Reliability and Feasibility of Administering a Child Language Assessment via Telehealth

PURPOSE

Despite the speed with which telehealth use advanced during the COVID-19 pandemic, evidence is needed to support the remote delivery of standardized assessments. This study investigated the reliability and feasibility of administering a standardized language assessment administered in real-world telehealth scenarios compared to in-person administration.

METHOD

A total of 100 children between the ages of 3 and 12 years were administered one of three versions of the Clinical Evaluation of Language Fundamentals (CELF). Children were administered the CELF by the same licensed speech-language pathologists (SLPs) in person and using telehealth, with the order counterbalanced. Means for Core Language standard scores were compared between conditions and among devices. Descriptive statistics summarized the behavior and technology disruptions during administration as well as the results of parent and SLP telehealth perception surveys.

RESULTS

In-person and telehealth mean scores on all three versions of the CELF revealed no systematic differences of one condition under- or overestimating another. The incidence of child behavior disruptions was similar for both test administration conditions. Adaptations compensated for the rare technology disruptions. Despite no significant language score and behavior differences between testing conditions, parents reported they continued to prefer in-person assessments. SLP participants viewed telehealth overall positively but identified conditions in which they continued to prefer in-person delivery.

CONCLUSIONS

This study provides evidence of minimal or no differences in scores and behavioral or technological disruptions between remote and in-person administration of the CELF core language assessments. SLP and parent participants' attitudes toward remote delivery of standardized tests appear to be evolving in a positive direction compared to previous studies.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25292752.

Tele-Assessment of Oral Personal Narratives in Arabic- and Hebrew-Speaking Children Using the Global TALES Protocol

INTRODUCTION

Tele-assessment (TA) has the potential to enhance access to speech therapy. This preliminary study aimed to investigate the impact of assessment mode (face-to-face [FTF] vs. TA) on the microstructure level and chosen topics of personal narratives produced by Arabic-speaking and Hebrew-speaking school-age children living in Israel. We also investigated whether performance variations, if evident, could be attributed to the children's language/culture.

METHODS

Eighty-nine 10-year-old children, 38 Arabic-speaking and 51 Hebrew-speaking, living in Israel, participated in this study. Forty participants were assigned to a TA group (via Zoom) and 49 to a FTF group. All participants were assessed using the Global TALES protocol, generating six personal narratives each. The narratives were analyzed regarding the following microstructural measures: total number of words, total number of utterances (TNU), number of different words, and mean length of utterance in words (MLU-W). Additionally, each narrative was categorized into a topic according to the Global TALES protocol.

RESULTS

The analysis revealed no significant main effect of assessment mode on any of the microstructure measures. However, a significant interaction effect between language/culture and assessment mode was found for TNU and MLU-W, with a significant main effect for TNU exclusively in the Arabic narratives, with the Arabic-speaking children producing more utterances through FTF compared to TA. Across language/culture groups, there was a significant effect of assessment mode on the chosen topic. Additionally, there were significantly higher scores in the Hebrew compared to the Arabic narratives in all microstructure measures, and language/culture also influenced the chosen topics.

CONCLUSIONS

The results support the feasibility of TA mode for assessing personal narratives in school-aged children, using the Global TALES protocol. However, the results also suggest that TA results may be affected by the language/culture of the narrator. Finally, the findings highlight the potential influence of TA on the chosen topics of personal narratives, perhaps due to a decrease in the quality of communication in TA.

Experiences of South African speech-language therapists providing telepractice during the COVID-19 pandemic: A qualitative survey

BACKGROUND

The COVID-19 pandemic necessitated that speech-language therapists (SLTs) make a radical change to provide services to their clients safely via telepractice. For many practitioners, telepractice was an unfamiliar mode of practice that had to be implemented under emergency conditions. Limited literature on SLTs' experiences of implementing telepractice in the Global South during this time is available.

AIMS

To explore the experiences of South African SLTs (N = 45) who implemented telepractice services during the COVID-19 pandemic.

METHODS & PROCEDURES

SLTs across the country were invited via professional bodies to participate in an online qualitative survey distributed in 2021. Data were analysed using thematic analysis principles.

