Access to Pediatric Voice Therapy: A Telehealth Solution

Children with voice disorders need therapy that requires specialized clinical skills optimally delivered by experienced voice specialists. However, individuals with those skills are in short supply, and trained voice specialists at public schools have high caseloads. Limited access to voice specialists is further exacerbated in rural and underserved areas of the country, where there are even fewer specialists.

This project tested a telehealth model of voice therapy service delivery for children with voice disorders. The research team assessed feasibility of the telehealth model including identification of adaptations required to improve the delivery of voice therapy via the Internet. Voice therapy was delivered in the child’s home or at the Center for Pediatric Voice Disorders at the Cincinnati Children’s Hospital. Study participants were 10 children between 8 and 15 years of age.

The specific aims of this project were as follows:

• Test a pilot program of personalized voice therapy in 10 children using a telehealth approach. 
• Explore the personal and interpersonal benefits and obstacles surrounding delivery of pediatric voice therapy using telehealth. 

First, the project team designed and tested the telehealth system that included a Web-based portal with interactive content and exercises to support voice therapy. Next, telehealth equipment was provided, and children and their families were trained to use the equipment. Children then received 8 weeks of voice therapy using the teleconferencing and Web-based systems.

Participants and clinicians strongly supported the use of telehealth to deliver voice therapy to children. While technology stability fluctuated due to variable Internet upload speeds at participants’ homes, most of these issues were overcome. One constraint was the acoustic fidelity of Internet transmission of the human voice. Importantly, parents reported that the system relieved numerous family burdens encountered when trying to access voice therapy for their child. While delivering health services through the Internet is a challenging paradigm shift, the clinicians and participants involved in this study indicated their acceptance of the technology and were eager to continue exploring this option.