Speech-Language Pathologist Practice Changes in Telehealth Speech-Language Therapy For Rural Children

Abstract

The purpose of this study was to understand practice changes made by speech-language pathologists and parents when shifting from in-person to telehealth delivery of paediatric speech-language therapy in a rural context. Participants in this qualitative exploratory study were two speech-language pathologists (SLPs), six managers, and 17 parents within BUSHkids, a not-for-profit organisation. Fieldnotes written during observations of in-person and telehealth therapy and clinician interview transcripts were analysed with an inductive thematic analysis approach. Two major practice change themes emerged from thematic analysis. These were extending parent roles (parents taking on a co-therapist role, including presenting therapy stimulus and instructions, delivering cues, supporting child posture, and judging speech accuracy), and preparing and adapting resources (clinicians creating or locating electronic stimuli or rewarding turn-taking games, and experiencing the lack of tactile cues in a telehealth modality). Telehealth with young children requires expanding parent roles to that of co-therapists. Increased support for clinicians and parents during the initial increased demands of telehealth practice could include providing ready-to-use electronic stimuli, explicitly discussing roles and responsibilities, and providing administrative support and telehealth room preparation. This study highlights the importance of understanding telehealth practice through the perspective of multiple stakeholders.

Keywords:

• Paediatric
• Rural
• Speech Therapy
• Telehealth
• Virtual Health

Acknowledgements

BUSHkids provided the setting, clinicians and equipment for this research and proposed the telehealth models to be trialled. BUSHkids sponsored the first author’s PhD scholarship and provided funds for transcription. The authors have no conflict of interest to declare. They take complete responsibility for the integrity of the data and accuracy of data analysis.

Additional information

Notes on contributors

Deborah Theodoros

Deborah Theodoros is an emeritus professor of The University of Queensland, Australia.

Trevor Russell

Trevor Russell is a professor in the Division of Physiotherapy within the School of Health and Rehabilitation Sciences at the University of Queensland.

Nicole Hartley

Dr Nicole Hartley is a research academic with the UQ Business School.

Nicole Gillespie

Professor Nicole Gillespie is the KPMG Chair in Organizational Trust and professor of management at the University of Queensland Business School, and an international research fellow at the Centre for Corporate Reputation, Oxford University.