mHealth Research Digest with Dylan Alegría

International humanitarian organizations regularly perform life-changing surgeries for patients with cleft palates.

Speech therapy is a cornerstone of appropriate long-term care for these patients but is logistically difficult to provide.

Researchers from the University of California San Diego used secure videoconferencing setups to perform remote speech evaluation for 9 patients in Tijuana, Mexico.

In person and remote Spanish-speaking speech-language pathologists were compared both for patient and family satisfaction and for the results of their evaluation.

Patients and their families were highly satisfied with the experience, endorsed comfort and ability to interact with the camera, and overwhelmingly indicated that they would participate again. Several components of the speech evaluation showed high levels of agreement between in person and remote evaluation including oral muscle tone, resonance, lingual lateralization, oral pressure, and dentition.

Other components of the speech evaluation demonstrated some agreement but were not statistically significant. Specifically lingual elevation, grimacing, palatal movement, and nasal air emission showed modest agreement but did not reach statistical significance.

Taken together, most patients reported high levels of satisfaction. For the most part the results of the speech exam were the same if conducted in person or by remote practitioners; however, differences in the findings of the exam were also demonstrated.

Lead author Elizabeth Whitehead indicated that the research team continues to expand their data set and

“…are planning to move the project along towards collecting data on clinical improvement through the use of telemedicine to facilitate speech therapy to international and remote areas.”

The authors point to increased resolution of telemedicine equipment as key to improving performance of remote evaluations. Future use of this technology could allow for longitudinal assessment of post-surgical patients by the entire interdisciplinary team at regular intervals, at relatively low cost, from the convenience of their home countries.


  • Elizabeth Whitehead
  • Valerie Dorfman
  • Glendora Tremper
  • Amanda Kramer
  • Alicia Sigler
  • Amanda Gosman


  • Division of Plastic Surgery, University of California
  • San Diego School of Medicine, Speech of Pathology Department
  • Rady Children’s Hospital-San Diego
  • South Bay Union School District, Multidisciplinary Cleft Palate/Craniofacial Team
  • Hospital Infantil de las Californias, Tijuana Mexico

Original Abstract: