Tools for Transformation
Tele-Collaboration in Speech Hearing Sciences
College of Arts and Sciences
Dramatic changes in educational and healthcare reform have reduced
resources for the delivery of services to individuals with communication
disorders. As a result, research practices must shift from laboratory to
field research to assure that the altered methods of service delivery
remain effective. With the advent of telecommunication technology, it
becomes possible to expand the contexts in which we conduct research to
include remote sites, allowing for the investigation of complex behavioral
phenomena in the natural environment. This technology also enables us to
provide experiential learning for our students as they can observe and
interact with clinicians in the field in real-time (i.e., "synchronous
communication"). The Tele-Collaboration Project involves the development
of a new model for conducting research, one that includes community
partners in collaborative research through the utilization of synchronous
telecommunication. While medical tele-consultation and Web-based
conferencing formats have begun to receive widespread use, to date, the
application of these technologies to research has been limited. The
Tele-Collaboration Project in Speech and Hearing Sciences provides an
opportunity to conduct field research, enhance community partnerships, and
provide experiential learning for our students through the application of
this technology to further our understanding of communication disorders
and their management.
Lesley B. Olswang
Professor, Speech and Hearing Sciences
December, 2001 (Final)
PROGRESS REPORT, November 1999
The tele-collaboration project has begun by hiring staff, developing a timeline, and establishing elements of the
infrastructure that will be necessary for the two phases of the project: asynchronous and synchronous phases.
Patricia Dowden PhD., was hired to coordinate the grant starting September 1. She and departmental faculty
subsequently identified and hired five work-study students who are graduate students in Speech and Hearing
Sciences. A detailed timeline has been developed for the first year of the project, achievements to date are
outline below. Simultaneously, space has been allocated and the infrastructure has been upgraded to permit the
establishment of the networks necessary for the stair of the project.
The asynchronous phase of the project, which is targeted for completion during the first year of funding, has begun
with the development of content materials for the collaborative web sites. These web sites will serve for
dissemination and data collection for departmental research. This phase of the project has three components:
audiology, K-12, and adult neurogenics. In audiology, faculty have developed a research protocol that will be used
for off-site data collection during clinical visits at the first site, the V.A. Hospital and Medical Center
Consultants at the Center for Educational Resources (CER) have begun working with the lead researcher in audiology
and grant coordinator to develop the website and protocols for this process to ensure that the data are collected
properly and made available to UW faculty for analysis. For the K-12 collaboration, faculty have developed some
significant materials for the website and begun to share it with other U W faculty via the departmental intranet.
All web-site material is being developed with assistance from CER to ensure that faculty can collect significant
and meaningful data from site visitors. The faculty in K-12 has submitted an application to conduct a mini-seminar
at an up-coming conference and also given two public presentations to community professionals and families about
the Tools project. Questionnaires were disseminated to the audiences at these presentations to identify the highest
priorities from the community's perspective to ensure that the asynchronous website draws the visitors for the data
collection and collaborations. In adult neurogenics, faculty has begun to develop materials for the website as well
as prepare the audio-visual equipment and materials that will be required for the asynchronous and synchronous
phases of the project.
The synchronous phase of the project is not slated to begin until Fall, 2000. However, preparations have begun for
this ambitious and complex transformation to teaching and research in the department and clinical collaboration
with the broader clinical community. First, this phase of the project builds on the asynchronous phase; therefore,
all progress made in developing the website for the first phase will apply to this second, more complex phase.
Second, CER staff has begun identifying the infrastructure modifications and specific equipment purchases that will
be required for the synchronous phase. Third, the coordinator has met with other faculty and staff at UW and
attended a workshop on telemedicine in order to understand the methods and approaches currently in use by others on
The tasks completed in the last two months correspond to the objectives established in the projected timeline.
Initial piloting of the web site for the asynchronous phase of the project is planned for the beginning of 2000.
This objective seems entirely feasible given the progress that has been made thus far. The community response to
developing collaborative field research with the Department of Speech and Hearing Sciences has been extremely
positive. Numerous individuals from across the state have volunteered to participate in initial piloting of the
asynchronous phase of the project. This reception has been extremely gratifying and encouraging.
