The Evolution of Telepractice Use during the COVID-19 Pandemic: Perspectives of Pediatric Speech-Language Pathologists

Abstract

The study investigated how pediatric speech-language pathologists (SLPs) applied telepractice to compensate for the loss of in-person services and the dynamics of telepractice use during the COVID-19 pandemic in a rural state. We conducted interviews with 10 SLPs and then a statewide survey in which 51 SLPs participated. The qualitative interviews revealed themes including changes in service environment due to the pandemic (e.g., transition to telepractice, losing clients), challenges in the transition to telepractice (e.g., limited training, difficulty engaging clients), worsening wellbeing of clinicians and clients, and SLPs’ perspectives and suggestions towards telepractice in the future. Survey results showed service disruptions and transition dynamics during the pandemic. SLPs’ weekly caseloads reduced from an average of 42.3 clients prior to the pandemic to 25.9 and 23.4 from March to May and from June to September 2020, respectively, and then recovered to 37.2 clients from October to December 2020. In contrast, the number of telepractice caseloads sharply increased from 0.2 clients per week prior to the pandemic to 14.8 from March to May 2020. The weekly telepractice caseloads then declined to 5.5 clients from June to September and 7.9 clients from October to December 2020. In the months right after the pandemic outbreak (i.e., March to May), client children struggled with treatment gains and behavioral wellbeing. However, their outcomes gradually improved by October to December and approached pre-pandemic levels. About one-third of the SLPs reported that they would be more likely or much more likely to use telepractice in the future regardless of the pandemic. However, only about a quarter perceived telepractice as comparable to in-person services. We concluded that the transition from in-person services to telepractice substantially mitigated service disruptions right after the pandemic outbreak and that telepractice’s substitute role evolved over time.

Changes in speech, language and swallowing services during the Covid-19 pandemic: The perspective of speech-language pathologists in Saudi Arabia

“…The high level of interest surrounding telehealth among non-user SLPs was also reported in a study conducted by ASHA [ 13 ], wherein 47% of SLPs in the latter study who never use telehealth showed an interest in using it in the future. For SLPs who used telehealth during the pandemic, a study found that around half of the respondents showed interest in using telehealth in the future regardless of the pandemic [ 21 ].…”

“…The identification of these benefits broadly supports the findings of other studies in this area. In terms of convenience and accessibility, telehealth can allow SLPs to offer their services to and expand in rural communities in order to provide services to those patients [ 21 ] [ 28 , 30 ]. The last point is particularly important as most speech therapy services in Saudi Arabia are clustered in the largest cities; thus, patients need to travel long distances to reach services [ 31 ].…”

“…Accessibility and time efficiency were also considered strong motives for using telehealth [ 21 , 32 ]. Following a study conducted by the Royal College of Speech & Language Therapists (RCSLT) [ 33 ] and the study conducted by Hao et al [ 21 ], the involvement of families and parents was also seen by respondents as a positive point, because the work can also be carried out through caregivers. Furthermore, 46% of respondents considered telehealth to be a cost-effective method of treatment, which is consistent with Hill and Miller’s [ 28 ] Australian study.…”

“…Adoption of telehealth by SLPs has increased significantly in different countries during the COVID-19 pandemic which has been provided as an alternative service without compromising individual safety. Most of the SLPs have exhibited a positive attitude toward the use of telehealth in the future which proved a fast response to the changes brought on by the COVID-19 pandemic [ 21 , 22 ]. The use of telehealth was judged to be adequate for different clinical practices (e.g., speech and language disorders, assessment and therapeutic interventions, and counseling), but less for other practices (e.g.…”

COVID-19 Pandemic Impacts on Children with Developmental Disabilities: Service Disruption, Transition to Telehealth, and Child Wellbeing

“…Because telehealth has been used as a substitute for in-person services extensively, it is important to examine how people’s experiences with telehealth may affect their views toward its future use. Previous research based on clinicians showed that clinicians had a high regard toward telehealth during the pandemic, but only a small proportion of them anticipated continuous telehealth use when the pandemic is over [ 27 ]. However, little is known about the clients’ perspectives.…”