Using design thinking to address challenges faced by students with special educational needs and/or disabilities in assessment within higher education assessment

This paper describes the development of a prototype framework to support students with special educational needs and/or disabilities (SEND) in assessment within an undergraduate physiotherapy course. Students with SEND are at high risk of not reaching their academic potential due to the lack of individualised and inclusive approaches taken to assessment design and delivery. Using a design thinking methodology, the approaches and learning from four stages of design thinking are described, including empathise, define, ideate and prototyping. A range of methods was used to understand the end user needs, including surveys, discussion, and anonymous data from the central university resources. Several ideas were generated before deciding on a final idea to move forward to the prototype phase. The identified prototype, an individualised educational plan developed using a student-centred approach, has the potential to provide an inclusive and individualised approach to assessment in education. Whilst designed for the specific programme, the framework has the potential to be embedded across a range of programmes within higher education

Airway clearance techniques for patients experiencing acute exacerbations of chronic obstructive pulmonary disease in the Republic of Ireland

Background and Objectives: Airway clearance techniques (ACTs) are used by physiotherapists with the purpose of clearing sputum from bronchial airways. They are commonly prescribed for patients experiencing acute exacerbations of chronic obstructive pulmonary disease (AECOPD), however large variability in practice is commonly observed. This study aimed to explore current physiotherapy practice regarding ACTs for people with AECOPD in the Republic of Ireland. Method: An online survey was distributed to physiotherapy clinicians via direct email and the Irish Society of Chartered Physiotherapists. Main survey themes, identified from previous studies using the same survey tool, included current practice in relation to use of ACTs, perception of their effectiveness, clinical reasoning and awareness of the literature and guidelines. For the purpose of this study, ACTs were defined as techniques used by a physiotherapist for the purpose of clearing sputum from patients’ airways. Results: 202 surveys were distributed and seventy responses (35%) were received. The majority of respondents (n = 56, 80%) reported prescribing ACTs for more than 60% of patients with AECOPD, the most common techniques being physical activity (n = 65, 93%) and active cycle of breathing techniques (n = 53, 90%). Sputum management (n = 66, 94%) was the most commonly reported indicator for use of ACTs. The majority of physiotherapists (n = 42, 60%) reported being unsure of the literature regarding ACTs in AECOPD. Conclusion: The response rate to this survey was low, however results show that physiotherapists in the Republic of Ireland regularly prescribe ACTs for patients with AECOPD. Physical activity and active cycle of breathing techniques were the most commonly used ACTs and perceived to be the most effective techniques in AECOPD, with sputum management the most commonly reported indicator for use. Further research is required to explore not only physiotherapists clinical reasoning in relation to the use of ACTs for AECOPD and the perceptions of their effectiveness, but also the lack of awareness of the literature and guidelines

Exploring Speech and Language Therapists’ Perspectives of Voice-Assisted Technology as a Tool for Dysarthria: Qualitative Study

Background: People living with Parkinson disease (PD) often experience low speech volume and reduced intelligibility. Research suggests that common voice-assisted technology (VAT) devices, like Amazon Alexa and Google Home, can encourage individuals to modify their speech, speaking more clearly, slowly, and loudly. This highlights the potential of VAT as a therapeutic clinical tool in speech and language therapy (SLT). However, while VAT is emerging as a novel health care technology, gaps exist regarding understanding speech and language therapists’ (SaLTs) experiences using these devices in clinical practice for PD-related speech and voice difficulties. Objective: This research set out to explore various experiences of using VAT to address hypokinetic dysarthria, secondary to PD, from a range of stakeholder perspectives. This paper specifically focuses on clinical insights from SaLTs. Methods: SaLTs with prior experience of using smart speakers in clinical practice with people with speech or voice difficulties were invited to participate in focus groups or interviews. Between September and December 2024, seven SaLTs participated in semistructured focus groups or interviews using a topic guide. Discussions were informed by published evidence. Results were transcribed and analyzed using a framework analysis approach and were managed through NVivo software (Lumivero). Results: Four main themes were identified across the groups: (1) potential for VAT in SLT, (2) managing therapeutic beige flags, (3) empowering SaLTs to become digitally enabled practitioners, and (4) envisioning the future of VAT in SLT. Conclusions: This study recognizes VAT’s potential as a therapeutic tool that may improve volume, clarity, intelligibility of speech, and facilitate at-home practice for people with PD. However, before VAT can be widely implemented, considerations around data privacy, device limitations, and practical integration into clinical care must be addressed. Future research is proposed to design solutions to address usability challenges for both clients and clinicians. Finally, this paper offers key clinical recommendations for the development of a therapeutic VAT tool for speech and voice difficulties in SLT

Exploring the Perceptions of Voice-Assisted Technology as a Tool for Speech and Voice Difficulties: Focus Group Study Among People With Parkinson Disease and Their Carers

