Journal of Communication Disorders最新文献

{"title":"The main concept analysis: Sensitivity, specificity and inter-rater reliability in Dutch-speaking people with aphasia","authors":"Yana Criel ,&nbsp;Evelien De Groote ,&nbsp;Evelyne Benbassat ,&nbsp;Britt Beirinckx ,&nbsp;Megan Van Damme ,&nbsp;Anthony Pak-Hin Kong ,&nbsp;Miet De Letter","doi":"10.1016/j.jcomdis.2025.106543","DOIUrl":"10.1016/j.jcomdis.2025.106543","url":null,"abstract":"<div><h3>Aims</h3><div>This study aimed to assess the sensitivity, specificity and inter-rater reliability of the Dutch Main Concept Analysis (MCA), a diagnostic tool that evaluates the effectiveness and efficiency of information transfer during verbal discourse production, in people with aphasia (PWA).</div></div><div><h3>Methods</h3><div>The MCA was administered to 30 persons with aphasia (17 fluent, 13 nonfluent). Sensitivity and specificity were assessed through (1) single-subject level comparison of MCA scores to normative data, (2) group-level comparison of MCA scores between PWA and 30 age-matched controls, and (3) ROC-analysis for total main concept score (MCS; effectiveness) and total number of accurate and complete main concepts per minute (AC/min; efficiency). Furthermore, the effect of aphasia type (fluent/nonfluent) and severity on these measures was assessed using a linear regression. Discourse samples were scored by two independent raters to calculate inter-rater reliability.</div></div><div><h3>Results</h3><div>Over 85 % of PWA showed aberrant outcomes on at least four out of seven MCA outcomes based on single-subject comparison to normative data. ROC analysis revealed that MCS and AC/min are sensitive and specific measures to differentiate between discourse of PWA and unimpaired speakers. Increased aphasia severity was associated with a reduced MCS. Good to excellent inter-rater reliability was achieved for all MCA measures.</div></div><div><h3>Conclusion</h3><div>The Dutch MCA is a sensitive and specific tool, characterized by a good to excellent inter-rater reliability, for identifying impaired effectiveness and efficiency of verbal information transfer during discourse production in PWA. Aphasia severity, but not type, is a determining factor for the effectiveness of information transfer in PWA.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"116 ","pages":"Article 106543"},"PeriodicalIF":1.8,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity of a new parent-report instrument determining the developmental language level and verbal status of children with communication disorders in Cyprus","authors":"Margarita Kilili-Lesta,&nbsp;Konstantinos Giannakou,&nbsp;Louiza Voniati","doi":"10.1016/j.jcomdis.2025.106542","DOIUrl":"10.1016/j.jcomdis.2025.106542","url":null,"abstract":"<div><div>The validity and reliability of the new parent-report questionnaire <em>Developmental/Verbal Language Phase</em> (DeVLP) was examined, in determining the developmental language phase (DLP) and nonverbal/minimally verbal (NV/MV) linguistic status of children with communication disorders. The scarcity of parent-report linguistic tools in Greek/Cypriot Greek emphasized its need.</div><div>Fifty 3–12-year-old children receiving private speech-language therapy in Cyprus participated through convenience sampling. Data was collected online between February 20 and June 23, 2023, regarding epidemiological, family, perinatal, developmental, and linguistic information. For criterion-referenced validity, parents’ and speech-language pathologists’ (SLPs) responses for 64.0 % of the sample were compared to the language sample analysis (LSA) by independent SLPs. For test-retest reliability, parent results were compared at two time-points, and for inter-rater reliability, with SLPs’ results.</div><div>DeVLP demonstrated strong validity for DLP both by parents and SLPs in all language domains (PCC=0.72–0.96, <em>p</em> &lt; .05), compared to LSA. For NV/MV status, parents presented strong validity in overall language (PCC=0.79, <em>p</em> &lt; 0.05), in contrast to weak validity by SLPs (PCC=0.39, <em>p</em> &lt; .05). With excellent specificity (100 %) and sensitivity at 67 %, it displayed an 83 % probability of distinguishing between NV/MV and verbal status in children. Reliability was good-to-excellent (ICC=0.74–1.00, <em>p</em> &lt; .05) across all domains and overall language.</div><div>The questionnaire was relatively valid and strongly reliable in determining the DLP and verbal status of Cypriot children with communication disorders. It offered potential clinical utility within evaluation protocols for language assessment and uniform identification of NV/MV status. Future research is needed to verify validity, especially for children with autism.