Language Intervention via Text-Based Tele-AAC: A Case Study Comparing On-site and Telepractice Services

Abstract

There is a shortage of qualified speech and language pathologists (SLPs) to not only meet the needs of students with a variety of communicative disabilities, but also the needs of those students with severe impairments who use augmentative and alternative communication (AAC). Special education administrators need to consider additional methods of service delivery, such as telepractice. However, there is limited evidence regarding the efficacy of services delivered to students using AAC via telepractice as opposed to face-to-face services. This study examines the effectiveness of services provided using both methodologies, and aims to provide some validation of telepractice as an alternative treatment method. Using a single-subject design to compare performance outcomes, a 7 year-old male participant, who used a Vantage Plus™ device with an 84-sequenced overlay, was studied over an eight-week period, with four weeks of on-site therapy immediately followed by four weeks of telepractice therapy. Student progress was measured by comparing outcomes in both conditions to baseline data with respect to short-term goals focused on grammatical morphemes. The results indicate that the performance outcomes were comparable in both conditions. The authors discuss the implications of using telepractice to deliver direct intervention and future applications of telepractice as a service delivery model for individuals using AAC.

School-Based Speech-Language Services Using Telepractice

“…Telepractice extends to collaboration and specialized support for both the SLP and the student to other SLPs or service providers. Telepractice for collaboration may include providing caregiver training of new therapy techniques (e.g., use of augmentative and alternative communication devices; Hall et al, 2014) or for instructional coaching when students are in the home setting during school closures (Reimers & Schleicher, 2020). In addition, telepractice allows the needs of a student to be matched with the expertise of a therapist (Ben-Aharon, 2019).…”

Telepractice in Speech–Language Therapy: The Use of Online Technologies for Parent Training and Coaching

“…The list of technologies in Table 1 is not intended to be comprehensive. We refer interested readers to other publications for additional information on technologies that have been used in telepractice (see Allen & Crutchley, Campbell, & Christiana, 2012;Hall et al, 2014;Keck & Doarn, 2014;McCarthy, 2013;Meadan et al, 2013). Both the SLP and the family must have an adequate Internet connection and a device that supports online videoconferencing, such as a computer, tablet, or smartphone.…”

“…Telepractice can be a means for delivering speech therapy with various population groups, ranging from infants to adults, who have speech and communication disorders (e.g., voice disorders, aphasia, articulation, dysarthria, speech sound disorders; Grogan-Johnson et al, 2013; Keck & Doarn, 2014; Theodoros, 2011). Telepractice has also been used to deliver services to individuals who have hearing loss (Galvan, Case, & Todd Houston, 2014; Houston & Stredler-Brown, 2012) and other conditions that affect speech and communication (e.g., schizencephaly, Hall, Boisvert, Jellison, & Andianopoulos, 2014; velo-cardio-facial syndrome, Shprintzen & Golding-Kushner, 2012). Researchers have also employed telepractice to deliver services to individuals with autism spectrum disorder (ASD; Allen & Shane, 2014; Meadan et al, 2016).…”

“…Telepractice also has been used to deliver services in actual intervention or therapy sessions (e.g., Grogan-Johnson et al, 2013; Theodoros, 2011). Finally, telepractice has been embraced as a tool for conversing with, providing consultation to, and providing training and supports to clients, caregivers, and other professionals (Anderson et al, 2014; Galvan et al, 2014; Hall et al, 2014; Meadan et al, 2016). Grogan-Johnson et al (2013) compared the use of telepractice in the delivery of speech–language therapy services with traditional on-site services, and found no difference with the intervention outcomes between the two service delivery models.…”

“…In addition, because the SLP is not in the same location, he or she cannot move throughout the environment with the child (Anderson et al, 2014) and may find it more difficult to effectively prompt the child (Grogan-Johnson et al, 2013; Keck & Doarn, 2014). The SLP may still need a skilled adult present with the child to assist with technical difficulties, loss of the child’s attention, or safety issues (Hall et al, 2014; Tindall, 2013). In addition to these challenges to direct intervention via telepractice, some children may require adaptive equipment to access telepractice technologies (Grogan-Johnson et al, 2013), or they may have an aversive response to some equipment (e.g., headphones; Grogan-Johnson et al, 2013; Keck & Doarn, 2014).…”