Abstract
BackgroundSpeech and language pathologists (SLPs) deal with a wide spectrum of disorders, arising from many different conditions, that affect voice, speech, language, and swallowing capabilities in different ways. Therefore, the outcomes of Speech and Language Therapy (SLT) are highly dependent on the accurate, consistent, and complete design of personalized therapy plans. However, SLPs often have very limited time to work with their patients and to browse the large (and growing) catalogue of activities and specific exercises that can be put into therapy plans. As a consequence, many plans are suboptimal and fail to address the specific needs of each patient.ObjectiveWe aimed to evaluate an expert system that automatically generates plans for speech and language therapy, containing semiannual activities in the five areas of hearing, oral structure and function, linguistic formulation, expressive language and articulation, and receptive language. The goal was to assess whether the expert system speeds up the SLPs’ work and leads to more accurate, consistent, and complete therapy plans for their patients.MethodsWe examined the evaluation results of the SPELTA expert system in supporting the decision making of 4 SLPs treating children in three special education institutions in Ecuador. The expert system was first trained with data from 117 cases, including medical data; diagnosis for voice, speech, language and swallowing capabilities; and therapy plans created manually by the SLPs. It was then used to automatically generate new therapy plans for 13 new patients. The SLPs were finally asked to evaluate the accuracy, consistency, and completeness of those plans. A four-fold cross-validation experiment was also run on the original corpus of 117 cases in order to assess the significance of the results.ResultsThe evaluation showed that 87% of the outputs provided by the SPELTA expert system were considered valid therapy plans for the different areas. The SLPs rated the overall accuracy, consistency, and completeness of the proposed activities with 4.65, 4.6, and 4.6 points (to a maximum of 5), respectively. The ratings for the subplans generated for the areas of hearing, oral structure and function, and linguistic formulation were nearly perfect, whereas the subplans for expressive language and articulation and for receptive language failed to deal properly with some of the subject cases. Overall, the SLPs indicated that over 90% of the subplans generated automatically were “better than” or “as good as” what the SLPs would have created manually if given the average time they can devote to the task. The cross-validation experiment yielded very similar results.ConclusionsThe results show that the SPELTA expert system provides valuable input for SLPs to design proper therapy plans for their patients, in a shorter time and considering a larger set of activities than proceeding manually. The algorithms worked well even in the presence of a sparse corpus, and the evidence suggests that the system will become more reliable as it is trained with more subjects.
Highlights
Developing and maintaining proper communication skills is a mainstay for every individual to express needs, to learn, to be related with the environment and, in general, to have the opportunity to participate as an active member of society
The evaluation showed that 87% of the outputs provided by the SPEech and Language Therapy Assistant (SPELTA) expert system were considered valid therapy plans for the different areas
The results show that the SPELTA expert system provides valuable input for Speech and Language Pathologist Speech and Language Therapy (SLT) (SLP) to design proper therapy plans for their patients, in a shorter time and considering a larger set of activities than proceeding manually
Summary
Developing and maintaining proper communication skills is a mainstay for every individual to express needs, to learn, to be related with the environment and, in general, to have the opportunity to participate as an active member of society. According to the World Health Organization, individuals with communication difficulties are at a significant social disadvantage in both developing and developed countries [1] This disadvantage often affects a person’s emotional and social life and can compromise educational and job opportunities, in sectors where effective communication is critical, such as health care, education, local government, and justice. Based on figures like the 7.5 million people in the United States who have voice disorders, the 3 million who stutter, and the 6-8 million who have been diagnosed with some form of language impairment, the American Speech-Language-Hearing Association estimates that 40 million Americans are affected by communication disorders, costing the nation US $154-184 billion annually [6].
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