Speech-language Pathology Services Delivered by Telehealth in a Rural Educational Setting: the School’s Perspective
doi: 10.29086/JISfTeH.6.e20
Abstract
Introduction: Access to speech-language pathology services for children in rural and remote communities is often limited. Telehealth is increasingly used to provide these services to schools, demonstrating high satisfaction with both service providers and recipients, but the requirements for successful program implementation are as yet unclear. We aimed to explore the implementation requirements for a telehealth speech-language pathology service for children from the perspective of a rural school. Methods: A qualitative approach, supplemented by program activity data, was used to understand the experiences and perceptions of the benefits, limitations, enablers and barriers of a telehealth speech-language pathology program delivered to a school servicing approximately 400 children in a small rural town in the state of Queensland, Australia. Thematic analysis was conducted of transcripts of individual semi-structured interviews with nine school teaching staff and field notes of informal discussions regarding 85 speech-language pathology telehealth sessions (n = 9 children) during program establishment and implementation. Results: The speech-language pathology telehealth service was acceptable to teaching staff at the rural school, who cited improved access, the suitability of the technology for child engagement, and perceived effectiveness. Implementation issues were highlighted as critical to program success and scalability, particularly staff workload, technological issues, communication processes, and sustainability. Conclusion: School-based speech-language pathology services delivered via telehealth were perceived as a suitable way of increasing access for children by rural school staff. Future implementations of telehealth speech-language pathology programs should prospectively consider workload implications and develop strategies to communicate with and involve school staff.
Downloads
References
Nelson HD, Nygren P, Walker M, Panoscha R. Screening for speech and language delay in preschool children: systematic evidence review for the US Preventive Services Task Force. Pediatrics 2006;117(2):e298-e319.
McLeod S, Harrison LJ. Epidemiology of speech and language impairment in a nationally representative sample of 4-to 5-year-old children. J Speech Lang Hear Res 2009;52(5):1213-1229.
Taylor OD, Armfield NR, Dodrill P, Smith AC. A review of the efficacy and effectiveness of using telehealth for paediatric speech and language assessment. J Telemed Telecare 2014;20(7):405-412.
Tucker JK. Perspectives of speech-language pathologists on the use of telepractice in schools: the qualitative view. Int J Telerehabil 2012;4(2):47.
O'Callaghan AM, McAllister L, Wilson L. Barriers to accessing rural paediatric speech pathology services: health care consumers' perspectives. Aust J Rural Health 2005;13(3):162-171.
Ukrainetz TA, Fresquez EF. "What isn't language?": a qualitative study of the role of the school speech-language pathologist. Lang Speech Hear Serv Sch 2003;34(4):284-298.
Law J, Lindsay G, Peacey N, et al. Consultation as a model for providing speech and language therapy in schools: a panacea or one step too far? Child Lang Teach Ther 2002;18(2):145-163.
Moffatt JJ, Eley DS. The reported benefits of telehealth for rural Australians. Aust Health Rev 2010;34(3):276-281.
Grogan-Johnson S, Alvares R, Rowan L, Creaghead N. A pilot study comparing the effectiveness of speech language therapy provided by telemedicine with conventional on-site therapy. J Telemed Telecare 2010;16(3):134-139.
Lewis C, Packman A, Onslow M, Simpson JM, Jones M. A phase II trial of telehealth delivery of the Lidcombe Program of Early Stuttering Intervention. Am J Speech Lang Pathol 2008;17(2):139-149.
Crutchley S, Campbell M. TeleSpeech therapy pilot project: stakeholder satisfaction. Int J Telerehabil 2010;2(1):23-30.
Smith AC, Caffery LJ, Saunders R, Bradford NK, Gray LC. Generating new telehealth services using a whole of community approach: experience in regional Queensland. J Telemed Telecare 2014;20(7):365-369.
Fairweather GC, Lincoln MA, Ramsden R. Speech-language pathology teletherapy in rural and remote educational settings: decreasing service inequities. Int J Speech Lang Pathol 2016;18(6):592-602.
Fairweather GC, Lincoln M, Ramsden R. Speech-language pathology telehealth in rural and remote schools: the experience of school executive and therapy assistants. Rural Remote Health 2017;17(3):4225.
Croll J, Norton CJ, Gray LC, Bryett A, Smith AC. Telehealth opportunities in regional Queensland: a scoping study. J Telemed Telecare 2012;18(8):451-454.
Australian Bureau of Statistics. (2017). Australian Census 2016. Available at: http://www.abs.gov.au/websitedbs/D3310114.nsf/Home/Census?OpenDocument&ref=topBar accessed 26 September 2018
Charmaz K, Liska L. Qualitative interviewing and grounded theory analysis. In: Gubrium J, Holstein J, Marvasti A, McKinney K, editors. The SAGE Handbook of Interview Research: The Complexity of the Craft. Thousand Oaks, California: SAGE Publications; 2012;347-365.
Damschroder LJ, Aron DC, Keith RE, et al. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci 2009;4:50.
Creswell JW, editor. Research design: Qualitative, quantitative, and mixed methods approaches. 4th ed. Los Angeles, California: SAGE Publications; 2013.
Lincoln M, Hines M, Fairweather C, Ramsden R, Martinovich J. Multiple stakeholder perspectives on teletherapy delivery of speech pathology services in rural schools: a preliminary, qualitative investigation. Int J Telerehabil 2014;6(2):65.
Freckmann A, Hines M, Lincoln M. Clinicians' perspectives of therapeutic alliance in face-to-face and telepractice speech-language pathology sessions. Int J Speech Lang Pathol 2017;19(3):287-296.
Macpherson CF, Linder LA, Ameringer S, et al. Feasibility and acceptability of an iPad application to explore symptom clusters in adolescents and young adults with cancer. Pediatr Blood Cancer 2014;61(11):1996-2003.
Palermo TM, Valenzuela D, Stork PP. A randomized trial of electronic versus paper pain diaries in children: impact on compliance, accuracy, and acceptability. Pain 2004;107(3):213-219.
Keck CS, Doarn CR. Telehealth technology applications in speech-language pathology. Telemed J E Health 2014;20(7):653-659.
Copyright (c) 2018 Natalie K Bradford, Liam J Caffery, Monica Taylor, Judith Meiklejohn, Anthony Smith C C Smith, Danette Langbecker

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.