OUTCOMES & RESULTS

We describe participants' reports of their current telepractices, discuss their perspectives on accessibility to telepractice for SLTs, clients and caregivers, and working with specific diagnoses, and consider the support needs of SLTs to enhance telepractice services. Most participants work in private practice or school settings with primarily paediatric caseloads. They reported telepractice as a positive experience and felt it was effective, although they judged that some clients were not well served by telepractice. SLTs felt underprepared for the rapid switch to telepractice and the flexibility required, especially given the limited availability of guidelines given the pandemic crisis. Greater preparation is required for telepractice sessions and more attention needs to be paid to supporting caregiver involvement online.

CONCLUSIONS & IMPLICATIONS

Telepractice involves various barriers and facilitators, many of which seem common across Global North and South contexts. Support is required to enhance current telepractices in terms of computer literacy, technical education, different telepractice methods and caregiver coaching. Our findings have the potential to enable the development of support, training and guidelines to improve SLTs' confidence in providing telepractice whilst delivering quality services in an accessible and safe manner.

WHAT THIS PAPER ADDS

What is already known on the subject Many SLTs had to transition quickly to telepractice service provision during COVID-19, with limited existing guidelines and support. Although there is some literature available on SLTs' experiences of implementing telepractice in the Global North, perspectives from the Global South during this time are limited. It is important to understand experiences, barriers and facilitators to telepractice provision to provide tailored support to practitioners. What this paper adds to existing knowledge Telepractice provides a viable alternative to in-person therapy for specific clients and contexts. Telepractice presents both benefits and barriers for effective clinical practice across Global North and South contexts. Greater preparation is required for telepractice sessions and more attention needs to be paid to enhancing caregiver involvement online, especially since many practitioners are likely to continue offering telepractice services post-pandemic. What are the potential or actual clinical implications of this work? Clinicians felt underprepared for the rapid switch from service delivery mode to telepractice. Greater support, training and guidelines for students and practitioners are required to enhance current practices and ensure practitioners are equipped to provide effective telepractice in the future. In particular, support should cover technological aspects, caregiver coaching and online assessment options, especially for paediatric clients.

Comparison of Voice Therapy Outcomes: Clinic vs Telehealth

BACKGROUND

Voice therapy provides patients with valuable exercises and techniques to optimize vocal behaviors and improve their ability to communicate effectively and efficiently. These sessions were typically held by speech-language pathologists (SLPs) in clinic. During the COVID-19 pandemic, SLPs were provisionally able to provide billable voice therapy services in telehealth format. There is a lack of existing research studies comparing outcomes based on the format of voice therapy.

METHODS

A retrospective chart review was performed on 101 patients who underwent voice therapy at a large academic institution in order to compare outcomes between clinic, telehealth, and mixed voice therapy formats. Demographics, dysphonia etiology, duration of symptoms, number of therapy sessions, and pre- and postvoice therapy scores using reflux symptom index (RSI), voice handicap index (VHI-10), consensus auditory-perceptual evaluation of voice (CAPE-V), and Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scoring were collected. Statistical comparisons were performed using Fisher's exact test and analysis of covariance.

RESULTS

There were no statistically significant differences in pre- to postvoice therapy RSI, VHI-10, CAPE-V, or GRBAS scores based on format of voice therapy, after adjustment for number of therapy sessions received. There were no differences in these outcomes when comparing voice therapy by etiology of dysphonia.

CONCLUSIONS

Overall, these data support the effectiveness of the telehealth voice therapy format. It is a promising platform for greater patient access to therapy. All formats of voice therapy were effective in improving key measures of voice perception.

An exploratory study of speech-language pathologists' clinical practice in the literacy domain: Comparing onsite practices with telepractice services during COVID-19

PURPOSE

To explore speech-language pathologists' (SLP) practice in literacy prior to, and during, COVID-19 to understand the practicalities, feasibility and sustainability of telepractice literacy services.

METHOD

This exploratory study employed a cross-sectional survey comprising 46 questions covering participants' caseload profile and service delivery models, their assessment and intervention practices and telepractice delivery of literacy services.

