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University of Karlstad
Disability & Language/ Department of Educational Science
S-651 88 KARLSTAD, Sweden
The Karolinska Institute/ Huddinge Hospital
Department of Speech Pathology
S-141 86 HUDDINGE, Sweden
Human communication is built on the usage of all our senses. Although speech is considered as being the most "natural" form of communication, people use more than the oral and the auditory channels when communicating with each other. Visual and tactile communication and interaction is important in all cultures even if there are cultural differences as to the relative stress on each channel of communication, in relation to the others. The tactile, olfactory and proprioceptive dimensions of communication seem to have lost in importance in modern information society, since distance communication has grown in importance and those dimensions have been almost impossible to reproduce in distance communication so far, that is, if you don't count metaphors in literature as a tool for communication.
Auditive distance communication has existed for almost a century, with technology involved. Visual distance communication has existed for even longer, at least in a limited sense. Most human cultures have developped sophisticated visual signal systems over the centuries for distance communication - smoke signals, fires, semaphors, flags etc. However, the technology involved did not help in receiving those messages from any longer distance than what the eyes of the receiver could manage. The invention of magnifying glasses helped. However, in the modern telematical society auditive distance communication has been totally dominating since the invention of the telegraph and later the telephone. Since the auditive signal contained less information it has been less demanding on the available technology than visual communication. It has been cheaper to develop auditive distance communication for everyday use than the visual communication which means that auditive communication has been available for interactive masscommunication while visual communication has been more non-interactive and limited to groups who have used the technology to give visually based information to receivers through media like cinema and TV.
However, beginning in the mid seventies, developpers have tried to create integrated audiovisual communication systems for distance communication and today we are on the verge of having a technology which could be called "picture telephony", or more common "videotelephony" for people with special needs as well as for people in general.
During the last decades, technology has allowed for an integration of different modes of communication as well as cheaper visual interactive communication. This also means that technology has become more available for people with special needs and offers new solutions to old problems of communication limitations for people with hearing impairments, speech disabilities, mental impairments etc. Today, Internet as the most wellknown application is offering a seemingly new framework for primarily indirect non-real time communication, also for people with communication disabilities like Aphasia (Lifvergren, Lundell, Magnusson, 1997). However, Internet is not the only public electronic "virtual transportation network" which will be shown below.
In Sweden, we are working with several projects based on videotelephony in the field of speech pathology in the general sense. The first large project was a three-year project at the University College of Karlstad, under professor Irene Johansson, where the aim was to study videotelephone-based language training for language disabled adults, meaning people with Aphasia or mental retardation (Johansson, Magnusson,Wallin, 1997). During the most of that time, the Karolinska Institute has managed a course for speech pathologists where the authors have been responsible. The course has given more than 20% of all Swedish speech pathologists a basic knowledge of information or computer technology.
In Sweden there are about 800 speech pathologists out of a population of some 8 millions. 40 of them are male so the group could be considered as mainly female. Most of them are working in the big city districts which means that the more unpopulated areas of Sweden, which would correspond to about half of the country's area, is understaffed.
That would mainly mean the northern half of the country, or seven of the 24 counties of Sweden or about 20% of the population. The medical services are mainly the business of the county-councils while the higher education and research is the business of the state and more of a centralized state of affairs. This means that doing research activities in the medical or care-taking field sometimes can be difficult to organize. However, most local counties support research in cooperation with the closest university or university college. There are also a few university hospitals in Sweden, situated close to the original five old universities of Sweden. There are four schools for speech pathologists in the country, including the one at the Karolinska Institute.
Below we will present a few of the projects where we are involved:
Recently the county council of Värmland (where the University College of Karlstad is situated) has started the project TELELOG, partly with financial support from the EU. Magnus Magnusson is the project leader for that project and the aim is to teach all speech pathologists of that county to use videophone equipment as a natural part of their intraprofessional relations within the county. The equipment is based on the Intel Proshare videocard and uses 2x64 kb/s ISDN and allows for LAN-communication and follows H320 and H323 standards. 10 stations are active at the moment and additional stations will be activated within the next months. The results of this project will decide on the future use of the technology as a more integrated part of the therapeutical part of the work of the speech pathologists. TELELOG 2 will be started in 1998 and concentrate on studying applications for language impaired people and is a direct continuation of TELELOG.
