This thesis presents work in the area of computer-based speech therapy using different types of visual feedback to replace the auditory feedback channel. The study includes diagnostic assessment methods prior to therapy, type of therapy design, and type of visual feedback for different users during different stages of therapy for increasing the efficiency. The thesis focuses on individual computer-based speech therapy (CBST) for profoundly hearing-impaired children as well as for computer-assisted pronunciation training (CAPT) for teaching and training the prosody of a second language. Children who are born with a profound hearing loss have no acoustic speech target to imi¬tate and compare their own production with. Therefore, they develop no spontaneous speech but have to learn speech through vision, tactile sensation and, if possible, residual hear¬ing. They have to rely on the limited visibility of phonetic features in learning oral speech and on orosensory-motor control in maintaining speech movements. These children constitute a heterogeneous group needing an individualized speech therapy. This is because their possibilities to communicate with speech depend not only on the amount of hearing, as measured by pure-tone audiometry, but also on the quality of the hearing sensa¬tion and the use the children through training are able to make of their functional hearing for speech. Adult second language learners, on the other hand, have difficulties in perceiving the phonetics and prosody of a second language through audition, not because of a hearing loss but because they are not able to hear new sound contrasts because of interference with their native language. The thesis presents an overview of reports made concerning speech communication and profound hearing impairment such as studies about residual hearing for speech processing, effects of speech input limitations on speech production, interaction between individual deviations and speech intelligibility, and speech assessment methods of phonetic realizations of phonological systems. Finally, through several clinical evaluation studies of three Swedish computer-based therapy systems, concerning functionality, efficiency, types of visual feedback, therapy design, and practical usability for different users, important recommendations are specified for future developments.

Sjukvårdsrådgivning via telefon har blivit allt vanligare i västvärlden. Tekniska lösningar har utarbetas som underlättar för de döva att själva kontakta sjukvården via telefon. Sjuksköterskor inom primärvården kommunicerar då med de döva via text- eller bildtelefoni. Studiens syfte var att beskriva döva och sjuksköterskors erfarenheter och upplevelser av sjukvårdsrådgivning via telefon. Sex sjuksköterskor och fem döva intervjuades med öppna frågor. Resultatet analyserades med konventionell innehållsanalys. Resultatet visar att för sjuksköterskorna är det mest framträdande upplevelsen av svårigheter att förstå och bli förstådd. För de dövas är det viktigaste att de, trots olika tekniska lösningar, har svårigheter att få kontakt med vårdcentralerna. Båda grupperna är eniga om att språket, den skrivna svenskan, kan vara en svårighet, särskilt för de äldre döva. För att komma förbi hindren och nå målen har båda grupperna utvecklat olika strategier. En gemensam strategi är att då kommunikationen via telefon upplevs som otillräcklig, planeras för ett personligt möte tillsammans med tolk. Svårigheterna att få kontakt gjorde att de döva ibland dröjde med att söka vård. Sjuksköterskorna upplevde att de döva som grupp, ibland var sjukare då de tog kontakt, än patientgruppen i stort. Båda grupperna framförde en oro för vad som kan hända vid allvarliga tillstånd om kontakt och förståelse inte fungerar tillfredställande. Konklusionen indikerar att kontaktvägarna till primärvården måste förbättras för de döva. Möjligheten förden döve och sjuksköterskan att kommunicera på sitt förstaspråk underlättar förståelsen och den möjligheten behöver utvecklas. Vårt resultat bör kunna utgöra ett underlag för förbättringsarbete och fortsatt forskning inom området.

<p>This thesis presents work in the area of computer-based speech therapy using different types of visual feedback to replace the auditory feedback channel. The study includes diagnostic assessment methods prior to therapy, type of therapy design, and type of visual feedback for different users during different stages of therapy for increasing the efficiency. The thesis focuses on individual computer-based speech therapy (CBST) for profoundly hearing-impaired children as well as for computer-assisted pronunciation training (CAPT) for teaching and training the prosody of a second language. Children who are born with a profound hearing loss have no acoustic speech target to imi¬tate and compare their own production with. Therefore, they develop no spontaneous speech but have to learn speech through vision, tactile sensation and, if possible, residual hear¬ing. They have to rely on the limited visibility of phonetic features in learning oral speech and on orosensory-motor control in maintaining speech movements. These children constitute a heterogeneous group needing an individualized speech therapy. This is because their possibilities to communicate with speech depend not only on the amount of hearing, as measured by pure-tone audiometry, but also on the quality of the hearing sensa¬tion and the use the children through training are able to make of their functional hearing for speech. Adult second language learners, on the other hand, have difficulties in perceiving the phonetics and prosody of a second language through audition, not because of a hearing loss but because they are not able to hear new sound contrasts because of interference with their native language. The thesis presents an overview of reports made concerning speech communication and profound hearing impairment such as studies about residual hearing for speech processing, effects of speech input limitations on speech production, interaction between individual deviations and speech intelligibility, and speech assessment methods of phonetic realizations of phonological systems. Finally, through several clinical evaluation studies of three Swedish computer-based therapy systems, concerning functionality, efficiency, types of visual feedback, therapy design, and practical usability for different users, important recommendations are specified for future developments.</p>