PROGRESS REPORT, November 2000, Year One
The Department of Speech & Hearing Sciences (SPHSC) has just completed a very
productive first year of its Tools for Transformation (TfT) Project. The
"Tele-Collaboration Project" is designed to enhance teaching and research
through collaborative interactions with our greater clinical and research
communities. The focus of Year 1 has been on establishing "asynchronous"
interactions via the Internet/Web, while setting the stage for the
"synchronous" (e.g. real-time) collaborations for Year 2. During this
first full year, there have been numerous accomplishments in both the asynchronous
and synchronous projects, as discussed in detail below.
Infrastructure Modifications: The TfT project has upgraded the
communications wiring in many rooms within the Speech & Hearing Clinic to meet
current C & C standards for high-speed, broad bandwidth connectivity as required
for our goals. These improvements (upgrading conduits, cabling and communications
switches) were made to clinic rooms, classrooms and laboratories that are crucial to
the specific Tele-Collaboration projects. Unfortunately, the process of upgrading
these spaces clarified the structural obstacles in Eagleson Hall that make upgrading
the entire Speech & Hearing Sciences Department prohibitively expensive.
Digital Archive: TfT faculty and staff have entered into a
collaborative relationship with UW’s Center for Information Systems Optimization
(CISO), headed by Dr. Greg Zick. We will be piloting an innovative application of
their photo archiving software, "Content", for a video archive for research and
education. The SPHSC faculty will be utilizing this archive initially for
asynchronous purposes, which include the following: 1) experiential learning by
students of Speech & Hearing Sciences, 2) web-based educational outreach for
pre-service and in-service education beyond the university, 3) storage of
community-based data collection for later analysis or research training purposes.
The video archive will also be utilized for some synchronous activities, including:
1) during streaming media presentations for the public or students outside of the
University, and 2) during real-time collaboration with research colleagues,
regionally and nation-wide.
- Video Production Studio: The SPHSC Department has negotiated an exchange
with the Social Work Department to obtain SW Room 40, a video production studio.
The development and use of this facility will be emphasized in Year 2 of this grant
as we enter into synchronous collaboration activities.
The following two video accomplishments are particularly important for the
asynchronous collaboration portion of the project:
- Clinic Recording Stations: Upon completion of the infrastructure
upgrades, we have begun to outfit clusters of therapy rooms in the Speech &
Hearing Clinic for video recording. The equipment that is being acquired will
permit digital video for editing and storage on "Content" as well as for
real-time observation from specific workstations within the department.
- Video Editing Workstations: We have acquired one workstation for
collecting, editing and uploading video to the "Content" archive discussed
above. We are in the process of ordering additional workstations for use within the
Web-based Educational and Research Modules: The
"Tele-collaboration Project" is developing four websites at the
University. The primary website (http://depts.washington.edu/tcollab/
) gives an overview of the project’s presence on the web. From this site, visitors
can also access two of the 4 sites described below.
- Augmentative Communication: Dr. Dowden has focused initial efforts on an
educational website on the topic of Augmentative and Alternative Communication.
The prototype version of the website can be viewed at: http://depts.washington.edu/augcomm
This site has two educational modules, "Customizing Vocabulary &
Symbols" and "Acquiring Equipment," the latter having been created in
collaboration with colleagues in the community. Both asynchronous teaching modules
have already been utilized as supplementary teaching material in one on-campus
course, SPHSC 454, and one course off-campus at Western Washington University.
Both modules have been critiqued by experts in the greater clinical community and
have received very positive reviews. The official debut for this site will be this
- Adult Neurogenics: Dr. Margaret Rogers and Ms. Nancy Alarcon have
concentrated their web innovation on an asynchronous clinical and research tool,
"Communication Notebook Builder," which is part of a broader site on
"Supported Communication." The Notebook Builder tool is a highly
interactive web resource designed to meet three purposes: 1) an educational
resource on supporting the communication of adults with acute and severe
communication impairments, 2) an on-line tool for clinicians, families and other
caregivers to develop custom communication notebooks for these individuals, and 3) a
method of data collection regarding the development and use of these communication
strategies. The development of this website went to bid and UW’s Health Sciences
Center for Educational Resources (HSCER) was selected as the development team.
