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Cited by 117Telemedicine and Telehealth ImplementationVoice and Speech DisordersAssistive Technology in Communication and Mobility

Telerehabilitation, Virtual Therapists, and Acquired Neurologic Speech and Language Disorders

Open access
Cherney, Leora, van Vuuren, Sarel·2012·Seminars in Speech and Language
DOI 10.1055/s-0032-1320044PMC PMC3691350
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Abstract

Telerehabilitation (telerehab) offers cost-effective services that potentially can improve access to care for those with acquired neurologic communication disorders. However, regulatory issues including licensure, reimbursement, and threats to privacy and confidentiality hinder the routine implementation of telerehab services into the clinical setting. Despite these barriers, rapid technological advances and a growing body of research regarding the use of telerehab applications support its use. This article reviews the evidence related to acquired neurologic speech and language disorders in adults, focusing on studies that have been published since 2000. Research studies have used telerehab systems to assess and treat disorders including dysarthria, apraxia of speech, aphasia, and mild Alzheimer disease. They show that telerehab is a valid and reliable vehicle for delivering speech and language services. The studies represent a progression of technological advances in computing, Internet, and mobile technologies. They range on a continuum from working synchronously (in real-time) with a speech-language pathologist to working asynchronously (offline) with a stand-in virtual therapist. One such system that uses a virtual therapist for the treatment of aphasia, the Web-ORLA™ (Rehabilitation Institute of Chicago, Chicago, IL) system, is described in detail. Future directions for the advancement of telerehab for clinical practice are discussed.

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Crossref · 10.1055/s-0032-1320044

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  • ORLA utilizes repetitive multimodal stimulation to enhance real-time language output.

    “ORLA (Oral Reading for Language in Aphasia)11,12, a representative intervention derived from cognitive neuropsychological models of word processing, utilizes repetitive multimodal stimulation to enhance real-time language output13.”

    From ORLA combined with telerehabilitation in patients with subacute Poststroke aphasia: a randomized controlled trial (2025) · cites this paper as [13]

    The Treatment section describes ORLA as repeated oral reading and reports improvements in oral expression. The Asynchronous Treatment with a Virtual Therapist section describes spoken and highlighted-text cues, supporting the multimodal characterization. Neither section establishes that ORLA enhances language output in real time; the reported improvements concern treatment outcomes. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Teletherapy shows promising outcomes in the management of chronic aphasia, dysarthria, voice disorders and Alzheimer's dementia.

    “Teletherapy allows the individual to access services from the comfort of their home and shows promising outcomes in the management of chronic aphasia, dysarthria, voice disorders and Alzheimer’s dementia.”

    From <p>Investigating the utility of teletherapy in individuals with primary progressive aphasia</p> (2019) · cites this paper as [51]

    The Treatment sections (page numbers unavailable) report improvements with remote therapy for aphasia and for speech and voice difficulties associated with Parkinson’s disease and hypokinetic dysarthria. The Assessment section reports reliable remote language assessment in people with mild Alzheimer’s disease, not promising treatment outcomes for Alzheimer’s dementia. The evidence for voice treatment is also specific to Parkinson’s disease rather than voice disorders generally. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Research in stroke-induced aphasia has suggested that treatment outcomes between teletherapy and traditional in-person treatment are equivalent.

    “Research in stroke-induced aphasia has suggested that treatment outcomes between teletherapy and traditional in-person treatment are equivalent.50,51”

    From <p>Investigating the utility of teletherapy in individuals with primary progressive aphasia</p> (2019) · cites this paper as [51]

    The Treatment section reports improvements following telerehabilitation for people with aphasia, but does not establish that treatment outcomes were equivalent to in-person therapy. The Assessment section reports equivalence between remote and face-to-face encounters for stroke patients with aphasia; that finding concerns assessment, not treatment. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Most existing studies with VR-based cognitive rehabilitation focused on specific language domains such as word retrieval, sentence building, and language comprehension.

    “Most of the existing studies with VR-based cognitive rehabilitation focused on specific language domains [25–28], such as word retrieval [18, 19, 43, 44, 46–48], sentence building [20, 21], and language comprehension [22].”

    From Conversational Therapy through Semi-Immersive Virtual Reality Environments for Language Recovery and Psychological Well-Being in Post Stroke Aphasia (2020) · cites this paper as [44]

    The Treatment section describes remotely delivered word-retrieval therapy and says telerehabilitation treatment studies have largely addressed aphasia. It does not establish that most VR-based cognitive rehabilitation studies focused on specific language domains; the cited word-retrieval example used home computer software rather than a VR environment. No page number is available in our copy. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Previous studies have reported improvements in overall language ability with TR ORLA alone, with clinical changes primarily observed in single intervention for specific language subskills.

    “Previous studies10–14 have reported improvements in overall language ability with TR ORLA alone, with clinical changes primarily observed in single intervention for specific language subskills.”

    From ORLA combined with telerehabilitation in patients with subacute Poststroke aphasia: a randomized controlled trial (2025) · cites this paper as [13]

    The Treatment section reports that Web-ORLA, a telerehabilitation version of ORLA, produced statistically significant improvements in auditory comprehension, oral expression, and written expression among participants with aphasia. It supports improvement in specific language skills, but does not clearly establish improvement in overall language ability or say that clinical changes were primarily observed in a single intervention. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

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Research works printed but not linked: 2

  1. [59]Van Vuuren S Ngampatipatpong N Interactive Learning Assistants for Online and Mobile Accessibility Presented at: 1st IEEE conference on Accessing the Future Boston, MA July 19–20, 2009
  2. [60]Van Vuuren S Ngampatipatpong N Digital Agents for Mobile, Tablet and HTML5 based Interactive Prompting Presented at: 11th Annual Coleman Institute Conference Westminster, CO October 13, 2011

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Authors
Cherney, L., & van Vuuren, S.
Affiliations
  • Northwestern University (US)
  • Institute of Cognitive Science, University of Colorado Boulder, Boulder, Colorado
ORCID
Cherney, Leora
Venue
Seminars in Speech and Language
Publisher
Georg Thieme Verlag KG
Published
2012-07-31
Volume
33
Issue
03
Pages
243-258
ISSN
  • 0734-0478 (ISSN-L)
  • 1098-9056
DOI
10.1055/s-0032-1320044
PMC
PMC3691350
OpenAlex
W1984091377
Cited by
117
References
49
Citations by year
2026: 6 · 2025: 6 · 2024: 7 · 2023: 3 · 2022: 10 · 2021: 13 · 2020: 7 · 2019: 6 · 2018: 19 · 2017: 9 · 2016: 11 · 2015: 10 · 2014: 6 · 2013: 4
FWCI
6.17
Type
journal article
Language
en
Open access
Locations
  • Seminars in Speech and Language (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Deafness and Other Communication Disorders (R01DC011754)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Health Sciences › Medicine › Physiology › Voice and Speech Disorders
  • Health Sciences › Health Professions › Occupational Therapy › Assistive Technology in Communication and Mobility
Keywords
telerehabilitation, virtual therapists, aphasia, apraxia of speech, dysarthria, mild Alzheimer disease, speech-language pathology services, telepractice, health care access, regulatory challenges, privacy and confidentiality, mobile technology
MeSH terms
Adult, Humans, Language Disorders, Speech Disorders, Speech Therapy, Telemedicine

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