The experiences of speech-language therapists providing telerehabilitation services to children with autism spectrum disorder

Abstract

Background: There has been an increased emergence of the use of telerehabilitation by speech-language therapists (SLTs) in South Africa since the COVID-19 pandemic in 2020.Objectives: To explore the criteria that SLTs use when recommending telerehabilitation for children with autism spectrum disorder (ASD), the technical skills required, strategies used by SLTs, the restrictions encountered when conducting telerehabilitation and the views of SLTs on telerehabilitation in comparison to face-to-face therapy for children with ASD.Method: A descriptive, phenomenological, qualitative study design was utilised. Purposive and snowball sampling techniques were employed. Six SLTs from the private sector, who had experience providing telerehabilitation to children with ASD, were recruited from three provinces in South Africa. Data were gathered via semistructured online interviews and analysed using thematic analysis.Results: Two out of five themes that emerged from this study are presented in this paper, i.e. approaches to telerehabilitation and the benefits of telerehabilitation. Results revealed that telerehabilitation was used to provide assessment and therapy during the COVID-19 pandemic lockdowns as an alternative method of service delivery. Assessment and treatment strategies included synchronous and asynchronous methods, family collaboration, social stories, frequent breaks and interactive sessions. Telerehabilitation reduced the client’s and SLT’s travel costs and increased caregiver and clinician satisfaction. Client progress and increased awareness of SLT were viewed as further benefits.Conclusion: Telerehabilitation was found to be beneficial to most children with ASD, and in most cases, the benefits far outweighed the challenges encountered. Clinical implications included the need for caregiver support in facilitating effective carryover, an increase in SLTs’ knowledge and the opportunity to provide services to a broader geographical range. Limitations of the study are included.

The impact of COVID-19 on speech–language and hearing professions in low- and middle-income countries: Challenges and opportunities explored

“…This knowledge and application gap is a missed opportunity for clinical care in these fields during and beyond COVID-19. Additionally, Karrim et al ( 2022 ) raised challenges with criteria, strategies and technical skills required for the utilisation of telerehabilitation by speech–language therapists and audiologists. For example, challenges were highlighted on telerehabilitation in children with autism spectrum disorder; middle ear assessments (Sebothoma & Khoza-Shangase, 2022 ); therapy for speech, language and swallowing following stroke (Tar-Mahomed & Kater, 2022 ); early communication intervention (Achmat & Gerber, 2022 ); neonatal feeding in neonatal intensive care units (Coutts et al, 2022 ); and geriatric audiology service provision in old age homes (De Andrade & Landman, 2022 ).…”

“…Furthermore, as far as challenges to practice are concerned, COVID-19 significantly increased the workload of clinicians (Balton et al, 2022 ; Hlayisi, 2022 ; Khatib & Hlayisi, 2022 ). Over and above the core function of providing clinical care, time devoted to establishing innovative modes of service provision, sourcing required resources that would allow for continuity of service provision during the pandemic, training and upskilling everyone on alternative service provision methods, as well as engagement in the national COVID-19 pandemic management were all added to clinicians’ workloads (Achmat & Gerber, 2022 ; Balton et al, 2022 ; Hlayisi, 2022 ; Karrim et al, 2022 ; Khatib & Hlayisi, 2022 ; Khoza-Shangase, 2022b ; Nagdee et al, 2022 ). Balton et al ( 2022 ) highlighted how such workload challenges were possibly influenced by a lack of or poor application of policies and regulations within the South African context.…”

“…Khoza-Shangase ( 2022b ) underscored how regulations around reimbursement and registration to practice were barriers to the provision of clinical care during COVID-19 internationally and how these regulations require careful engagement. Karrim et al ( 2022 ) raised restrictions around policies regarding the use of telepractice for assessment and treatment as another challenge. Khoza-Shangase ( 2022b ) highlighted this challenge around policies and regulations as it relates to the use of PSFs, their training and their regulation as part of telepractice.…”

“…Clinical practice-related solution themes to COVID-19 that emerged from the articles in the Special Issue of SAJCD in 2022 were the following: (1) intensified research into contextually relevant and responsive solutions to guide best practice, (2) technologically intelligent clinical skills training, (3) the need to explore and/or formalise and regulate the use of task-shifting and PSFs during telepractice, (4) robust technical infrastructure to support telepractice, (5) use of hybrid rehabilitation models, (6) prioritisation of mental health services for both patients and their caregivers as well as health care workers and (7) the need for quality standards and best-practice models to be maintained (Coutts et al, 2022 ; De Andrade & Landman, 2022 ; Karrim et al, 2022 ; Khatib & Hlayisi, 2022 ; Khoza-Shangase, 2022a , 2022b ; Madahana et al, 2022a, 2022b; Naidoo et al, 2022 ; Tar-Mahomed & Kater, 2022 ).…”

“…• Not applicable 16. Karrim et al (2022) The experiences of speech-language therapists providing telerehabilitation services to children with autism spectrum disorder Practice:…”