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Telerehabilitation, Virtual Therapists, and Acquired Neurologic Speech and Language Disorders
Open accessAbstract
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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“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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 Investigating the utility of teletherapy in individuals with primary progressive aphasia (2019) · cites this paper as [51]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Research in stroke-induced aphasia has suggested that treatment outcomes between teletherapy and traditional in-person treatment are equivalent.50,51”
From Investigating the utility of teletherapy in individuals with primary progressive aphasia (2019) · cites this paper as [51]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
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Irani, D. J., Purmohammad, M., & Abbasian, S. (2025) · Applied Neuropsychology Adult · doi:10.1080/23279095.2025.2515127 · Cited by 1
Pervasive mobile application to assist elderly people with cognitive impairment
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Zobair, K. M. (2019) · Griffith Research Online · doi:10.25904/1912/1330 · Cited by 1
Cummings, L. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316796061.007 · Cited by 1
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Konnerup, U. (2016) · VBN Forskningsportal (Aalborg Universitet) · doi:10.3109/02699052.2016.1162060
RetractedTaylor, O. (2018) · The University of Queensland · doi:10.14264/uql.2018.357
The Profession of Speech and Language Therapy
Cummings, L. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316796061.008
Cummings, L. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316796061.006
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Medical and Scientific Disciplines
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Introduction to Speech-Language Neurology
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Cummings, L. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316796061.003
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Metadata
- 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
- 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
- green
- europepmc.org
- 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 › Health Professions › Speech and Hearing › 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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