Speech-Language Pathologist Perspectives of the Implementation of Telepractice-Delivered Stuttering Treatment for School-Age Children.

PURPOSE: The impact of stuttering can be significant, and effective treatment is critical. Despite evidence supporting direct treatment approaches for school-age children who stutter, a complex set of barriers can prevent access at school. One potential solution is telepractice. To date, however, there is no published evidence regarding the use of telepractice to deliver the Lidcombe Program within a school setting. METHOD: In this pilot study, a telepractice service was established and the perspectives of the five treating speech-language pathologists (SLPs) were evaluated before, during, and after the trial through focus groups and recorded telesupervision sessions. RESULTS: An inductive and reflexive thematic analysis identified four main themes: (a) Understanding and managing technology is critical; (b) logistical considerations can be time-consuming and challenging; (c) preparation and support are essential; and (d) family engagement, acceptance, and independence with telepractice services can be facilitated by external support and coaching. Initially, the SLPs shared feelings of uncertainty, fear, and apprehension. Yet, despite this concern, the SLPs ultimately reported that telepractice can play an important role in their service. CONCLUSIONS: In order to maximize the potential value of telepractice, SLPs require training and support to (a) manage the technology and troubleshoot problems that invariably arise, (b) have the opportunity to watch demonstrations of the technology, and (c) clearly explain the roles, responsibilities, and expectations of the parent engaging in treatment. These findings have particular relevance now, as schools and support services navigate a COVID-safe delivery model for the indefinite future.

An evidence-based synthesis of instructional reading and spelling procedures using telepractice: A rapid review in the context of COVID-19.

BACKGROUND: Due to COVID-19, many educators and allied health practitioners are facing the challenge of rapidly transitioning to telepractice delivery of instructional reading and spelling procedures without being fully informed of the evidence. AIMS: A rapid review was conducted to provide educators, allied health practitioners and policymakers with a synthesis of valid, relevant and actionable evidence relating to telepractice delivery of instructional reading and spelling procedures. The aim was to investigate the nature and outcomes of studies examining instructional reading and spelling procedures delivered via telepractice to school-aged students. METHODS & PROCEDURES: A rapid review was undertaken in accordance with the eight-step process published by the Cochrane Rapid Reviews Methods Group. Medline (all databases), Embase, Cochrane and ProQuest Central were systematically searched with predefined search terms organized across four key concepts relating to the research questions. OUTCOMES & RESULTS: Nine studies were included in this rapid review. Reading and spelling instruction and intervention using telepractice can be feasible and engaging. Telepractice assessment for reading and spelling can be equally effective as onsite assessment. CONCLUSIONS & IMPLICATIONS: The evidence base for telepractice delivery of reading and spelling procedures is in its infancy in terms of both the quantity and the quality of the evidence. Insufficient evidence exists to draw clear conclusions about its efficacy, and therefore practitioners should proceed cautiously. What this paper adds What is already known on the subject For onsite delivery, evidence-based reading and spelling assessment, instruction and interventions delivered by educators and allied health practitioners have been shown to accelerate students' skills; less is known about the efficacy of instructional reading and spelling procedures in a telepractice model, which have rapidly become the new norm in many countries due to the COVID-19 pandemic. The benefits of telepractice include improved access to services, increased service availability, convenience, time efficiency, caseload management efficiency and removal of logistical barriers relating to cost and geographical location. During the COVID-19 pandemic, telepractice has facilitated continued access to services. What this study adds to existing knowledge Reading and spelling instruction and intervention delivered via telepractice can be feasible and engaging. Telepractice is a viable mode to deliver reading and spelling assessments with strong agreement between telepractice and onsite scores. Given their low methodological quality, the studies in this review provide valuable information around the how of telepractice reading and spelling procedures and highlight the factors that may contribute to positive outcomes with this service delivery model. What are the potential or actual clinical implications of this work? Educators and allied health practitioners need a thorough understanding of the student's telepractice environment and require adequate training and support to engage in telepractice service delivery. Educators and allied health practitioners should consider students for telepractice on a case-by-case basis. Practitioners should proceed cautiously with telepractice reading and spelling assessment, intervention and instruction, with the knowledge that the current available evidence is of limited quality.