RESULT

Participants were 44 SLPs working primarily in private practice and education with children and adolescents. Students with literacy difficulties comprised a significant proportion of SLPs' caseloads. Individual and group sessions were the most common format of delivery prior to COVID-19. In a telepractice model during COVID-19, SLPs saw fewer students overall. Most provided individual sessions only and reported cancellation of group sessions. SLPs described their practice in literacy as being aligned with evidence-based principles. A range of resources were used for literacy assessment and intervention. For most, their usual practice changed for telepractice. Many felt underprepared to use telepractice and experienced numerous challenges mostly relating to technology and family engagement.

CONCLUSION

Literacy has become a core area of practice for SLPs; however, continued advocacy towards consultative and collaborative services is needed within onsite and telepractice models. Telepractice required SLPs to develop additional skills and modify usual practice. Despite experiencing challenges, many indicated they would continue with telepractice given its perceived benefits.

Views of Speech-Language Pathologists on Telepractice for Children Who Use Augmentative and Alternative Communication

Telepractice has become increasingly utilized in disability services, particularly with recent and ongoing measures to slow the spread of the novel coronavirus (COVID-19). In this study, 361 speech-language pathologists (SLPs) responded to a national, web-based survey about their views on utilizing telepractice with children aged 3 to 21 who used aided augmentative and alternative communication (AAC), such as picture symbols or speech-generating devices. The views of SLPs varied, and SLPs who received training on AAC telepractice within the last 12 months had more positive views about telepractice than those who did not. Several factors were associated with when and how SLPs thought telepractice was beneficial to serve children who use aided AAC, including SLPs' foundational perspectives about telepractice, service delivery options, considerations related to the child and family, and broader resources and constraints.

Students Tele-All: Self-Efficacy and Self-Reflection as Measures of Student Success in Telepractice Training

(1) Background: With an increasing demand for telepractice services, the need for telepractice education is more important than ever. In addition to learning how to deliver these services, certain clinical and technological skills learned through telepractice apply more broadly to in-person care. Evaluating students’ abilities to master these skills is necessary to ensure clinical skill competence. (2) Methods: We utilized self-efficacy ratings and self-reflections to determine student growth after hands-on telepractice training among nursing, occupational therapy, physical therapy, and speech-language pathology students. (3) Results: Students across disciplines demonstrated growth in all measured skill areas and reported overall increased confidence. Students with less prior telepractice experience reported greater increased confidence in seven measured competency areas than students with more prior telepractice experience. The number of completed sessions at the end of student placements was correlated with increased confidence for one measured skill area. Regardless of whether or not students had prior experience when starting their placement, as the number of telepractice sessions completed increased, thus did students’ confidence levels. The results of this study support telepractice as a viable clinical education tool for student growth and the use of self-efficacy and self-reflection as valuable tools for monitoring the effectiveness of telepractice clinical learning activities.

The Effects of Virtual Assessment on Capturing Skill Growth in Children With Hearing Loss

PURPOSE

The purpose of this study is to evaluate the effects of switching from in-person assessment to virtual assessment during the COVID-19 pandemic on the growth trajectories of children with hearing loss who are learning spoken language.

METHOD

Sixty-eight children with typical hearing, 44 children with cochlear implants, and 47 children with hearing aids were assessed with a norm-referenced measure of receptive vocabulary, a criterion-referenced measure of phonological awareness, and a criterion-referenced measure of conceptual print knowledge at least 4 times, at 6-month intervals, between the ages of 4 and 6 years. Of those participants, 26 children with typical hearing, 13 children with cochlear implants, and 13 children with hearing aids entered virtual testing as a result of the COVID-19 pandemic. The slopes of growth for children who entered virtual testing were compared to their own slopes prepandemic and to the growth slopes of children who completed all testing in-person, prepandemic.

RESULTS

Within-subject comparisons across all measures did not show a change in growth slopes prepandemic to postpandemic. For the measure of conceptual print knowledge, children who were tested during the pandemic showed slower overall growth than children who were tested prepandemic. No effects of hearing status were found across growth on any measure.

CONCLUSION

These preliminary data support the use of virtual assessment to measure growth in receptive vocabulary, phonological awareness, and conceptual print knowledge in children with hearing loss learning spoken language.

