of speech-language pathology and testing additional voice therapy concepts that facilitate successful client-centered outcomes.