A review of the efficacy and effectiveness of using telehealth for paediatric speech and language assessment

Abstract

We reviewed the literature relating to the use of telehealth for paediatric speech and language assessment. Four databases, and relevant reference lists, were searched for articles published between January 2004 and July 2014. A total of 180 articles were identified, of which only five were relevant. All studies assessed efficacy using method comparison techniques; no studies assessed effectiveness. The method comparison studies investigated the validity and/or reliability of speech and language assessment via telehealth, when compared with face-to-face assessment. Studies varied in terms of participant group, assessment tools, statistical analysis and telehealth equipment. The papers reviewed presented some evidence that telehealth can be used to make valid assessments of oromotor function, speech intelligibility and language. Articulation screening via telehealth was found to be valid, but there was conflicting evidence about full articulation assessment. Intra- and inter-rater reliability was good for all speech and language tasks, with the exception of oromotor assessment, which also had reduced reliability when assessed face-to-face. There were discrepancies between the two modalities for individual oromotor tasks, judgement of individual speech sounds, detection of pluralisation, and discriminating between similar sounding words; these have the potential to be clinically important. Evidence regarding satisfaction was extremely limited, with only one study reporting parental satisfaction, and no studies reporting child or clinician satisfaction. Although there is limited evidence to support the validity and reliability of speech and language assessment via telehealth, it is probably not yet sufficient to influence clinical practice or policy development.

The Efficacy of Telehealth-Delivered Speech and Language Intervention for Primary School-Age Children: A Systematic Review.

“…Interestingly, all of the reviewed studies utilised real-time videoconferencing facilities, allowing the clinician and client to visualise each other. This finding is consistent with results from previous reviews ( Mashima & Doarn, 2008 ; Reynolds et al, 2009 ; Taylor, Armfield, Dodrill, & Smith, 2014 ), indicating that real-time interactions support the delivery of services and strongly influence the clinical outcomes achieved through telehealth. Delivering speech and language intervention services through real-time videoconferencing facilities is an effective method of service delivery as this medium most closely resembles in-person interactions through the transmission of auditory and visual signals at a distance ( Mashima & Doarn, 2008 ; Reynolds et al, 2009 ).…”

Telehealth language assessments using consumer grade equipment in rural and urban settings: Feasible, reliable and well tolerated

“…Very good levels of inter-and intra-rater agreement were found on all measures with some variation between subtests (k range from 0.93 to >0.99). A limitation of this study, as noted by Taylor et al, 13 is that it was not conducted in real world settings but rather under ideal research conditions. In addition, none of the studies reported client or clinician satisfaction and only Ciccia et al reported on parent satisfaction.…”

The Implementation of Telepractice in Speech Language Pathology in Hong Kong During the COVID-19 Pandemic

“…We believe this is sensible and would be typical in how face-to-face services transition to telepractice. However, emerging evidence also supported that telepractice is a viable and reliable means for screening or assessment in specific areas, including articulation screening, 26 aphasia assessment, 27 and poststroke dysphagia evaluation. 15 The use of telepractice in assessment and screening is likely to be more common as SLPs gather experience on this model of service delivery.…”