Preparedness, Training, and Support for Augmentative and Alternative Communication Telepractice During the COVID-19 Pandemic

PURPOSE

The global COVID-19 pandemic brought about widespread use of telepractice to provide services to children with communication disorders, including students who use aided augmentative and alternative communication (AAC) such as speech-generating devices. This descriptive quantitative study utilized network analysis to investigate the nature of speech-language pathologists' (SLPs') professional resource networks during the pandemic, including what aspects of their professional networks were associated with their confidence to use telepractice to serve students who use aided AAC and whether there were differences for school-based compared to nonschool-based SLPs.

METHOD

Participants were 283 SLPs who responded to an online survey that consisted of closed- and open-ended survey items. A resource generator approach was used to gather data about SLPs' professional resource networks for AAC telepractice.

RESULTS

SLPs varied widely in their confidence for AAC telepractice. School-based SLPs and SLPs who had 3 years or fewer of AAC experience reported lower confidence, whereas SLPs who spent more work time each week using telepractice and who accessed a greater number of different types of training reported higher confidence. The number of people in different roles providing personal support and the number of different electronic/print resources accessed were not significant predictors of SLPs' confidence. The majority of SLPs wanted additional training, support, or resources related to AAC telepractice.

CONCLUSION

The findings from this research suggest the importance of SLPs' access to quality training and support in the areas of AAC and telepractice, particularly for school-based SLPs.

From a Distance: Comparison of In-Person and Virtual Assessments With Adult-Child Dyads From Linguistically Diverse Backgrounds

PURPOSE

Our proof-of-concept study tested the feasibility of virtual testing using child assessments that were originally validated for in-person testing only.

METHOD

Ten adult-child dyads were assigned to complete both in-person and virtual tests of language, cognition, and narratives. Child participants fell between the ages of 4 and 8 years; adult participants were speech-language clinicians or researchers with experience in administering child assessments. Half of child participants were Spanish-English bilinguals, and half were monolingual English speakers.

RESULTS

Results showed similar performance across in-person and virtual modalities on all assessments. Recommendations for adapting, administering, and scoring virtual measures with linguistically diverse children are discussed.

CONCLUSIONS

Although additional research on virtual assessment is needed, our results open opportunities for appropriate remote assessment, particularly for bilingual children, who may not have in-person access to speech-language pathology services.

Experience Delivering Tele-practice Services among Upcoming and Working Professionals of Speech Language Pathology

Introduction Since the outbreak of the COVID-19 epidemic, tele-practice has become the new normal in the field of Speech-Language Pathology. Students and professionals throughout the country are embracing this new normal. Both groups confront problems; documentation of the problems may provide insight into how to improve tele-practice services.

Aim The purpose of this study was to compare the problems that undergraduate students, postgraduate students, and working professionals in the field of Speech-Language Pathology experience in daily practice.

Methods A descriptive cross-sectional survey study using a web-based questionnaire was conducted to examine the obstacles experienced by students and working professionals in the field of speech-language pathology, as well as their perspectives about tele-practice. There was a total of 20 questions. Divided into four sections, closed questions and Likert scale questions were used for demographic details, practice aspects, experience during telerehabilitation, and evaluation and treatment.

Results The study had 118 participants (47% postgraduate students, 29% undergraduate students, and 24% professionals). Only 16% of clinicians were properly trained to provide services via tele-mode. All participants reported providing service to the pediatric population to be challenging, with autism spectrum disorder, fluency disorders, and hearing impairment to be difficult to handle cases. In tele-mode, undergraduate students reported a decrease in the number of cases and difficulties selecting therapy materials when compared with the other two groups. All three groups reported a lack of evidence-based teletherapy resources available. There was no difference in perceived difficulty between the three groups while conducting assessment and achieving treatment goals via tele-mode.

Conclusion Tele-practice is generally recognized and employed, according to data availability. In terms of resource selection, evaluation, and treatment sessions, the difficulties faced by students and experts are disturbing. In the realm of speech-language pathology, strategies to address these issues could pave the way for tele-practice. As a result, better policies are strongly advised to address these difficulties to improve future tele-mode service quality.

Augmentative and Alternative Communication Telepractice During the COVID-19 Pandemic: A National Survey of Speech-Language Pathologists

PURPOSE

The novel coronavirus (COVID-19) pandemic has led to sudden, widespread use of telepractice, including providing services to children who use aided augmentative and alternative communication (AAC). This exploratory study examined speech-language pathologists' (SLPs) experiences using telepractice to provide services to children and youth aged 3-21 years who used aided AAC during the earlier months of the pandemic (May-June 2020).

