Computers can be used effectively in the assessment of children's speech and language. Biofeedback instrumentation allows the clinician to obtain relatively objective measures of certain aspects of speech production. For example, measures of jitter and shimmer can be recorded, along with perceptual judgments about a client's pitch and intensity perturbations (Case, 1999). Acoustic analyses (Kent and Read, 1992) can be used to supplement the clinician's perceptions of phonological contrasts (Masterson, Long, and Buder, 1998). For the evaluation of a client suspected of having a fluency disorder, recent software developments allow the clinician to gather measures of both the number and type of speech disfluencies and to document signs of effort, struggle, or disruption of airflow and phonation (Bakker, 1999a). Hallowell (1999) discusses the use of instrumentation for detecting and measuring eye movements for the purpose of comprehension assessment. This exciting tool allows the clinician to evaluate comprehension in a client for whom traditional response modes, such as speaking or even pointing, are not possible.

Computers can also be used to administer or score a formal test (Cochran and Masterson, 1995; Hallowell and Katz, 1999; Long, 1999). Computer-based scoring systems allow the input of raw scores, which are then converted to profiles or derived scores of interest (Long, 1999). The value of such programs is inversely related to the ease of obtaining the derived scores by hand. If the translation of raw scores to derived scores is tedious and time-consuming, clinicians might find the software tools worth their investment in time and money.

Although few computerized tests are currently available, the potential for such instruments is quite high. Hallowell and Katz (1999) point out that computerized test administration could allow tighter standardization of administration conditions and procedures, tracking of response latency, and automated interfacing with alternative response mode systems. Of particular promise are the computerized tests that adapt to a specific client's profile. That is, stimuli are presented in a manner that is contingent on the individual's prior responses (Letz, Green, and Woodard, 1996). The type of task or specific items that are administered can be automatically determined by a client's ongoing performance (e.g., Masterson and Bernhardt, 2001), which makes individualized assessment more feasible than ever. Incorporation of some principles from artificial intelligence also makes the future of computers in assessment exciting. For example, Masterson, Apel, and Wasowicz (2001) developed a tool for spelling assessment that employs complex algorithms for parsing spelling words into target orthographic structures and then aligning a student's spelling with the appropriate correct forms. Based on the type of misspellings exhibited by each individual student, the system identifies related skills that need testing, such as phonological awareness or morphological knowledge. This system makes possible a comprehensive description of a student's spelling abilities that would otherwise be prohibitive because of the time required to perform the analyses by hand and administer the individualized follow-ups.

Computerized language and phonological sample analysis (CL/PSA) has been in use since the 1980s (Evans and Miller, 1999; Long, 1999; Masterson and Oller, 1999; Long and Channell, 2001). These programs allow researchers and clinicians to perform complex, in-depth analyses that would likely be impossible without the technology. They provide instant analysis of a wide range of phonological and linguistic measures, and some provide tools that reduce and simplify the time-consuming process of transcribing samples (Long, 1999). Many of the CL/PSA programs also include comparison databases of language samples from both typical and clinical populations (Evans and Miller, 1999). Despite the power of CL/PSA programs, their use in clinical settings remains limited, for unclear reasons. It is possible that funding for software and hardware is insufficient; however, data from recent surveys (McRay and Fitch, 1996; ASHA, 1997) do not support this conjecture, since most respondents do report owning and using computers for other purposes. Lack of use is more likely related to insufficient familiarity with many of the measures derived from language sample analysis and failure to recognize the benefits of these measures for treatment planning (Cochran and Masterson, 1995; Fitch and McRay, 1997). In an effort to address this problem, Long established the Computerized Profiling Website (http://www.computerizedprofiling.org) in 1999. Clinicians can visit the web site and obtain free versions of this CL/PSA software as well as instructional materials regarding its use and application.

Computer software for use in speech and language intervention has progressed significantly from the early versions, which were based primarily on a drill-and-practice format. Cochran and Nelson (1999) cite literature that confirms what many clinicians knew intuitively: software that allows the child to be in control and to independently explore based on personal interests is more beneficial than computer programs based on the drill-and-practice model. Improvements in multimedia capacities and an appreciation for maximally effective designs have resulted in a proliferation of software packages that can be effectively used in language intervention with young children. As with any tool, the focus must remain on the target linguistic structures rather than the toys or activities that are used to elicit or model productions. In addition to therapeutic benefits, computers offer reasonable compensatory strategies for older, school-age students with language-learning disabilities (Wood and Masterson, 1999; Masterson, Apel, and Wood, 2002). For example, word processors with text-to-speech capabilities allow students to check their own work by listening to as well as reading their text. Spell and grammar checkers can be helpful, as long as students have been sufficiently trained in the optimal use of these tools, including an appreciation of their limitations. Speech recognition systems continue to improve, and perhaps someday they will free writers with language disorders from the burden of text entry, which requires choices regarding spelling, and spelling can be so challenging for students with language disorders that it interferes with text construction. Currently, speech recognition technology remains limited in recognition accuracy for students with language disorders (Wetzel, 1996). Even when accuracy improves to an acceptable level, students will still need specific training in the optimal use of the technology. Optimal writing involves more than a simple, direct translation of spoken language to written form. Students who employ speech recognition software to construct written texts will need focused instruction regarding the differences between the styles of spoken and written language. Finally, the Internet provides not only a context for language intervention, but a potential source of motivation as well. The percentage of school-age children who use the Internet on a daily basis for social as well as academic purposes continues to increase, and it is likely that speech-language pathologists will capitalize on this trend.

Computers add a new twist to an old standard in phonological treatment. Instead of having to sort and carry numerous picture cards from one treatment session to the next, clinicians can choose one of several software packages that allow access and display of multimedia stimuli on the basis of phonological characteristics (Masterson and Rvachew, 1999). New technologies, such as the palatometer, provide clients with critical feedback for sound production when tactile or kinesthetic feedback has not been sufficient. Similarly, computer programs can be used to provide objective feedback regarding the frequency of stutterings, which might be considered less confrontational than feedback provided by the clinician (Bakker, 1999b). One particularly promising technology, the Speech Enhancer, incorporates real-time processing of an individual's speech production and selectively boosts energy only in those frequencies necessary for maximum intelligibility. Cariski and Rosenbek (1999) collected data from a single subject and found that intelligibility scores were higher when using the Speech Enhancer than when using a high-fidelity amplifier. The authors suggested that their results supported the notion that the device did indeed do more than simply amplify the speech output.

The decision to use computers in both assessment and treatment activities will continue to be based on the clinician's judgment as to the added value of the technology application. If a clinician can do an activity just as well without a computer, it is unlikely that she or he will go to the expense in terms of time and money to invest in the computer tool. On the other hand, for those tasks that cannot be done as well or even at all, clinicians will likely turn to the computer if they are convinced that the tasks themselves are worth it.

See also aphasia treatment: computer-aided rehabilitation.