Telepractice and effort during interactive conversations: Using EmbracePlus health monitor to study normal-hearing children

Wearable sensors are increasingly being used to evaluate physiological biomarkers associated with perceived effort in adverse listening conditions. The current study examined the feasibility of using EmbracePlus (E4), a wearable health monitor, to assess effort in normal-hearing children who interacted with a clinical provider during telepractice. Ten children (mean age = 10.4 years, age range 8–12 years)participated in four (two in-person, two tele) weekly visits, order counterbalanced. At each visit, the clinician asked the children to hold a standardized conversation using a Diapix picture task and provide subjective ratings of perceived effort. Measures of electrodermal activity and blood volume pulse amplitude were collected from the EmpracePlus wristband worn by each child. Children self-reported a significant increase in perceived effort during tele- compared to in-person sessions. Their effort, however, decreased over time. Based on preliminary data, it is predicted that physiological measures of effort will be consistent with child subjective ratings, although individual differences may affect the results. The study demonstrates the feasibility of using EmbracePlus to collect physiological biomarkers associated with perceived effort in normal-hearing children during remote compared to in-person communication. This may impact the telepractice delivery of speech-language intervention in the pediatric population with and without hearing loss.