METHOD

Three hundred thirty-one SLPs responded to an online survey. Closed- and open-ended survey items were analyzed quantitatively and qualitatively and mixed at the point of interpretation to understand the experiences of SLPs related to the use of telepractice with children who use aided AAC, including how they perceived effectiveness.

RESULTS

Most SLPs were using telepractice to provide both direct and consultation/coaching services to children who used aided AAC. There was fairly wide variation in perceptions of effectiveness of both types of services, but SLPs were more likely to rate consultation/coaching services as being more effective than direct services. SLPs identified factors impacting effectiveness across five dimensions: broader factors, practice-based factors (i.e., technology, the type of services), the child, parents and family members, and professionals. School-based SLPs perceived telepractice as being less effective than non-school-based SLPs.

CONCLUSIONS

The use of telepractice during the COVID-19 pandemic has unfolded quite differently for different SLPs and the children who use aided AAC that they serve. Although AAC telepractice offers promise for the future, particularly for partnering with families, further research is needed to know how to overcome challenges experienced by SLPs.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.17139434.

Digital Health and Digital Learning Experiences Across Speech-Language Pathology, Phoniatrics, and Otolaryngology: Interdisciplinary Survey Study

BACKGROUND

Advances in digital health and digital learning are transforming the lives of patients, health care providers, and health professional students. In the interdisciplinary field of communication sciences and disorders (CSD), digital uptake and incorporation of digital topics and technologies into clinical training programs has lagged behind other medical fields. There is a need to understand professional and student experiences, opinions, and needs regarding digital health and learning topics so that effective strategies for implementation can be optimized.

OBJECTIVE

This cross-sectional survey study aims to interdisciplinarily investigate professional and student knowledge, use, attitudes, and preferences toward digital health and learning in the German-speaking population.

METHODS

An open-ended, web-based survey was developed and conducted with professionals and students in CSD including phoniatricians and otolaryngologists, speech-language pathologists (German: Logopäd*innen), medical students, and speech-language pathology students. Differences in knowledge, use, attitudes, and preferences across profession, generation, and years of experience were analyzed.

RESULTS

A total of 170 participants completed the survey. Respondents demonstrated greater familiarity with digital learning as opposed to eHealth concepts. Significant differences were noted across profession (P<.001), generation (P=.001), and years of experience (P<.001), which demonstrated that students and younger participants were less familiar with digital health terminology. Professional (P<.001) and generational differences were also found (P=.04) in knowledge of digital therapy tools, though no significant differences were found for digital learning tools. Participants primarily used computers, tablets, and mobile phones; non-eHealth-specific tools (eg, word processing and videoconferencing applications); and digital formats such as videos, web courses, and apps. Many indicated a desire for more interactive platforms, such as virtual reality. Significant differences were found across generations for positive views toward digitalization (P<.001) and across profession for feelings of preparedness (P=.04). Interestingly, across profession (P=.03), generation (P=.006), and years of experience (P=.01), students and younger participants demonstrated greater support for medical certification. Commonly reported areas of concern included technical difficulties, quality and validity of digital materials, data privacy, and social presence. Respondents tended to prefer blended learning, a limited to moderate level of interactivity, and time and space-flexible learning environments (63/170, 37.1%), with a notable proportion still preferring traditional time and space-dependent learning (49/170, 28.8%).

CONCLUSIONS

This comprehensive investigation into the current state of CSD student and professional opinions and experiences has shown that incorporation of digital topics and skills into academic and professional development curricula will be crucial for ensuring that the field is prepared for the ever-digitalizing health care environment. Deeper empirical investigation into efficacy and acceptance of digital learning and practice strategies and systematic training and practical organizational supports must be planned to ensure adaptive education and practice.