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"116 ","pages":"Article 106542"},"PeriodicalIF":1.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring cognitive predictors of language in children with developmental language disorder: The role of nonverbal IQ, working memory, implicit statistical learning, and speed of automatization","authors":"Ashley Blake ,&nbsp;Ewa Dąbrowska ,&nbsp;Nick Riches","doi":"10.1016/j.jcomdis.2025.106541","DOIUrl":"10.1016/j.jcomdis.2025.106541","url":null,"abstract":"<div><div>Children with developmental language disorder (DLD) have varied strengths and difficulties in both language and cognition but we do not yet have a comprehensive understanding as to how these abilities are interrelated. In this study, we explore performance in language typical children and children with DLD to evaluate how different areas of nonverbal cognition predict linguistic outcomes. We investigate nonverbal intelligence, working memory, implicit statistical learning, and the speed of automatization. 77 children (54 language typical children and 23 children with DLD), aged between 6;9 and 10;8 years, completed a battery of cognitive and language tasks. Our results show between-group differences in both language and cognitive abilities. We propose a cumulative risk model, suggesting that important predictors of language in children with DLD are a combination of nonverbal working memory, nonverbal intelligence, and the speed of automatization.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"116 ","pages":"Article 106541"},"PeriodicalIF":1.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speech-language pathologists' views on visual discourse elicitation materials for cognitive communication disorder after TBI: An exploratory study","authors":"Kai Yuan Lim ,&nbsp;Elizabeth Spencer ,&nbsp;Elise Bogart ,&nbsp;Joanne Steel","doi":"10.1016/j.jcomdis.2025.106540","DOIUrl":"10.1016/j.jcomdis.2025.106540","url":null,"abstract":"<div><h3>Background</h3><div>Spoken discourse is elicited as part of speech-language pathology (SLP) practice after traumatic brain injury (TBI). Research literature reports on a range of monologic tasks for eliciting discourse samples, including different visual stimuli. The preferences of SLPs for these materials has not previously been investigated.</div></div><div><h3>Aims</h3><div>To explore the practice and views of SLPs on available visual discourse elicitation stimuli, specifically the clinical utility and acceptability of these tasks, and alignment with materials reported in research studies. We also sought SLPs’ perspectives on future discourse elicitation task development.</div></div><div><h3>Methods &amp; Procedures</h3><div>We conducted a survey of Australian SLPs working with adults with cognitive-communication disorder post TBI. SLPs were asked about their use of and preferences around visual imagery, client engagement with visuals, and their suggestions for future stimuli development. Survey responses were analysed using descriptive statistics, and free text responses provided qualitative insights.</div></div><div><h3>Outcomes &amp; Results</h3><div>Responses from 17 SLPs were included in the study. SLPs reported The Cookie Theft picture as the most frequently used visual stimulus. Reasons for use included familiarity with the task, ability to generate sample of sufficient length and complexity, and its accessibility. There were no strong preferences for any visual materials reported in this survey; however, overall, participants reported finding the existing visual materials to be unsatisfactory. Factors affecting choice of visual stimuli included the client’s visual abilities, interests, age-group, and severity of injury.</div></div><div><h3>Conclusion &amp; Implications</h3><div>This exploratory study provided insight into SLPs' views on visual elicitation stimuli for discourse post-TBI, a largely unexamined area. The current findings contribute to limited knowledge of stakeholder views on elicitation tasks and will inform future research on discourse resource development after TBI.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"116 ","pages":"Article 106540"},"PeriodicalIF":1.8,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the use of artificial language learning (ALL) paradigms to differentiate intrinsic versus extrinsic sources of language impairment","authors":"Liron Reznik-Nevet ,&nbsp;David L. Share ,&nbsp;Ravit Cohen-Mimran","doi":"10.1016/j.jcomdis.2025.106532","DOIUrl":"10.1016/j.jcomdis.2025.106532","url":null,"abstract":"<div><h3>Purpose</h3><div>The current investigation aimed to explore the potential of Artificial Language Learning (ALL) paradigms to distinguish between poor language abilities due to intrinsic difficulties in language learning as opposed to difficulties stemming from extrinsic factors such as environmental factors.