Telepractice vs. in-person therapy for persons with laryngectomy: Advantages and challenges

Research Objectives: To Identify considerations for voice treatment via telepractice.
To compare therapy for persons with laryngectomy via telepractice and in-person.
To discuss the advantages and challenges of treatment via telepractice vs. in-person.

Design: This research is a single-subject case study.

Setting: This study took place at a university outpatient clinic and via telepractice.

Participants: A 53-year-old male s/p laryngectomy 15 months.

Interventions: Speech therapy was provided to work on voicing using the electrolarynx. Therapy sessions were held in-person and via telepractice

Main Outcome Measures: Speech intelligibility at the word, sentence, and conversation level during in-person therapy sessions and telepractice therapy sessions.

Results: Benefits to telepractice including safety and convenience; however, unique challenges arose when treating this client, particularly due to the acoustic differences of an alaryngeal voice on telepractice platforms, the client's use of non-speech communication (typing in the chat) during communication breakdowns during telepractice sessions, and decreased intelligibility of speech during telepractice sessions. Intelligibility at the word, sentence, and conversation level was lower during telepractice therapy sessions when compared to in-person sessions.

Conclusions: This case study highlights the advantages and challenges of telepractice services when working with a person with a laryngectomy, during telepractice and in-person therapy. Speech-language pathologists must consider the advantages and challenges of both modes of therapy when working with persons with laryngectomy since alaryngeal voice has different acoustic features than the laryngeal voice.

Author(s) Disclosures: Miriam Carroll-Alfano, Ph.D., CCC-SLP is a paid employee of Midwestern University