This thesis explores the potentials of e-health for adult neurological patients with acquired dysarthric speech. The general introduction in Chapter 1 sheds some light on the background of increasingly emerging telehealth applications. Due to the current demographic developments, the group of chronic neurological patients who experience limitations in their daily life activities is rapidly growing. Along with the decreasing therapeutic and financial resources these developments cause a healthcare capacity
problem, which calls for innovations in healthcare. Telerehabilitation might contribute to a solution o f this need-and-capacity problem. In this context a web application for speech training in neurological patients with dysarthric speech is introduced: E-learning based Speech Therapy (EST). The EST research program and the research questions addressed in this dissertation are presented.
In Chapter 2, potentials o f telehealth devices for patients with neurological diseases, particularly for patients with Parkinson’s disease, are described. Attention is paid to the technical requirements for telehealth and its benefits for both therapeutic purposes and scientific research in the field of speech pathology and speech technology. In this perspective, the possibility o f collecting speech samples for a database o f dysarthric speech by means of EST is highlighted. The potentials of speech technology for pronunciation training are elaborated.
In Chapter 3 EST is presented. The infrastructure, the application requirements, and the architecture o f EST training programs are elucidated. In addition, the speech training procedure, the target users and the potentials for therapeutic and research purposes are described in more detail.
Chapter 4 focuses on the assessment of auditory speech discrimination skills in dysarthric speakers. The development and the evaluation o f an Auditory Discrimination Test (ADT) are described. The test contains five subtests that each concern one speech dimension which is addressed in EST: segmental speech elements (articulation), intensity (loudness), overall-pitch, speech rate and intonation. Test items that met the predetermined criteria for sensitivity to diminished auditory discrimination were used to compare14dysarthricspeakersand14controlsubjectswhowerematchedforage,gender
and education. The outcomes support the hypothesized diminished auditory speech discrimination skills in dysarthric speakers and hence, call for augmented (e.g. visual) feedback on speech in the training procedure implemented in EST.

Zie proefschrift voor een volledige samenvatting.