</div></div><div><h3>Method</h3><div>Using a 2-step population-based screening procedure, 35 children from mid-high SES with presumed developmental language disorders (pDLD) were compared to an unselected sample of 33 children from low SES on measures of accumulated lexical and morphological knowledge and on tasks assessing lexical and morphological learning ability using artificial language learning (ALL) paradigms.</div></div><div><h3>Results</h3><div>No significant differences between the pDLD and the low-SES groups were found on lexical and morphological knowledge. However, the low-SES group outperformed the pDLD group in both learning an artificial morphological rule and learning new pseudowords.</div></div><div><h3>Conclusions</h3><div>These findings indicate that children from low SES, as a group, exhibit diminished language performance similar to that of children with pDLD when tested on conventional measures of accumulated linguistic knowledge yet outperform children with (persumed) DLD when assessed on their ability to learn and make use of new linguistic information to extract morphological rules and establish novel lexical representations. The potential of ALL paradigms in this population is discussed.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"116 ","pages":"Article 106532"},"PeriodicalIF":1.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and associated factors of voice symptoms among Mexican prospective teachers: A cross-sectional study","authors":"Lady Catherine Cantor-Cutiva ,&nbsp;Carlos Manzano ,&nbsp;Eric J. Hunter","doi":"10.1016/j.jcomdis.2025.106531","DOIUrl":"10.1016/j.jcomdis.2025.106531","url":null,"abstract":"<div><h3>Aims</h3><div>This study aimed to determine the prevalence and associated factors of voice symptoms among Mexican prospective teachers.</div></div><div><h3>Method</h3><div>This cross-sectional study was conducted in the fall of 2023. Data was collected from all four years of the teacher education program offered by participating institutions. A total of 1233 students participated across the four institutions. Before completing the questionnaire, students read and virtually signed an informed consent form outlining the study's details and their rights. A self-report web-based questionnaire was developed for this study consisting of the following: (1) demographic details, (2) educational details, (3) lifestyle habits, and (4) use of health care services due to voice symptoms. Further, participants completed the Spanish version of the Voice Symptom Scale (VoiSS), the Vocal Fatigue Index (VFI), and the Screening Index for Voice Disorder (SIVD).</div></div><div><h3>Results</h3><div>The prevalence of voice symptoms varied depending on the instrument used. The perception of dust in the practicum placement was the most significant teaching-training condition associated with voice symptoms reported using different scales (VoiSS, OR = 2.00; SIVD, OR = 2.08) and being statistically associated with tiredness of voice (Factor 1 of the VFI) (OR = 1.72). Prospective teachers in their third year of training or who were starting their practicum placement were more likely to report voice symptoms measured using all the scales (VFI Factors 1 and 2, VoiSS, and SIVD).</div></div><div><h3>Discussion and conclusion</h3><div>Before experiencing the full occupational vocal demands of the teaching profession, prospective teachers may be exposed to teaching-training conditions that increase their likelihood of reporting voice symptoms. There may be an opportunity for implementing early intervention and education programs by identifying associated demands and the prevalence of voice symptoms during prospective teachers’ training.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"116 ","pages":"Article 106531"},"PeriodicalIF":1.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peer attitudes towards children with cleft lip and palate: An interaction of visual and auditory cues?","authors":"Kim Bettens ,&nbsp;Karen De Keyser ,&nbsp;Kristiane Van Lierde","doi":"10.1016/j.jcomdis.2025.106530","DOIUrl":"10.1016/j.jcomdis.2025.106530","url":null,"abstract":"<div><h3>Background and aims</h3><div>For children with speech disorders related to cleft palate with or without cleft lip (CP±<em>L</em>), effective communication presents significant challenges. Listeners often form judgments based on the speech signal, contributing to stigmatization and negative stereotyping. When a child also has a cleft lip, perceptions may be further influenced. Limited research has explored peer attitudes towards individuals with CP±<em>L</em> using audiovisual stimuli. This study aimed to examine peer attitudes of children towards children with CP±<em>L</em>, analyzing how these attitudes vary based on auditory, visual, and audiovisual cues and cleft type. Additionally, the relationship between speech intelligibility, speech acceptability, and social acceptance was evaluated.