Reliability of Scoring Telehealth Speech Sound Assessments Administered in Real-World Scenarios.

PURPOSE: COVID-19 caused a worldwide conversion from in-person therapy to telehealth; however, limited evidence to support the efficacy of remotely delivering standardized tests puts the future of widespread telehealth use at risk. The aim of this study is to investigate the reliability of scoring a speech sound assessment administered in real-world scenarios including two examples of telehealth technology. METHOD: A total of thirty-nine 3- to 8-year-olds were administered the Goldman-Fristoe Test of Articulation-Third Edition. Licensed speech-language pathologists (SLPs) concurrently scored children's responses in person and in two telehealth conditions considered typical and enhanced. Mean standard scores and interrater reliability results were compared among the three conditions. Descriptive statistics were used to summarize the frequency of technology and behavior disruptions during administration and the results of an SLP telehealth perception survey. RESULTS: All scoring conditions were found to be highly correlated, with mean differences revealing no systematic differences of one condition over- or underestimating another. Although response agreement was high (85%-87%), final sounds in words or sounds that are difficult to observe tended to attenuate reliability. Neither child nor technology disruptions affected SLPs' ability to score responses. Despite no significant differences between conditions on scoring reliability, SLP participants reported they continued to prefer in-person over a telehealth speech sound assessment. CONCLUSIONS: This study supports the provision of a pediatric speech sound assessment using consumer-grade equipment, as in-person, typical telehealth, and enhanced telehealth scoring conditions produced similar results. However, SLP participants' skeptical attitudes toward remote delivery of standardized tests reveal an ongoing barrier to widespread telehealth use. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.19593367.

A new age of telehealth: Pediatric speech-language pathology services during the covid-19 pandemic and beyond

The COVID-19 pandemic potentially changed the landscape of how speech-language pathologists provide services. Prior to March 2020, pediatric speech-language therapy provided via telehealth was limited;however, the COVID-19 pandemic caused a worldwide conversion from in-person care to a remote service delivery model. This conversion brought to the fore possible benefits and utility of telehealth use. Yet, clinicians potentially experienced barriers to its use, including the lack of validity and reliability evidence for remote administration of several pediatric assessments. For the viability of remotely delivered speech-language services to continue and evolve in a post-pandemic world, further research is needed to identify changes to telehealth barriers and benefits. This manuscript includes investigations into how telehealth delivery of pediatric speech-language pathology services changed as a result of the COVID-19 pandemic, and also examined the extent to which clinicians' reservations about the reliability and validity of telehealth speech sound assessments were justified.Study 1 sought to capture changes in speech-language pathology clinicians' telehealth experiences before and during the COVID-19 pandemic and predictions about post-pandemic telehealth services. The Telehealth Services: Pediatric Provider Survey (Part 1) was created to gather self-reported responses from speech-language clinicians in a variety of employment settings who were serving primarily pediatric (i.e., children from birth through age 21) clients. Survey results documented how pediatric speech-language clinicians' (n=293) use of telehealth dramatically increased from before March 2020 to October 2020. This shift from in-person care to synchronous videoconferencing effectively created a new generation of telepractitioners. Even though most clinicians initially used telehealth due to employer mandates to lower infection risk for both client and clinician, over time pediatric speech-language pathology clinicians increased their telehealth proficiency and recognized the benefits of telehealth. This new generation's adoption of telehealth and the rapid improvement in proficiency was a testament to the resiliency of providers and potentially had long-term effects on the future of telehealth use.Study 2 examined the resulting evolution in the technology, connectivity, and the extent of implementation of evaluation and treatment services before and during the COVID-19 pandemic and predictions about post-pandemic telehealth services. The Telehealth Services: Pediatric Provider Survey (Part 2) was created to identify telehealth barriers that were eliminated and those that persisted during the pandemic. Additionally, the survey sampled pediatric speech-language clinicians' perceptions about advantages and disadvantages of remote delivery of evaluation and treatment services. Elimination of regulatory and insurance hurdles allowed children from varying socioeconomic backgrounds living in rural, suburban, and urban areas access to telehealth. Telehealth technology shifted from computers with external hardware and specialized software to commercially available equipment, such as handheld portable devices with built-in audio-visual components and publicly available videoconferencing platforms. Connectivity of these devices continued to be problematic, however, and lack of technology prevented some children from accessing care. Judgments about the appropriateness and effectiveness of evaluations and treatments varied based on the age and communication disorder of a child. Although some participants expressed uncertainty about the effectiveness of telehealth compared to in-person care, telehealth was widely recognized as a viable delivery method. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Evolution of Telehealth Technology, Evaluations, and Therapy: Effects of the COVID-19 Pandemic on Pediatric Speech-Language Pathology Services.

PURPOSE: Telehealth services experienced exponential growth during the COVID-19 pandemic. This survey examined the resulting evolution in the technology, connectivity, implementation of services, and attitudes of pediatric speech-language pathology clinicians using synchronous videoconferencing. METHOD: The Telehealth Services: Pediatric Provider Survey participants were 259 speech-language clinicians in a variety of employment settings from across the country and abroad. Analyses identified telehealth barriers eliminated and those that persisted during the pandemic, advantages, and disadvantages of remote delivery of evaluation and treatment services, the most common telehealth technology used by clinicians and their clients to access care, and clinicians' predictions about the optimization and future of telehealth. RESULTS: Elimination of regulatory and insurance hurdles allowed children from varying socioeconomic backgrounds living in rural, suburban, and urban areas access to telehealth. Telehealth technology shifted from computers with external hardware and specialized software to commercially available equipment, such as handheld portable devices with built-in audiovisual components and publicly available videoconferencing platforms. However, connectivity of these devices continued to be problematic, and lack of technology prevented some children from accessing care. Judgments about the appropriateness and effectiveness of evaluations and treatments varied based on the age and communication disorder of a child. Although some participants expressed uncertainty about the effectiveness of telehealth compared with in-person care, telehealth was widely recognized as a viable delivery method. CONCLUSIONS: Although clinicians reported many advantages of telehealth, some barriers identified reported prior to COVID-19 still persist. Clinicians anticipate that new developments have the potential to continue improving telehealth service delivery, bolstering the viability of telehealth long after the COVID-19 pandemic is gone. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.16959361.

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.