Genesis of a New Generation of Telepractitioners: The COVID-19 Pandemic and Pediatric Speech-Language Pathology Services

Purpose In March 2020, the COVID-19 pandemic caused a worldwide shift from in-person care to synchronous videoconferencing or telehealth. Many barriers to remote service delivery were eliminated, effectively creating a new generation of telepractitioners. This study chronicles changes in speech-language pathology clinicians' use and perceptions of telehealth with pediatric populations. Method The Telehealth Services: Pediatric Provider Survey was created in multiple steps and then distributed broadly through social media and professional community sites. Respondents were speech-language pathologists and speech-language pathology assistants in a variety of employment settings from across the country and abroad who were serving primarily pediatric clients (n = 269). Survey questions sought to capture changes in speech-language pathology clinicians' experiences with and perceptions of telehealth before, during, and predictions after the COVID-19 pandemic. Analyses identified factors that influenced the use of telehealth services before and after March 2020 (COVID-19). Results Survey results documented the dramatic increase in telehealth use from before March 2020 to October 2020. The reasons pediatric speech-language pathology clinicians used telehealth during the pandemic were mostly a result of employer mandates or lowering infection risk for both client and clinician; however, over time, pediatric speech-language pathology clinicians increased their telehealth proficiency and discovered the benefits of telehealth. Conclusion The adoption of telehealth and the rapid improvement in proficiency is a testament to the resiliency of providers and has long-term effects on the use of telehealth into the future. Supplemental Material https://doi.org/10.23641/asha.15183690.

Telerehabilitation for Communication and Swallowing Disorders in Parkinson's Disease

Communication and swallowing disorders are highly prevalent in people with Parkinson's disease (PD). The negative impact of these disorders on the quality of life of the person with PD and their families cannot be underestimated. Despite a demand for speech-language pathology services to support people with PD, many barriers to services exist. Telerehabilitation provides an alternate and complementary approach to in-person therapy that is patient-centered, enables timely assessment and intervention, and facilitates continuity of care throughout the course of the disease. This review explores the telerehabilitation applications designed for the management of the communication and swallowing disorders in PD, addresses the benefits and challenges of telerehabilitation, identifies future research directions, and highlights the potential of new technologies to enhance the management of communication and swallowing disorders and quality of life for people with PD.

Transitioning Speech-Language Assessment to a Virtual Environment: Lessons Learned From the ELLA Study

Purpose The COVID-19 pandemic has necessitated a quick shift to virtual speech-language services; however, only a small percentage of speech-language pathologists (SLPs) had previously engaged in telepractice. The purpose of this clinical tutorial is (a) to describe how the Early Language and Literacy Acquisition in Children with Hearing Loss study, a longitudinal study involving speech-language assessment with children with and without hearing loss, transitioned from in-person to virtual assessment and (b) to provide tips for optimizing virtual assessment procedures. Method We provide an overview of our decision making during the transition to virtual assessment. Additionally, we report on a pilot study that calculated test-retest reliability from in-person to virtual assessment for a subset of our preschool-age participants. Results Our pilot study revealed that most speech-language measures had high or adequate test-retest reliability when administered in a virtual environment. When low reliability occurred, generally the measures were timed. Conclusions Speech-language assessment can be conducted successfully in a virtual environment for preschool children with hearing loss. We provide suggestions for clinicians to consider when preparing for virtual assessment sessions. Supplemental Material https://doi.org/10.23641/asha.14787834.

Influence of the COVID-19 pandemic on telepractice in speech-language pathology

Prior to the COVID-19 pandemic, speech-language pathology telepractice was used by a small percentage of consumers. The 2020 pandemic necessitated the transition of most services to an online format. This article reports on a brief, electronic survey that was completed by 145 speech-language pathologists (SLPs) during the early months (June 2020) of the pandemic. Results showed that the majority of SLPs will continue using a telepractice model into 2021 and beyond, as more than half of SLPs rated the quality as similar to services delivered in-person. The absence of earlier preparation, access to and hindrances with technology, and client factors were the main elements influencing telepractice success for SLPs. However, telepractice was rated as an efficient means of consultation, evaluation, and intervention and survey results revealed that 53.84% of SLPs plan on maintaining this modality at a higher than pre-pandemic level.