This project is nearing the initial prototype stage and will be presented at the
annual convention for the American Speech, Language & Hearing Association in
November. During Year 2, this prototype will be completed and it will be posted on
the Internet/Web along with one or more corresponding educational modules. At this
time, there is currently a home page for this site accessible at:
- Audiology: Dr. Pam Souza has planned a clinical data collection website
to use in collaborative research with VA Hospital & Medical Center staff. The
development of this website has been put out to bid; it will be developed by Dr.
Marc Coltrera’s development team here at UW. This project is due to commence this
- Social Communication: Dr. Lesley Olswang and Dr. Truman Coggins have
developed a website that is both an educational and research oriented. It is
designed to provide information to professionals and families about school-age
children with social communication problems. This unique site will also be
structured to gather important research data from professionals. The site is
currently being piloted and should be developed in the next three months. A second
component of this project is an expansion of the research module. This component
will be designed to gather observational data about social communication via
hand-held computers. A prototype of this methodology will be developed during the
coming year as part of the synchronous collaboration goals.
Patient Consent & Confidentiality: Dr. Dowden and the TfT team have
been working closely with Clark C. Shores, Assistant Attorney General on UW campus
to ensure that patient consent forms are up-to-date and appropriate, even for
future, innovative uses of digital media. Mr. Shores has also assisted us with
copyright and ethics rules within the University as they apply to our projects. We
plan to have Mr. Shores speak to all faculty and staff about these complex legal
issues, which have changed for the entire department with the use of new educational
In just the first year, the Tools for Transformation project has reshaped
research and educational methodologies within the Department of Speech
& Hearing Sciences. The second year of this project is expected to
have a similar impact and we anticipate that this project will resonate
throughout the department’s research and training projects for many
FINAL PROGRESS REPORT, December 2001:
The Tele-Collaboration ("Tcollab") Project:
The Department of Speech & Hearing Sciences at the University of
Washington has just completed a two-year project to enhance teaching and
research through collaborative interactions with clinical and research
communities within and beyond the University.
staff, under the direction of Lesley Olswang, Ph.D., PI, and Pat Dowden,
Ph.D., Project Coordinator, furthered the infrastructure and capabilities
in the department in several respects:
Infrastructure Upgrade: The project has upgraded the communications
wiring in many classrooms, clinic rooms and labs within the Speech &
Hearing Department for high-speed, broad bandwidth connectivity. This was
essential for a number of the project goals.
Digital Resource Library: The Tcollab project has developed an
innovative digital archive system, based on CONTENTdm software. This
archive is a searchable database of video/audio clips for educational and
clinical purposes. This archive brings together in a searchable library
an array of exemplars of communication disorders across the lifespan. The
ability to easily search and locate examples will enhance teaching
Video Facilities: The project has upgraded the digital video recording
capabilities in key clinic rooms as well as in a new recording studio
acquired from Social Work. These facilities will support high quality
videotaping of clinical experiences to be used in research and teaching
(i.e., contributions to the Digital Resource Library). Further, the
additional video capabilities afforded through the recording studio will
permit our department to move further into (1) synchronous data collection
from colleagues serving low-incidence populations, and (2) real-time field
data collection from natural communication contexts.
Video Editing Facilities: The project has obtained 3 workstations for
collecting, editing and uploading video to the "Content" archive discussed
above. Key personnel have been trained to support faculty, staff and
students in their editing work.
Client Confidentiality: Because of the expansion of our video
capabilities and dissemination of video clips via the Digital Resource
Library and related Web-based projects, we have needed to address issues
of client confidentiality. As a result, the Tools project has developed
consent forms that meet the highest standards of client confidentiality.
The new consent form used in the Speech and Hearing Clinic is designed to
fully inform the family and the client of all potential uses of any
audio-video files. This form has been approved by the UW Attorney
General's Office as well as by the UW team involved in compliance with the
more stringent standards of the Health Insurance Portability &
Accountability Act (HIPAA), due to be implemented in 2005. This form has
served as a template for many faculty members who are developing consent
forms for research that involves human subjects and videotaping
Demonstration Projects: These tools have permitted the development of
numerous demonstration projects in specific areas of specialization:
Augmentative and Alternative Communication (AAC): This educational Web
site, UW Augcomm, has been
developed through the collaborative efforts of
UW faculty and regional clinical experts in AAC. The information relates
to three topic areas of particular interest to the community: AAC
Vocabulary & Symbols, Understanding AAC Features and Funding for AAC
Subsequent Grants: The Tools for Transformation funds have permitted
the Speech & Hearing Sciences Department to compete successfully for
funding for several projects. The Social Communication Handheld Data
Collection project will be continued via a large research grant funded by
the Centers for Disease Control to the Departments of Speech and Hearing
Sciences, Epidemiology, and Psychiatry and Behavioral Sciences. This
research will examine the social communication problems of school-age
children diagnosed with Fetal Alcohol Syndrome and Alcohol Related
Neurodevelopmental Disorders. The grant will be implemented across three
years. The first two years will focus on validating the handheld
methodology for describing social communication problems in schools. The
third year of the project will explore the uses of the methodology for
providing intervention in the school setting.
