A look at Stuttering Therapy Online – a seven-part series
Please join us every Wednesday for the next five weeks as we examine the unique aspects of treating stuttering with online therapy.
This week’s focus – technical requirements for teletherapy
The technology available for videoconferencing is constantly improving. The treatment platform must be reliable and easy to use. It is very important for the client and me to be able to see and hear each other clearly. The video streaming has to be natural and the lip and audio sync have to be good. Delays in either audio or video would make it difficult for me to evaluate what the client is doing and make it impossible to model differences in speech processing that are important to the treatment goals. Another requirement is file sharing. I send clients units of the Dynamic Stuttering Therapy Workbook and rely on diagrams, pictures and videos to clarify explanations. I also need to video and audio record clients with an option for immediate playback.
I tried out a handful of companies that are Mac compatible and offered white board and file sharing along with video streaming capabilities, but was disappointed with the quality of video streaming, the audio, or the synchronization of the two together. Also, I found that many platforms were difficult for new users to learn. As a last resort I tried Skype, the commonly used instant messaging platform that many people have or that can be easily downloaded at no cost. It works beautifully. The video and audio quality is usually good and has improved over the past two years. Incidentally, I have also used ichat/AIM, but have not been as happy with the video quality. Skype has options for sending files and screen sharing. It does not have a recording option, but I solved my recoding issues by purchasing both an audio recorder http://www.rogueamoeba.com/audiohijack/ and a video recorder http://ecamm.com/mac/callrecorder/. Together, I have all the recording functionality that I have in clinic.
Clients can record their practice between session on their personal MP3 or on computer recording software. For those who don’t have this software, a free personal recorder can be downloaded from Audacity http://audacity.sourceforge.net/ .
While most times the connection quality is good, there are interferences that need to be considered. Occasionally, the video freezes or the voice cuts out. Most of the time this can be resolved simply by hanging up and reconnecting. On occasion it is necessary to reboot the whole system. The video/audio quality can be greatly improved by using a decent web cam and headset with microphone. Each of these can be purchased for under $100 in most countries. I always use a headset with an attached microphone during treatment. However, some of my clients do not use one. The necessity depends on the quality of the built in hardware.
Last week: Ethical Considerations
Coming next week: Appropriate Populations for online therapy