Another project which is in its initial stage is called REGLOG. The northernmost college for speech pathologists is situated in the city of Umeå, not far from the Polar Circle. A lot of the courses during the basic training period are spent in local hospitals or training centres ranging over an area of half of the country meaning that the pupils have to travel a lot and also the supervisors. Therefore the staff has decided to install desktop videophone systems in all of the nine main training places, thereby offering pupils and supervisors the possibility to interact without having to travel. The person responsible for the speech pathology school in Umeå is ass. Professor Ms Elisabeth Sederholm. The project is planned to develop a network during three years, including all speech pathologists in that part of the country.
At the college of speech therapists in Stockholm a post-graduate course has been given on the subject of telematics and distance communication for speech therapists. The course will cover 10 academical credits and give a basic knowledge into theory and practice of telematics and different methods of distance education. 40% of the lectures are transmitted over ISDN using videophones. The course will result in a report in English, available on the Internet with results from usage of the technology.
There is a common technology and methodology in all three of the projects. First of all the common user group is speech pathologists, specialists in communication and problems with speech and language. Secondly the aim is to develop professional networks, that is, the communication will be very goal-oriented. Thirdly, the technology is desktop-videotelephony meaning that the videophone function is integrated in a standard PC and can be combined with any other of the functions of the PC. Fourthly, the network used is ISDN which is an open network. In other words, a standardized technology is used in a natural environment.
The same type of system has been or will be used in all of the projects. The software includes standard word processing, database, graphical and language training software. The hardware of the system includes 19" monitor, colour ink-writer, flat-bed scanner, CD-ROM, Pentium processor (mostly PII), loudspeakers, headset and a separate digital stillpicture camera.
Totally about 40 speech pathologists and 20 students are or will be involved in those projects. Sofar, about 25 professionals have been involved and the response has been very positive. The participants rapidly develop user patterns where they interact on an everyday basis with their colleagues instead of using the phone or meeting physically. Some interactive work has also been done, mostly writing texts together, sharing a word processing software between two users. People have also tried to share therapeutical software, thereby simulating a session with a patient. The next step will be to try and practice therapy through the videophone. The main problem involved has to do with the experienced conflict of priorities between having to choose between the computer and the patients. However, this problem is not an objective one since some of the participants make their priorities with no experience of problems at all. All participating speech pathologists have also been allowed by their employers to take some time off for the technology usage.
The final aim of all the projects is threefold. First we want to establish a wellfounded description of the quality of the communication situation in relation to its physical counterpart. Secondly we want to establish cost-effective alternatives in the professional caretaking of people with speech and Language problems. Thirdly we want to make this technology a commonly used tool among speech pathologists and therapists in all of Sweden since its multifunctionality seems to offer new possibilities in our work.
Magnusson, Magnus Brodin, Jane (1993) Picture Based Distance Communication for Dysphasic and Dysartric People - Another Step towards Everyday Multimedia-communication CSUN/California State University, In H. Murphy (Ed): Proceedings of the Eighth Annual Conference: "Technology and Persons with Disabilities"
Brodin,, Jane Magnusson, Magnus (Ed) (1993) Virtual Reality and Disability Stockholm University, Dept of Education, Technology, Communication and Disability Report nr 9, 100
Brodin, Jane Magnusson, Magnus (1993/a) Videotelephones and Disability - a Literary Review Stockholm University, Dept of Education, Technology, Communication and Disability Report nr 5
Magnusson, Magnus, Gunnilstam, Olle (1995) Remote therapy for Persons with Aphasia In: Murphy, Harry (Ed): Proceedings from 3rd conference on Virtual Reality and Persons with Disabilities, (1995), University of Karlstad
Johansson, Irene, Magnusson, Magnus Wallin Eva (1997) Videotelephony as a Training Tool for People with Aphasia and Mental Retardation, Aphasia In: Murphy, Harry (Ed): Proceedings from Technology for Disabled People, Los Angeles, 16-22.3
Lifvergren, Brita, Lundell, Jonny, Magnusson, Magnus (1997) Internet for People with Aphasia, Aphasia In: Murphy, Harry (Ed): Proceedings from Technology for Disabled People, Los Angeles, 16-22.3
Magnusson, Magnus (1998/a) Videotelephony in Language Rehabilitation of People with Aphasia, Proceedings, International Conference on Aphasia Rehabilitaion, Kwa Maritane, South Africa
Magnusson, Magnus (1998/b) Videotelephony Networks for Speech language Pathologists, SAARDHI-Proceedings, Conference on Distance Education, Pretoria South Africa
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