By Dr. Brenda Gorman, CCC-SLP, Lingua Health Advisory Clinical Director and Marquette University Assistant Professor, College of Health Sciences Speech Pathology and Audiology
Dr. Brenda Gorman, CCC-SLP
The technological advances we have seen over the last decades are amazing. I first used a computer, the one computer at school, in junior high. I remember typing papers in high school on a typewriter, which my own kids have seen only in museums. They would probably think that white-out was nail polish. Now we are rarely without a computer, iPod, iPad, or iPhone within arm’s reach. My three-year-old just asked if we could get him his own iPod. Technology has changed our daily lives, and it’s fascinating to consider how much technology is changing our profession.
You’ve probably heard about the recent surge in telepractice, or as it is also referred to, telespeech or teletherapy, in many fields including speech-language pathology. Comparatively, telepractice in speech-language pathology is still in its infancy. Due to its rapid growth, however, I’ve been incorporating this topic more and more into my courses, knowing that telepractice may very well be a part of my graduate students’ future practice.
ASHA defines telepractice as “The application of telecommunications technology to deliver professional services at a distance by linking clinician to client, or clinician to clinician for assessment, intervention, and/or consultation (www.asha.org/practice/telepractice). The technology requirements typically include videoconferencing platforms and equipment, high bandwidth internet, scanners, printers, and headphones.
Many of you have already used some type of video chat system such as Skype. I’ve had some success using it so that my kids can chat with their family members overseas. Neither was too keen on sitting for as long as hoped, and the intermittent delays taxed their attention spans. It should be noted that Skype is not sufficiently secure for telepractice. A very helpful and detailed comparison of web conference platforms can be found at http://web-conferencing-services.toptenreviews.com/.
You may be wondering how well telepractice works when serving young clients. What do SLPs who have engaged in telepractice say about their experience? According to Mashima and Doarn (2008), although initially skeptical, most SLPs have had positive experiences.
Tucker (2012) interviewed several SLPs who all had more than five years of clinical experience and at least nine months of telepractice experience in school settings. As you might suspect, technical difficulties, such as interrupted internet access or problems with audio, were among the more commonly reported challenges.
Some SLPs also commented that difficulties arose when the support staff who were assisting the children were not properly trained to use the equipment, were not ready to begin the session on time, did not have the necessary materials ready, or were unable to resolve behavioral issues. In addition, challenges were reported when procedures were not clearly established for how the clinician and support staff would handle technical glitches during the session. Some noted disadvantages associated with having less contact with the students’ teachers, the inability to team teach, and difficulty promoting carryover of skills in the classroom. On a more personal note, you might wonder what it would be like not to have physical contact with your clients, their families, and colleagues. Among Tucker’s sample, one therapist described the format as lonely and difficult due to less physical movement.
ASHA clearly states that the quality of services delivered via telepractice must be consistent with the quality of services delivered face-to-face (ASHA, 2004). Training and establishment of clear “how to” procedures can help address many of the challenges previously described.
On the more positive side, one clinician who was interviewed described the telepractice format as exciting. Parents and teachers can indeed be involved. And while some children might not be suitable candidates for telepractice, some of the clinicians felt that many children actually made faster progress because the telepractice format helped elicit more responses than in-person service delivery. Clinicians reported that some children are particularly interested in the computer and more motivated to stay on task and that the headphones appeared to help some children concentrate and attend better. In addition, telepractice can reduce the time, transportation, and scheduling burdens on both families and clinicians alike.
Telepractice exists and will continue to grow because it fulfills numerous needs. There are shortages of SLPs in many parts of the country, and telepractice helps extend serves to remote areas. With the limited number of SLPs with expertise in serving culturally and linguistically diverse populations, telepractice can also help fulfill diverse clients’ needs. While we have yet to learn more about best practice and effectiveness, more and more resources about telepractice such ASHA’s webpage as indicated above are becoming available.
We can only imagine how else technology will change our profession in the decades to come.
Mashima, P. A., & Doarn, C. R., (2008). Overview of telehealth activities in speech-language pathology. Telemedicine and e-Health, 14, 1101-1117.
Tucker, J. K. (2012). Perspectives of speech-language pathologists on the use of telepractice
in schools: The qualitative view. International Journal of Telerehabilitation, 4, 47-59.