The results of this study support the validity and reliability of scoring the core language subtests of the CELF-4 via telehealth.

We investigated the feasibility of assessing childhood speech disorders via an Internet-based telehealth system (eREHAB). The equipment provided videoconferencing through a 128 kbit/s Internet link, and enabled the transfer of pre-recorded video and audio data from the participant to the online clinician. Six children (mean age ¼ 5.3 years) with a speech disorder were studied. Assessments of single-word articulation, intelligibility in conversation, and oro-motor structure and function were conducted for each participant, with simultaneous scoring by a face to face and an online clinician. There were high levels of agreement between the two scoring environments for single-word articulation (92%), speech intelligibility (100%) and oro-motor tasks (91%). High levels of inter-and intra-rater agreement were achieved for the online ratings for most measures. The results suggest that an Internet-based assessment protocol has potential for assessing paediatric speech disorders.

We examined the validity and reliability of an Internet-based telehealth system for screening speech intelligibility and oro-motor structure, and function in children with speech disorders. Twenty children aged 4-9 years were assessed by a clinician in the conventional, face-to-face (FTF) manner; simultaneously, they were assessed by a second clinician via the videoconferencing system using a 128-kbit/s Internet connection. Speech intelligibility in conversation was rated and an informal assessment of oro-motor structure and function was conducted. There was a high level of agreement between the online and FTF speech intelligibility ratings, with 70% exact agreement and 100% close agreement (within ± point on a 5-point scale). The weighted kappa statistic revealed very good agreement between raters (kappa = 0.86). Data for online and FTF ratings of oro-motor function revealed overall exact agreement of 73%, close agreement of 96%, moderate or good strength of agreement for six variables (kappa = 0.48-0.74), and poor to fair agreement for six variables (kappa = 0.12-0.36). Intra- and inter-rater reliability measures (ICCs) were similar between the online and FTF assessments. Low levels of agreement for some oro-motor variables highlighted the subjectivity of this assessment. However, the overall results support the validity and reliability of Internet-based screening of speech intelligibility and oro-motor function in children with speech disorders.

As issues with audio latency, break-up, and echo were observed, some modifications to the technology may improve system effectiveness and usability. However, the overall positive results of this study support the validity and reliability of the assessment of children's literacy skills via telehealth.

A number of professional disciplines employed internally and externally provide services in Residential Aged Care Facilities (RACFs). Literature has long highlighted numerous workplace issues in RACFs, yet little progress has been made in addressing these. As such there has been a call for greater understanding of shared issues among service providers. The aim of the current study is to explore and compare the perceptions of a cross-section of service providers regarding the challenges and motivators to working in RACFs. In-depth semi-structured interviews were conducted with 61 participants including: care managers, nurses, assistants in nursing, care, domestic and support staff, and speech pathologists. Analysis revealed few issues unique to any one service discipline, with four key themes identified: (a) working in RACFs is both personally rewarding and personally challenging; (b) relationships and philosophies of care directly impact service provision, staff morale and resident quality of life; (c) a perceived lack of service-specific education and professional support impacts service provision; and (d) service provision in RACFs should be seen as a specialist area. These data confirm there are key personal and professional issues common across providers. Providers must work collaboratively to address these issues and advocate for greater recognition of RACFs as a specialist service area. Acknowledging, accepting and communicating shared perceptions will reduce ongoing issues and enhance multi-disciplinary care.