Social Communication: This demonstration project has several components,
each of which advances both our research and collaborative goals.
Social Communication Website serves both educational and research
purposes. The site provides information to professionals and families
about school-age children with social communication impairments. At the
same time, Web-based questionnaires gather data for University researchers
regarding diagnosis and treatment of these children.
- The Handheld Data
Collection project uses handheld computer technology to gather data in the
field from community professionals who are working with children with
social communication impairments. The data are automatically uploaded
into our database via the Internet. This innovative project will
demonstrate the value of this data collection method for researching and
serving individuals with hard-to-serve impairments.
Supported Communication: This project has two key components:
Website provides an educational resource for
professionals, families and caregivers of individuals with acute loss of
speech and language. The site is designed to provide information
concerning how communication is affected by neurological damage to speech
and language areas in the brain and how communication with these affected
individuals can be enhanced. A forced-choice question format accompanies
this teaching tool to facilitate learning and to provide University
researchers with data concerning knowledge acquisition by the users.
After accessing this educational module, users are directed to create a
communication notebook that can greatly enhance communication for
individuals with moderate-to-severe impairments.
The Communication Notebook Builder (CNB) is a Web-based tool for
creating and customizing communication books for this same clinical
population. The site also provides University researchers with field data
about the development and use of such books.
Audiology: The Audiology Database was designed to support
multi-site research in audiology. Although initially designed to serve
hearing researchers, the database can serve a variety of uses, and, in
fact, has been used for the Social Communication project described above.
As created for this demonstration project, the database provides a
structured format for data collection, exchange and analysis in a
multi-site clinical trial of hearing aid efficacy. In this project,
clients are seen for hearing aid fittings at individual clinical sites
(current core sites are the Speech and Hearing Clinic at the University of
Washington and the Department of Audiology and Speech Pathology, Veterans
Administration Medical Center, Seattle). Data can be collected via direct
downloads from clinical equipment (audiometers and hearing aid test
systems) or manually entered by the tester. Data from all sites are then
available to the principal investigators for analysis. Incorporation of
multiple clinical sites via the Audiology Database allows for a broader
data pool, improved statistical power and the ability to study specific
population factors. Current study questions include the effect of circuit
type and hearing aid features on satisfaction, efficacy and adherence.
The Digital Resource Library and the UW Augcomm Website have resulted
in a grant from the NEC Foundation of America for Dr. Dowden and Dr. Rogers.
This project will be the first application of the video archiving system
into a public Web site, developing a site that uses video clips and text
stories to profile individuals who use augmentative and alternative
communication. The Website, AAC
enABLES, is scheduled for debut in
Future Projects: In addition to the projects that will be carried
forward by the grants described in the previous section, plans are
underway to continue or expand teaching and research efforts made possible
by the Tools for Transformation Award.
Funding for this project was made available through the University's Tools
for Transformation Funding Initiative.
Currently, data are being collected from the Social Communication Website.
These research data will provide important information about the
prevalence of social communication problems in school-age children.
Further the data will provide insights into caregivers' and professionals'
impressions of these children and their problems. The results of the
research will provide valuable information to the development of
assessment and intervention procedures.
The Digital Resource Library has begun to be incorporated into the
Department's teaching mission. The plan is to provide students with
access to examples of communication disorders (both prototypical and
atypical) as well as exemplary clinical interactions. The development of
self-directed teaching modules is underway and is conceived of as an
enrichment resource to supplement instruction concerning the nature,
assessment, and treatment of communication disorders at both the
undergraduate and graduate levels.
Tools for Transformation