Videoconference Administration of the Western Aphasia Battery-Revised: Feasibility and Validity

Purpose There is a rapid growth of telepractice in both clinical and research settings; however, the literature validating translation of traditional methods of assessments and interventions to valid remote videoconference administrations is limited. This is especially true in the field of speech-language pathology where assessments of language and communication can be easily conducted via remote administration. The aim of this study was to validate videoconference administration of the Western Aphasia Battery-Revised (WAB-R). Method Twenty adults with chronic aphasia completed the assessment both in person and via videoconference with the order counterbalanced across administrations. Specific modifications to select WAB-R subtests were made to accommodate interaction by computer and Internet. Results Results revealed that the two methods of administration were highly correlated and showed no difference in domain scores. Additionally, most participants endorsed being mostly or very satisfied with the videoconference administration. Conclusion These findings suggest that administration of the WAB-R in person and via videoconference may be used interchangeably in this patient population. Modifications and guidelines are provided to ensure reproducibility and access to other clinicians and scientists interested in remote administration of the WAB-R. Supplemental Material https://doi.org/10.23641/asha.11977857.

Stakeholders' qualitative perspectives of effective telepractice pedagogy in speech-language pathology

BACKGROUND

Academic programmes in speech-language pathology are increasingly providing telehealth/telepractice clinical education to students. Despite this growth, there is little information describing effective ways to teach it.

AIMS

The current exploratory study analyzed the perceptions of speech-language pathology/therapy (SLP/SLT) faculty, student and SLP/SLT clinicians to ascertain effective pedagogical approaches for telepractice service delivery, rank the relative importance of telepractice skills and knowledge competencies, and define any pedagogical challenges to teaching them.

METHODS & PROCEDURES

Qualitative data were collected from two sources: three open-ended questions within an online survey (SLP/SLT faculty n = 31, graduate students n = 16, telehealth ('telepractice') clinicians n = 16); and follow-up telephone interviews (n = 22). Data were analyzed with a grounded theory approach followed by a summative rank-order analysis of themes.

OUTCOMES & RESULTS

All three groups agreed the most effective telepractice instructional approach was telepractice demonstrations (such as students role playing or watching a supervisor). Professional development approaches such as workshops or training manuals were less effective and didactic approaches such as lecture-only were ineffective. Skills and knowledge competencies students needed before entering the workforce were, in order of implied importance: telepractice clinical skills, telepractice technology skills, legal knowledge pertinent to telepractice and knowledge of telepractice literature. The most important telepractice clinical skills students needed to acquire were appropriate selection of telepractice materials and engaging the client over the internet. Many participants said teaching and learning telepractice was more challenging than in-person service delivery because of the difficulties in selecting appropriate telepractice clinical materials, managing technology problems and engaging with clients over the internet.

CONCLUSIONS & IMPLICATIONS

Despite substantial limitations to this investigation, findings imply that telepractice instruction, like other methods of SLP/SLT clinical education, may be most effective when students engage in critical thinking and problem-solving issues through intense practice. Because the skills and competencies associated with telepractice appear to vary in their perceived value, academic programmes may wish to consider prioritizing how they are taught, giving students additional instruction in the selection of telepractice clinical materials and development of online interpersonal communication skills. For some clinical educators, the challenges associated with telepractice may necessitate additional educator training.

Perceptions of telepractice pedagogy in speech-language pathology: A quantitative analysis

Introduction Despite the growth of telecommunication applications to provide clinical healthcare services, there has been little attention to the pedagogical framework needed to train healthcare students to deliver these services. Methods In this exploratory investigation, perceptions of speech-language pathology/therapy (SLP/SLT) faculty ( n = 31), graduate students ( n = 16), and telehealth ("telepractice") clinicians ( n = 16) were examined with a 15-item survey regarding the 1) comparative pedagogical importance of four skills common to telepractice and face-to-face service (f2f) delivery, and 2) relative pedagogical value of seven skills and competencies unique to telepractice. Results Statistical analyses revealed nonverbal communication skills and knowledge of the literature related to service delivery methods were more important in telepractice than in f2f service delivery. Among seven skills unique to telepractice, participants believed the most important was solving problems related to the Internet and recommended at least two hours of instruction each in telepractice technology, patient confidentiality, and role-playing telepractice. Results suggest that SLP/SLT students may need additional and/or focused academic training in nonverbal communication, telepractice literature, and in solving connectivity issues to enter the telepractice marketplace with sufficient preparation. Discussion Further study is needed to compare the relative importance of additional SLP/SLT skills and competencies, describe components of effective healthcare training telepractice programs, and explore effective pedagogical strategies for healthcare telepractice instruction.