In the past couple years, more and more research has been conducted on how telepractice/telehealth may benefit the populations Worldwide Speech services in the areas of Speech-Language Pathology, Special Education, Reading Intervention and Occupational Therapy. For this month’s newsletter, we wanted to provide you with an update on current literature surrounding telepractice/telehealth.
Research Updates in Speech Language-Pathology
The studies in this section verify the effectiveness of telepractice for the following treatment areas: Augmentative Alternative Communication (AAC), Speech Sound Disorder, Aphasia, Stuttering, Language Disorder, and Early intervention services (EI).
AAC includes all the ways we share ideas and feelings without talking. Some populations that may use AAC include those with Autism Spectrum Disorder, aphasia, traumatic brain injury. There is growing research to support the use of tele-AAC (Hall & Boisvert, 2014).
A speech sound disorder is a communication disorder in which children have difficulty saying words or sounds correctly. A study conducted in 2018 suggests comparable treatment outcomes between traditional service delivery and telepractice for treatment of children exhibiting speech sound disorders (Coufal, et. al., 2018).
Aphasia is an impairment of production and/or comprehension of language and the ability to read or write. Aphasia is always due to injury to the brain, most commonly from stroke. A study was conducted in 2018 that found Script training, a treatment method for persons with aphasia (PWA), provided via telepractice had gains in communication (Rhodes & Isaki, 2018). Another study published in 2019 found that there was no difference in outcomes between the telehealth and face-to-face conversation partner training, another treatment method for PWA (Cameron, et. al., 2019).
Stuttering is a speech disorder which causes disruptions by involuntary repetitions and prolongations of sounds, syllable or phrases as well as involuntary silent pauses or blocks. A systematic review conducted in 2018 suggested that Live-stream, video telepractice are promising service- delivery methods for treatment of stuttering using the Camperdown Program, Lidcombe Program, and integrated approaches (Mcgill, Noureal, & Siegel, 2019).
A language disorder is an impairment that makes it hard for someone to put thoughts into words or make it difficult to understand what another person says. A study in 2010 compared the effectiveness of speech-language therapy provided by telepractice which showed videoconferencing of speech-language therapy services was a reliable and effective method of service delivery (Grogan-Johnson, Alvares, Rowan, & Creaghead, 2010).
EI services are typically provided for infants and toddlers who have a disability or who are at risk of developmental delay due to a diagnosed mental/physical condition. Parent training and coaching has been found to be effective as a communication intervention in EI services. A study conducted in 2017 found that the use of videoconferencing and online training tools via telepractice to provide parent training and coaching is a viable alternative or supplemental means to performing speech-language therapy (Snodgrass, et. al., 2017).
Research Updates in Special Education
Recent research is still limited for special education services, but the following studies have been conducted for Autism Spectrum Disorder and Intellectual Disabilities which confirm services provided via telepractice are equivalent to in-person services.
Autism Spectrum Disorder: A systematic review conducted in 2018 suggests that services delivered via telehealth are equivalent to services delivered face to face, and superior to comparison groups without telehealth sessions (Sutherland, Trembath, & Roberts, 2018).
Intellectual disabilities: A study was conducted in 2010 that compared effectiveness of standard care to the effectiveness of telecare. While both types of supports resulted in consumers completing tasks, results indicated consumers achieved slightly more independence when prompted by the telecare support provider. Additionally, telecare supports resulted in greater duration for task completion per consumer (Taber-Doughty, Shurr, Brewer, & Kubik, 2010).
Research Updates in Reading Intervention
Literacy services are provided for children and adults who have difficulty reading. Below are two studies that confirm the efficacy of both assessment and treatment of literacy disorders.
Literacy Assessment: A study conducted in 2019 found that telepractice can enable remote delivery of literacy assessment to increase availability of assessments to meet the needs of children who live remotely (Hodge, et. al., 2019).
Literacy Intervention: A study conducted in 2013 found that participants improved in each foundational reading skill in both, the face-to-face and telepractice settings within a similar number of sessions (Beth, 2013).
Research Updates in Occupational Therapy
Occupational therapy (OT) services via telehealth are up and coming! Below are two studies that conclude there is no significant difference between in-person and telehealth services:
Parkinson’s Disease: There are multiple efficacy studies that conclude there is no significant difference in clinical outcomes between OT services provided in-person vs. telehealth for wheelchair assessment, pre-admission orthopedic occupational therapy home visits, assessment of activities of daily living and hand function in patients with Parkinson’s disease, and ergonomic assessment (Cason, 2014).
