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.

Voices From the Field: Strategies for Effective Telepractice for Children With Autism Who Use Augmentative and Alternative Communication

Purpose: Providing telepractice services to young children with autism who use augmentative and alternative communication (AAC) can present many challenges for speech-language pathologists (SLPs). At the same time, telepractice can be a valuable service delivery option with unique benefits, such as improving partnerships with families, integrating AAC services with other educational services, promoting communication skills in natural settings, and addressing the need for clinicians with AAC experience in locations that have been under-served. The purpose of this study was to learn from SLPs utilizing telepractice about the strategies they found most effective in serving children learning to use aided AAC, particularly young children with autism. Method: Participants were 230 SLPs who responded to a national survey about using telepractice to serve children who use aided AAC. The survey occurred during the COVID-19 pandemic, when more SLPs than ever before were navigating how to use telepractice effectively. Open-ended survey questions asked SLPs about advice and strategies they found to increase effectiveness. These responses were analyzed using an iterative, team-based approach to qualitative content analysis. Results: SLPs raised strategies to support the effectiveness of telepractice in three areas: (a) Be strategic about how to provide services. (b) Communicate and collaborate with others. (c) Keep learning and hold onto reasonable expectations. Conclusions: Telepractice can be an advantageous service delivery option for SLPs serving children with autism who use aided AAC. These strategies can help SLPs navigate challenges and support the effectiveness of their services.

Five Tips for Implementing Telepractice Interventions With Family Members of Young Children With Autism Spectrum Disorder

Purpose: Telepractice has become a popular service delivery option for young children with autism spectrum disorder (ASD), especially as a result of the COVID-19 pandemic. However, practitioners can face some unique challenges when delivering interventions to young children and their families via telepractice. Furthermore, the use of telepractice requires specific practitioner skills, technologies, and family participation to ensure that interventions are effectively delivered. Drawing on the existing literature and our collective experience implementing telepractice-based interventions with families, we provide five practical tips for supporting families of children with ASD while implementing effective interventions via various telepractice modalities. Telepractice tips include the following: (a) think beyond video conferencing formats, (b) establish a meaningful and culturally responsive relationship with the family, (c) select appropriate interventions to support the child's development, (d) adhere to ethical and professional standards when implementing telepractice, and (e) gain knowledge and skills through professional development to enhance telepractice delivery. Conclusion: Using each of these tips will help practitioners support families with children with ASD in effective implementing telepractice interventions.

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.

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.

Characteristics and outcomes of patients with COVID-19 admitted to hospital and intensive care in the first phase of the pandemic in Canada: a national cohort study.

BACKGROUND: Clinical data on patients admitted to hospital with coronavirus disease 2019 (COVID-19) provide clinicians and public health officials with information to guide practice and policy. The aims of this study were to describe patients with COVID-19 admitted to hospital and intensive care, and to investigate predictors of outcome to characterize severe acute respiratory infection. METHODS: This observational cohort study used Canadian data from 32 selected hospitals included in a global multisite cohort between Jan. 24 and July 7, 2020. Adult and pediatric patients with a confirmed diagnosis of COVID-19 who received care in an intensive care unit (ICU) and a sampling of up to the first 60 patients receiving care on hospital wards were included. We performed descriptive analyses of characteristics, interventions and outcomes. The primary analyses examined in-hospital mortality, with secondary analyses of the length of hospital and ICU stay. RESULTS: Between January and July 2020, among 811 patients admitted to hospital with a diagnosis of COVID-19, the median age was 64 (interquartile range [IQR] 53-75) years, 495 (61.0%) were men, 46 (5.7%) were health care workers, 9 (1.1%) were pregnant, 26 (3.2%) were younger than 18 years and 9 (1.1%) were younger than 5 years. The median time from symptom onset to hospital admission was 7 (IQR 3-10) days. The most common symptoms on admission were fever, shortness of breath, cough and malaise. Diabetes, hypertension and cardiac, kidney and respiratory disease were the most common comorbidities. Among all patients, 328 received care in an ICU, admitted a median of 0 (IQR 0-1) days after hospital admission. Critically ill patients received treatment with invasive mechanical ventilation (88.8%), renal replacement therapy (14.9%) and extracorporeal membrane oxygenation (4.0%); 26.2% died. Among those receiving mechanical ventilation, 31.2% died. Age was an influential predictor of mortality (odds ratio per additional year of life 1.06, 95% confidence interval 1.03-1.09). INTERPRETATION: Patients admitted to hospital with COVID-19 commonly had fever, respiratory symptoms and comorbid conditions. Increasing age was associated with the development of critical illness and death; however, most critically ill patients in Canada, including those requiring mechanical ventilation, survived and were discharged from hospital.