فناوری و تکامل روش بالینی برای لکنت زبان

The World Wide Web (WWW) was 20 years old last year. Enormous amounts of information about stuttering are now available to anyone who can access the Internet. Compared to 20 years ago, people who stutter and their families can now make more informed choices about speech-language interventions, from a distance. Blogs and chat rooms provide opportunities for people who stutter to share their experiences from a distance and to support one another. New technologies are also being adopted into speech-language pathology practice and service delivery. Telehealth is an exciting development as it means that treatment can now be made available to many rural and remotely located people who previously did not have access to it. Possible future technological developments for speech-language pathology practice include Internet based treatments and the use of Virtual Reality. Having speech and CBT treatments for stuttering available on the Internet would greatly increase their accessibility. Second Life also has exciting possibilities for people who stutter. Educational objectives: The reader will (1) explain how people who stutter and their families can get information about stuttering from the World Wide Web, (2) discuss how new technologies have been applied in speech-language pathology practice, and (3) summarize the principles and practice of telehealth delivery of services for people who stutter and their families.

We live in a rapidly growing technological age. It is now 40 years since the development of the Internet and 20 years since the conception and invention of the World Wide Web (WWW). The WWW is one of the many services running on the Internet. Access to information and communications technology is now widespread in developed countries and in many developing countries, and we can access and exploit relevant information about almost anything, with resources such as the popular web browser Google and the online peer-fed encyclopedia Wikipedia. We can communicate easily and effectively with friends, family and colleagues around the world with interactive resources such as Skype, both seeing and hearing our distance communication partner in real time. Email allows almost instantaneous text communications and cell phones allow for easy and convenient connections with speech and text, regardless of location. The WWW can be accessed in some fashion by many types of computers, PDAs, laptops, mobile phones and other inexpensive devices. In recent times, the technology for accessing all these advancements has become even cheaper, easier to use, more portable and publicly accepted. As well as increased communications, we now have an array of digital items on hand in everyday use such as cameras, camcorders, audio recorders, DVD players, microwave ovens, electronic games…. the list goes on and on. These technological developments have led to exciting changes in the area of health care. These are of course most notable in the in the area of diagnosis and treatment of disease, such as with body scanning techniques, radiotherapy and sophisticated surgical procedures. One development in the delivery of health care to emerge from the technological age is telemedicine (e.g., Balas et al., 1997). So, more specifically, what has the technological age delivered for people who stutter (PWS) and their families? Has the increased access to knowledge provided by the Internet empowered PWS and has it enriched their lives? And has the speech-language pathology profession exploited recent technological advances to improve services for PWS and their families? In this article, we first explore how PWS and their families have benefited from access to and sharing of information on the Internet. We then overview the contribution that advances in technology have made to speech-language pathology practice for stuttering. We conclude by suggesting some ways that clinical services for PWS and their families will change, hopefully for the better, with further technological developments. The use of technology is not without problems, however, and for this reason we have included caveats in some sections. This has been done to raise awareness of limitations and possible problems associated with the technology discussed.

The most striking developments for PWS and their families in this technological age are the availability of information on the Internet and the almost boundless opportunities for exchanges of information via blogs and chat rooms. As alluded to previously, this is empowering as it means that PWS now have access to considerable knowledge about stuttering and its treatment, as well as professionals. However, it can be said that over the last two decades or so there has been little technological advancement in day-to-day speech-language pathology practice for PWS. The development of AAF devices is innovative and potentially revolutionary; however, it seems that to date at least, they have failed to live up to the hype that accompanied their release on to the market. That is not to say that there is no reason for hope. There is considerable research being conducted into VR and service delivery models such as telehealth and Internet based treatments that may well change practices in the future, if they are shown to be safe and effective and if and when they are taken up by practitioners. Stuttering is a disorder of communication and speech-language therapy interventions have traditionally involved face-to-face contact. Speech-language pathologists may find themselves reluctant to move from this. However, some of these recent developments, such as Internet-based treatment, may also be used as a first step in stepped care or as an adjunct to face-to-face treatment. Importantly, as alluded to previously, there are many regions in the world where face-to-face treatment is simply not an option for PWS and their families, especially in developing countries. The speech-language pathology profession now needs to think outside the square and develop ways of making interventions accessible to all. New developments in technology promise experiences and treatment possibilities for PWS that would have been inconceivable 10 years ago. The technological age is upon us and the possibilities it offers are indeed exciting.