</div></div><div><h3>Method</h3><div>Audio samples, photographs, and audiovisual samples were collected from 11 Caucasian children: four with cleft palate (CP), four with cleft lip and palate (CLP) and three typically developing children without cleft. These stimuli were judged by 48 typically developing peers aged 7 to 12 (24 boys, 24 girls) based on three attitude components, i.e. cognitive, affective and behavioral. They also rated speech intelligibility and acceptability. Correlations were calculated between the attitude components and speech intelligibility/acceptability. The impact of the medium on peer attitudes per cleft type was verified.</div></div><div><h3>Results</h3><div>Strong and significant positive correlations were found between all attitude dimensions and the mean speech intelligibility and speech acceptability scores given by peers, particularly with audio and audiovisual samples. Deviant speech (audio) negatively influenced all peer attitudes, whereas variations in facial appearance alone (photo) did not substantially impact peer attitudes. When speech and appearance were combined (audiovisual), deviant speech negatively influenced cognitive attitudes without substantial impact of variation in appearance. Affective and behavioral attitudes were negatively influenced when deviant speech was present in combination with a cleft lip.</div></div><div><h3>Conclusion</h3><div>This study underscores the importance of multidimensional approaches to understanding and improving peer attitudes towards children with CP±<em>L</em>. Addressing both auditory and visual aspects of cleft-related disorders can better support these children's social inclusion and well-being. Further research should explore the long-term impact of speech and psychological interventions and educational programs on peer attitudes and examine specific visual cues' roles in social perceptions.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"115 ","pages":"Article 106530"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptual and acoustic predictors of speech intelligibility among Hebrew-speaking young adults with down syndrome","authors":"Micalle Carl,&nbsp;Michal Icht","doi":"10.1016/j.jcomdis.2025.106529","DOIUrl":"10.1016/j.jcomdis.2025.106529","url":null,"abstract":"<div><h3>Background</h3><div>Down syndrome (DS) is a common chromosomal disorder associated with various speech impairments, including reduced intelligibility. While speech subsystem deficits in DS have been documented, their relative influence on intelligibility remains understudied, particularly in non-English speaking populations. This study investigated speech intelligibility and select subsystem functioning in Hebrew-speaking young adults with DS, aiming to describe the speech production disorder and identify predictors of single-word intelligibility in this population.</div></div><div><h3>Methods</h3><div>Twenty-four adults with DS and 24 typically developing (TD) peers produced common single words in Hebrew. Perceptual and acoustic analyses were conducted on select speech subsystems, including articulatory (consonant and vowel production) and phonatory measures.</div></div><div><h3>Results</h3><div>Speakers with DS had higher error rates for complex consonants and demonstrated vowel space centralization compared to TD peers. Group differences were observed in most acoustic vowel measures, with interactions with speaker gender, but only select acoustic voice measures. Stepwise regression analysis identified three significant predictors of single-word intelligibility in the DS group, namely Percentage of Consonants Correct (PCC), Jitter (ppq), and average ellipse size of vowel clusters within the acoustic vowel space.</div></div><div><h3>Conclusions</h3><div>These findings highlight the complex nature of speech intelligibility deficits in individuals with DS, emphasizing both articulatory and phonatory contributing factors. The results also suggest potential cross-linguistic differences in subsystem contributions to intelligibility. Clinical implications include the need for comprehensive assessment and targeted interventions addressing multiple speech subsystems in this population.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"115 ","pages":"Article 106529"},"PeriodicalIF":1.