Mayo Clinic ProceedingsTelemedicine and the Diagnosis of Speech and Language Disorders
Section snippets
METHODS
Environment and Examination Protocol (ACTS Project and Mayo TMCs).—The teleconference environment during the ACTS project and the Mayo TMCs enabled patients to see the clinician—usually from the waist up—on a television monitor. The loudness could be adjusted to a comfortable listening level. An overhead camera allowed projection of pictures and printed materials on the monitor, and size and focus were adjustable by the clinician or technical assistant.
The camera could be adjusted to provide
RESULTS
ACTS Project.—The characteristics of the eight patients who underwent assessment for the ACTS project are summarized in Table 1. Seven patients had a history of central nervous system disease and had signs and symptoms beyond those reflected in their speech and language. The duration of their disorders ranged from several months to 18 years. One patient had a long history of an unexplained voice problem. Five of the eight patients had hearing loss, visual impairment, or cognitive impairment; in
DISCUSSION
Our experiences with telemedicine have been positive for participating clinicians, referring health-care providers, and patients and their caregivers. They demonstrate that speech pathology consultation-by-satellite to both rural areas and large multidisciplinary medical settings can contribute to medical diagnosis and management of numerous communication disorders. The contributions range from evaluation and management recommendations for disorders commonly dealt with by speech-language
CONCLUSION
Our experience supports the conclusion that telemedicine is an appropriate medium for providing speech-language pathology consultation that is reliably accurate in identifying various acquired neurogenic and psychogenic speech disorders, with implications for lesion localization and, sometimes, specific medical diagnosis. Such evaluation may also identify a need for additional medical assessment or may help formulate appropriate medical or behavioral management strategies. Telemedicine
ACKNOWLEDGMENT
We thank the many members of the Mayo Foundation Video Communications staff who contributed to the ACTS project and to our Mayo TMCs. We appreciated the technical and administrative support and encouragement of Bijoy K. Khandheria, M.D., Marvin P. Mitchell, Abdul R. Bengali, Michael B. Wood, M.D., and Barry K. Gilbert, Ph.D., during the NASA project. We also thank the staff at St. Elizabeth's Hospital in Wabasha, Minnesota, for assistance in identifying and facilitating the assessment of
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Appraisal and diagnosis of neurogenic communication disorders in remote settings
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