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Why Rural and Remote Telehealth?

Updated: Apr 2

Did you know research shows that speech pathology therapy (including assessments) conducted by telehealth is as effective as face to face sessions?

 

Whilst studying for my masters of Speech Pathology I conducted several literature reviews and one systematic review on this very topic. One of my topics included reviewing several journal articles and investigating the effectiveness of parent mediated therapy for children diagnosed with autism spectrum disorder (ASD) and looking at the fidelity of the intervention, improvement in childhood communication, parent perceptions toward telepractice and the technological barriers that impact therapy with children and families (Vismara et al., 2013). We know early childhood intervention is pivotal in helping children with ASD (and all children by the way), to help them progress to their highest level of functionality (Baharav & Reiser, 2010; Boisvert & Hall, 2014). It is particularly important during COVID times as access to quality intervention for children and families in the country can be limited.


Here is what I found:

  • The telepractice model may consist of initial face to face training with follow up sessions using telepractice, self-directed online programs or a combination of coaching and self-directed programs delivered online (Boisvert, Lang, Andrianopoulos & Boscardin, 2010; Sutherland, Trembath, Hodge, Rose & Roberts, 2019).

  • Telepractice can incorporate a variety of training modules and core content that uses online self-guided manuals, handouts, video clips and slide shows that are self-directed (asynchronous) and can be supported by coaching for follow up sessions (Boisvert et al., 2010, Wainer & Ingersoll, 2011).

  • Telepractice can be two-way videoconferencing (in real-time), from homes, schools or remote settings with a therapist who guides the parent to learn and practice the new strategies over the length of the program (Boisvert et al., 2010, Wainer & Ingersoll, 2011).

  • Parents are the most natural teachers of their children and have the greatest interest and influence on the long-term growth and development of their children (Vismara, McCormick, Wagner, Monlux, Nadhan & Young, 2018).

  • Conducting therapy in your own home, saves time and costs for travel to and from a clinic which may be kilometres away.

  • Therapy in your natural environment may alleviate problems with new settings and possible anxiety associated with heading into a clinic.

  • Training parents to implement therapy to naturally enhance their child's communication via telepractice can be an valid and safe way to improve services across Australia (McDuffie, Machalicek, Oakes, Haebig, Weismer & Abbeduto, 2013).

  • Studies showed parents or care givers can be trained as interventionists to improve their child's social communication skills (Baharav & Reiser, 2010).

  • Vocalisations, joint attention and imitation increased across three of the studies in both self-directed groups and therapist assisted groups (Vismara et al., 2012; Vismara et al., 2013; Vismara et al., 2018).

  • Overall child communication outcomes increased across telepractice and self-directed groups (Bearss et al., 2018; Hao et., 2020; Ingersoll et al., 2016; Kuravackel et al., 2018; McGarry et al., 2020; Machalicek et al., 2016; Meaden et al., 2016; Neely et al., 2020; Suess et al., 2014; Vismara et al., 2012; Vismara et al., 2013; Vismara et al., 2018; Wainer & Ingersoll, 2015).

  • Parents in two of the studies described barriers to their web-based program as poor connectivity made slide shows and videos to play slowly (Bearss et al., 2018) and incompatibility of the website to their iPad’s and iPhone’s (Wainer & Ingersoll, 2015).

  • Parents described some degree of frustration when using the video conferencing programs, i.e. not being able to log on to the internet, the internet freezing mid conversation, or the audio or web-camera not working when first connecting with the therapist (Vismara et al., 2012). Even though limitations and challenges do occur with technology this is usually overcome in sessions, except for connectivity issues which relate to factors out of the therapist and families control.

  • Parents satisfaction across programs was reported as “high” or “very acceptable” or “highly usable” for the telepractice models and self-directed programs (Kuravackel et al., 2018; McGarry et al., 2020, Suess et al., 2914; Wainer & Ingersoll, 2015).

  • Overall parents responded favourably to the intervention approaches via telepractice in many studies commented they would recommend telepractice to other parents who have children with ASD particularly where community services are limited (Meaden et al., 2016; Vismara et al., 2012; Wainer & Ingersoll, 2015).

  • Previous studies have also shown parents can effectively apply evidence-based strategies to enhance their child’s learning provided the skills are acquired and maintained through high quality training and support is provided by professionals (Roberts & Kaiser, 2011; Wong et al., 2015).


If you live in a rural or remote region and would like to access telehealth services, give me a call or send an email to access2speech@gmail.com

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