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reading in aphasia: Supporting engagement in and enjoyment of reading in an aphasia support centre","authors":"Janet Webster ,&nbsp;Julie Morris ,&nbsp;Kathy Cann","doi":"10.1016/j.jcomdis.2025.106528","DOIUrl":"10.1016/j.jcomdis.2025.106528","url":null,"abstract":"<div><div>People with aphasia often experience difficulties with reading. Within the literature, there are a small number of reports of dedicated book clubs for people with aphasia, providing a social activity for individuals to reconnect with reading in a supportive environment. This paper describes an exploratory study investigating how to support people with aphasia's engagement and enjoyment of reading in an aphasia support centre. The study consisted of two phases. In phase 1, a focus group explored people with aphasia's reading and preferences about social reading activities. In phase 2, a novel reading group that reflected the preferences shared within the focus group was offered in the support centre.</div><div>The focus group revealed individual variability in both pre- and post-stroke reading. People were motivated to read but found it effortful. Participants were interested in a social reading activity but felt a book club was not feasible due to differences in reading preferences, ability, and the effort required to read. The novel reading group was designed to allow individuals to share what they had read at home in a supportive and encouraging environment. The format allowed everyone to engage and participants reported improved reading. This social reading activity encouraged people to read their own reading material rather than a shared book, allowing consideration of personal preference and accommodation of different levels of reading ability. Individuals did not need to read the same reading material to benefit from sharing the experience of reading.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"115 ","pages":"Article 106528"},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The perceptions, attitudes and experiences of service users with telehealth speech-language pathology services","authors":"Reem S.W. Alyahya","doi":"10.1016/j.jcomdis.2025.106527","DOIUrl":"10.1016/j.jcomdis.2025.106527","url":null,"abstract":"<div><h3>Aims</h3><div>To investigate the perceptions, attitudes, and experiences of clients and caregivers towards telehealth Speech-Language Pathology (SLP) services.</div></div><div><h3>Methods</h3><div>A comprehensive questionnaire was developed and validated to investigate the perceptions, attitudes, and experiences of service users towards telehealth services. The questionnaire included questions related to telehealth experience, client's preferences, and the perceived facilitators, barriers, advantages, and disadvantages of telehealth. Phone survey was used to collect data from clients and caregivers of clients who received telehealth SLP services during and after the COVID-19 pandemic.</div></div><div><h3>Results</h3><div>A total of 293 clients and caregivers participated in this study. The findings indicated that 97.95 % of the respondents reportedly received telehealth SLP services for the first time during the COVID-19 pandemic, mainly through video-communication (51.2 %), and for different clinical services, with therapy (31.04 %) and monitoring (31.28 %) being the highest services. Of the total respondents, 54.95 % felt that telehealth appointments were similar to in-person appointments. However, 41.30 % of the respondents preferred receiving in-person appointments. Statistical analyses indicated that eight factors were perceived by service users as significant primary facilitators of telehealth (e.g., good internet connection, available resources, experience with technology), whereas only three factors were perceived as significant primary barriers (e.g., poor image/sound quality, and client's communication impairments). Furthermore, 10 factors were perceived as significant primary advantages of telehealth (e.g., reduced cost and travel time), while only one factor was identified as a significant primary disadvantage (inability to conduct a physical examination).</div></div><div><h3>Conclusions</h3><div>Service users identified numerous advantages of telehealth, including improved access to healthcare, and reduced costs, while only one disadvantage was identified (lack of physical examinations). The perceived facilitators and barriers of telehealth by service users can be classified into technology-related factors (e.g., comfort with technology, internet connection) and client-related factors (e.g., client's cognitive and sensory abilities). These technology and client-related factors should be considered by policy makers and funding bodies while planning the establishment or expansion of telehealth services.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"115 ","pages":"Article 106527"},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}