Exploring Speech and Language Therapist perspectives of Voice Assisted Technology as a tool for dysarthria: A Qualitative Study (Preprint)

Background: People living with Parkinson’s Disease (PD) often experience low speech volume and reduced intelligibility. Research suggests that common voice-assisted technology (VAT) devices, like Amazon Alexa and Google Home, can encourage individuals to modify their speech, speaking more clearly, slowly, and loudly. This highlights the potential of VAT as a therapeutical clinical tool in speech and language therapy. However, while VAT is emerging as a novel healthcare technology, gaps exist regarding understanding speech and language therapists’ (SLTs) experiences using these devices in clinical practice for PD-related speech and voice difficulties.

Objective: This research is one of two papers which explore explores experiences of using voice assisted technology to address hypokinetic dysarthria, secondary to PD, from a range of stakeholder perspectives. This paper specifically focuses on clinical insights from SLTs.

Methods: SLTs with prior experience of using smart speakers in clinical practice with people with speech or voice difficulties, were invited to participate in focus groups or interviews. Between September and December 2024, seven SLTs participated in semi structured focus groups and interviews using a topic guide. Discussions were informed by published evidence. Results were
transcribed and analysed using a framework analysis approach and were managed through NVivo software.

Results: Four main themes were identified across the groups: (1) Potential for VAT in speech and language therapy, including its therapeutic applications, role in self-managing dysarthrophonia, and perceptions beyond disability-related use, (2) Managing therapeutic beige flags, including challenges posed by technology and therapeutic and practical concerns, (3) Empowering SLTs to become digitally enabled practitioners, including education and guidance needs for around GDPR and privacy, technical concerns, practical implementation and improved knowledge and (4) Envisioning the future of VAT in speech and language
therapy, exploring the development of an Alexa skill, VAT’s potential in delivering LSVT, and its role in increasing self-awareness in individuals with PD.

Conclusions: This study builds upon on previous research, reinforcing VAT’s potential as a therapeutic tool that may improve volume, clarity, intelligibility of speech, and facilitate at-home practice for PwPD. However, before VAT can be widely implemented as a clinical tool, considerations around data privacy, device limitations, and practical integration must be addressed. The study highlights areas for future research, such as designing solutions to usability challenges for both service users and clinicians. Finally, this paper offers key clinical recommendations for the development of a therapeutic VAT tool for speech and voice difficulties in speech and language therapy. Clinical Trial: None