Pediatric OT: a 2019 study found clear evidence of the effectiveness of the use of Telehealth in Pediatric Occupational Therapy (Figueiredo, 2019).
American Speech and Hearing Association. Picture of Evidence-Based Practice (EBP) Triangle. Retrieved from https://www.asha.org/research/ebp/evidence-based-practice/
Worldwide Speech is dedicated to using evidence-based practice to provide the most effective care available. This means we not only incorporate scientific evidence in our therapy/education, we also use our clinical expertise and your perspectives! We love your input. This helps us individualize care to maximize client success.
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- American Occupational Therapy Association Telehealth [Position paper] American Journal of Occupational Therapy. 2013b;67(Suppl):S69–S90. doi: 10.5014/ajot.2013.67S69.
- Hetherton, Mary Beth. (2013). Treatment of foundational reading skills through Telepractice and face-to-face environments: Single subject design. Ph.D. diss., University of Massachusetts Amherst, http://proxygw.wrlc.org/login?url=https://search-proquest-com.proxygw.wrlc.org/docview/1468453908?accountid=11243 (accessed February 24, 2020).
- Cameron, A., Mcphail, S., Hudson, K., Fleming, J., Lethlean, J., & Finch, E. (2019). Telepractice communication partner training for health professionals: A randomised trial. Journal of Communication Disorders, 81, 105914. https://doi.org/10.1016/j.jcomdis.2019.105914
- Cason J. (2014). Telehealth: a rapidly developing service delivery model for occupational therapy. International journal of telerehabilitation, 6(1), 29–35. https://doi.org/10.5195/ijt.2014.6148
- Coufal, K., Parham, D., Jakubowitz, M., Howell, C., & Reyes, J. (2018). Comparing traditional service delivery and telepractice for speech sound production using a functional outcome measure. American Journal of Speech – Language Pathology (Online), 27(1), 82-90. doi:http://dx.doi.org.proxygw.wrlc.org/10.1044/2017_AJSLP-16-0070
- Figueiredo, M. (2019). The use of telehealth in pediatric occupational therapy. Annals of Medicine, 51(sup1), 66–66. doi: 10.1080/07853890.2018.1561616
- Grogan-Johnson, S., Alvares, R., Rowan, L., & Creaghead, N. (2010). A pilot study comparing the effectiveness of speech language therapy provided by telemedicine with conventional on-site therapy. Journal of Telemedicine and Telecare, 16(3), 134–139. doi: 10.1258/jtt.2009.09060
- Hall, N., & Boisvert, M. (2014). Clinical Aspects Related to Tele-AAC: A Technical Report. Perspectives on Augmentative and Alternative Communication, 23(1). https://doi.org/10.1044/aac23.1.18
- Hodge, M., Sutherland, R., Jeng, K., Bale, G., Batta, P., Cambridge, A., … Silove, N. (2019). Literacy Assessment Via Telepractice Is Comparable to Face-to-Face Assessment in Children with Reading Difficulties Living in Rural Australia. Telemedicine and e-Health, 25(4), 279–287. https://doi.org/10.1089/tmj.2018.0049
- Mcgill, M., Noureal, N., & Siegel, J. (2019). Telepractice Treatment of Stuttering: A Systematic Review. Telemedicine and e-Health, 25(5), 359–368. https://doi.org/10.1089/tmj.2017.0319
- Naomi C. Rhodes, & Emi Isaki. (2018). Script Training Using Telepractice with Two Adults With Chronic Non-fluent Aphasia. International Journal of Telerehabilitation, 10(2), 89–104. https://doi.org/10.5195/ijt.2018.6259
- Snodgrass, M. R., Chung, M. Y., Biller, M. F., Appel, K. E., Meadan, H., & Halle, J. W. (2017). Telepractice in Speech–Language Therapy: The Use of Online Technologies for Parent Training and Coaching. Communication Disorders Quarterly, 38(4), 242–254. https://doi.org/10.1177/1525740116680424
- Sutherland, R., Trembath, D., & Roberts, J. (2018). Telehealth and autism: A systematic search and review of the literature. International Journal of Speech-Language Pathology, 20(3), 324–336. doi: 10.1080/17549507.2018.1465123
- Taber-Doughty, T., Shurr, J., Brewer, J., & Kubik, S. (2010). Standard care and telecare services: comparing the effectiveness of two service systems with consumers with intellectual disabilities. Journal of Intellectual Disability Research, 54(9), 843–859. doi: 10.1111/j.1365-2788.2010.01314.x