People with Parkinson disease (PD) often report low volume and reduced intelligibility of speech. Common household devices that use voice-assisted technology (VAT) require users to speak slowly, clearly, and loudly for the technology to function. For people with PD, this can be challenging, but this also suggests that VAT may have potential as a therapeutic tool. While VAT is an emerging health care technology, it is important to better understand the thoughts and experiences of people with PD who are already using it despite having speech and voice difficulties. This study aimed to explore experiences of using VAT to address hypokinetic dysarthria secondary to PD, based on the perspectives of people with PD and family carers. People with PD experiencing mild to moderate speech changes who were smart speaker users, and their carers, were invited to participate in 1 of 4 in-person focus groups. Between September and December 2024, focus groups were audiovisually recorded. A semistructured topic guide informed by published evidence was used to guide discussions. Results were transcribed and analyzed through a framework analysis approach (managed using NVivo software). A total of 15 participants, including 8 (53%) people with PD and 7 (47%) carers, participated in 4 in-person focus groups. Findings revealed shared experiences with VAT that were marked by its therapeutic potential and practical challenges. Five main themes were identified: (1) therapeutic potential for speech and voice, with subthemes of changes in volume, intelligibility, and clarity of speech; the role of VAT feedback; and VAT as an everyday device; (2) distrust of technology, with concerns surrounding data privacy, the listening nature of devices, and measures users take to protect themselves; (3) frustrations with devices, including devices not understanding, devices timing out, and the lack of conversation; (4) support needs, including the impact of a lack of knowledge and the need for education and guidance; and (5) design considerations for a future VAT tool in speech and language therapy (SLT). This study extends on previous research findings, demonstrating that VAT may be acceptable to people with PD to create changes in volume, clarity, and intelligibility. However, attention must be given to users' privacy concerns and frustrations with devices before VAT can used as a tool in SLT. Future research should design solutions to address current usability challenges with people with PD and professionals in three ways: (1) co-designing education and guidelines for people with PD, describing the use of VAT for speech and voice difficulties; (2) refining commercial VAT for use in SLT; and (3) establishing the feasibility of a therapeutic VAT intervention for people with PD with speech and voice difficulties. [Abstract copyright: ©Jodie Mills, Orla Duffy, Katy Pedlow, George Kernohan. Originally published in JMIR Rehabilitation and Assistive Technology (https://rehab.jmir.org), 16.07.2025.

Voice Assisted Technology as a tool for speech problems in Parkinson's Disease and related conditions: a scoping review:English

Background: People with neurological conditions like Parkinson’s Disease may have speech and voice difficulties impacting volume, speech clarity and intelligibility. Voice assisted technology, (like Alexa™) poorly recognises speech difficulties and prompts people to change their speech to enable interaction. Aims: This study aims to identify literature regarding the utilization of voice assisted technology to address speech and voice difficulties associated with neurological conditions. We explore: (1) voice assisted technology recognition of speech difficulties or dysarthric speech, and (2) the impact of using voice assisted technology on intelligibility, clarity, or volume for people with dysarthria or speech difficulties. Methods and Procedures: A review of available literature was guided by Arksey and O’Malley’s (2005) scoping review framework in 2023. Five electronic databases were systematically searched, yielding 840 results, before screening and data extraction. Outcomes were narratively reviewed. Findings are reported using the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR). Outcomes and Results: Five papers were reviewed to include dysarthria, stammering and reduced intelligibility. Results indicate limited evidence regarding the role of voice assisted technology for assessment in speech and language therapy (SLT). Voice assisted technology holds promise as a SLT management tool to improve volume, clarity and intelligibility of speech, with implications for participation and wellbeing. Conclusions and Implications: This review provides tentative conclusions that voice assisted technology may improve volume, intelligibility and clarity of speech for people with dysarthria or speech difficulties. This technology has potential as a SLT tool to aid self-management and maintenance. Relevance to conference This research indicates that cross disciplinary partnerships are vital to advance how voice assisted technology, like Alexa and Google Home, can be used therapeutically in speech and language therapy. Combining the knowledge of computer science and allied health, may contribute to more timely management of dysarthrophonia in Parkinson’s Disease, which is known to worsen over time. This may facilitate home based healthcare, which is both personalised and accessible, and mitigates long waitiling lists in Northern Ireland. <br/

The key role of feedback in institutional readiness for programmatic assessment

Programmatic assessment for learning represents a shift from fragmented, summative assessment practices to integrated, developmental systems where feedback is central to learning. This paper argues that feedback is foundational to programmatic assessment (PAx) implementation. Using feedback as an analytical lens, it examines institutional readiness for the deep structural and cultural shifts that PAx requires, drawing on a qualitative case study of course coordinators across three disciplines at an Australian university. Five interrelated barriers were identified: fragmented feedback, summative assessment reliance, workload constraints, absence of coordinated feedback pathways, and unconstrained educator autonomy. These reflect structural and cultural misalignments with PAx principles. This paper positions feedback as a diagnostic of systemic readiness for PAx implementation. Reconceptualising feedback as central to curriculum and pedagogy enables institutions to move beyond siloed unit assessment to coherent, student-centred programs, offering practical and conceptual guidance to institutions seeking to undertake meaningful assessment reform