This week, I found an article by researchers Wales, Skinner, and Hayman (2017) that highlights a systematic review of the literature pertaining to the effectiveness of telehealth (telepractice) service delivery for primary-aged children with speech and language needs in comparison to in-person SLP intervention. The research that I have been engaging in over the past few weeks has been highlighting individual research and studies on this topic and my hope of diving into this review of the literature by Wales, Skinner, and Hayman (2017), was to shed more light on this comparison between telepractice and face-to-face service provision. The research cited by Wales, Skinner, and Hayman (2017) originates in Australia and the United States, as I have not yet been successful in finding current research in a Canadian context.
To begin their literature review, the authors engaged in a systematic search strategy that utilized this database search string: “(telehealth OR telepractice OR telerehabilitation OR teletherapy) AND (speech pathology OR speech-language pathology OR speech therapy) AND (child OR paediatric)” (p. 56, 2017). With the search results, studies were included that reviewed speech and language intervention (speech sound production, intelligibility, and expressive and receptive language) delivered through telepractice of primary-aged children (4 – 12 years old) across various settings with outcome and data results on intervention effectiveness. Results that reviewed “special client populations” (e.g. autism or childhood apraxia), voice, fluency, and pragmatics interventions were not included.
All of the studies used in the review cited using real-time videoconferencing, however across the 7 different studies that were selected by Wales, Skinner, and Hayman (2017), there were six different types of outcome that were measured, which made it difficult to directly compare the studies. The researchers also stated that due to the highly variable practice area of language, it makes it more challenging to identify comprehensive measures for data and outcome comparison (2017). For example, the studies examining functional communication had conflicting results, whereas other studies focusing on articulation found no significant different between telepractice and face-to-face intervention (Wales, Skinner, & Hayman, 2017). However, even with the limitations and variables in comparing the literature in regards to telepractice effectiveness for speech and language service, the researchers indicated that this service delivery model has potential in providing support for remote and rural students and alleviating detrimental effects of speech and language challenges in education and social-emotional well-being for students (2017). It is clear that more research is required as the technology advances and telepractice becomes acknowledged and utilized as a potential support in removing the barrier to equitable speech and language support for children. With time, I hope that it will become more clear on whether there are specific aspects of speech and language support that are more effective than others (e.g. speech sound production versus pragmatics) so that we can advocate and provide timely and effective intervention for our students.
Reflecting on the types of service provision that my students are engaged in with our teletherapy with TinyEYE, I have 3 students who are currently engaged with this service delivery model and their areas of focus range from voice, speech sounds and articulation, and pragmatics. These students have only had 4 sessions so far this school year, so it will be interesting to see how they progress with this range of therapy intervention since their needs reflect areas that were both included and not included in the systematic review by Wales, Skinner, and Hayman (2017). I do believe, as has been highlighted in past articles that I have reviewed for this inquiry, that the collaboration between myself, the SLP, and our eHelper will be instrumental in the effectiveness of our therapy intervention for our students.
Looking forwards, in the next few weeks I hope to broaden my inquiry and research to explore the literature in regards to computer-based interventions and applications in relation to service support for speech and language. Reflecting upon the research that I’ve engaged with over the past couple of weeks in regards to teletherapy, it seems that with efficient technology, a therapy assistant (TA or eHelper), and collaborating with teachers and families are imperative in providing effective teletherapy for speech and language. Therefore, I’m curious to explore computer-based interventions to determine if there is a difference in service provision and effectiveness for supporting students with speech and language needs, or if teletherapy should be considered as the primary option for remote and rural schools who do not have access to a face-to-face SLP.
Wales, D., Skinner, L., & Hayman, M. (2017). The efficacy of telehealth-delivered speech and language intervention for primary school-age children: A systematic review. International Journal of Telerehabilitation, 9(1), 55-70.