Preferences of speech and language therapists for telepractice in the COVID-19 pandemic and factors affecting their acceptance of the delivery model

Abstract

Objectives: With the COVID-19 pandemic, telepractice became a great option in speech-language therapy services, as in many healthcare utilities. However, the transition to this service model did not occur at a similar rate for every clinician. Therefore, this study aimed to determine the experiences, preferences and factors affecting the acceptance of speech-language therapists (SLT) regarding telepractice in Turkey.

Methods: Sixty-seven SLTs were presented with a questionnaire that addressed the professional tendencies, experiences and views on telepractice of them. Descriptive statistics regarding the preferences and experiences of SLTs were calculated. Moreover, factors that might be related to the number of sessions they held at the pandemic were examined with the Chi-squared test.

Results: The speech-language disorders that SLTs find the most suitable for telepractice were fluency disorders, voice disorders and speech sound disorders. Groups that SLTs deemed most suitable for receiving telepractice in terms of age were 12-21, 22-64 and 7-11, respectively. A significant relationship was found between the frequency of online meetings and telepractice sessions before the pandemic and the number of sessions during the pandemic. Furthermore, a significant relationship also was found between satisfaction with using clinician skills in telepractice and the number of telepractice sessions during the pandemic.

Conclusions: The importance of the first experiences of SLTs in the acceptance of the delivery method emerged. The necessity of in-service trainings and exemplary models to improve attitudes emerged. With these trainings, ensuring security, standardizing practices and increasing qualified services will be provided as well.

Keywords

• clinicians' perspective
• COVID-19 pandemic
• speech and language therapy
• Telepractice
• technology acceptance

References

1. 1. World Health Organization. Naming the coronavirus disease (COVID-19) and the virus that causes it. 2020. Available at:https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it. Accessed September 12, 2020.
2. 2. TR. Ministry of Health, General Directorate of Public Health. COVID-19 Guide. COVID-19 (SARS-CoV-2 Infection) Guide. Scientific Committee Study. Available at: https://covid19bilgi.saglik.gov.tr/depo/rehberler/COVID-19_Rehberi.pdf. Accessed September 13, 2020.
3. 3. ASLT-Association of Speech and Language Therapists. COVID-19 pandemic guide for speech and language therapists. 2020. Available at: https://www.dktd.org/tr/files/download/p1e6m6ogp1142oouinq9175s12oh4.pdf. Accessed: September 15, 2020.
4. 4. Cangi ME, Toğram B. Stuttering therapy through telepractice in Turkey: a mixed method study. J Fluency Disord 2020;66:105793.
5. 5. ASHA-American Speech-Language-Hearing Association. Telepractice services and coronavirus/COVID-19. 2020. Available at: https://www.asha.org/practice/telepractice-services-and-coronavirus/. Accessed September 15, 2020.
6. 6. ASHA-American Speech-Language-Hearing Association. Telepractice. 2020. Available at: https://www.asha.org/prpprinttemplate.aspx?folderid=8589934956. Accessed September 15, 2020.
7. 7. Lin FC, Chien HY, Chen SH, Kao YC, Cheng PW, Wang CT. Voice therapy for benign voice disorders in the elderly: a randomized controlled trial comparing telepractice and conventional face-to-face therapy. J Speech Lang Hear Res 2020;63:2132-40.
8. 8. Burns CL, Ward EC, Gray A, Baker L, Cowie B, Winter N, et al. Implementation of speech pathology telepractice services for clinical swallowing assessment: an evaluation of service outcomes, costs and consumer satisfaction. J Telemed Telecare 2019;25:545-51.

9. 9. Bridgman K, Onslow M, O’Brian S, Jones M, Block S. Lidcombe program webcam treatment for early stuttering: a randomized controlled trial. J Speech Lang Hear Res 2016;59:932-9.
10. 10. Finch E, Lethlean J, Rose T, Fleming J, Theodoros D, Cameron A, et al. Conversations between people with aphasia and speech pathology students via telepractice: A Phase II feasibility study. Int J Lang Commun Disord 2020;55:43-58.
11. 11. Neely L, Rispoli M, Gerow S, Hong ER, Hagan-Burke S. Fidelity outcomes for autism-focused interventionists coached via telepractice: a systematic literature review. J Dev Phys Disabil 2017;29:849-74.
12. 12. Pullins V, Grogan-Johnson S. A clinical decision making example: implementing intensive speech sound intervention for school-age students through telepractice. Perspect ASHA Spec Interest Groups 2017; 2:15-26.
13. 13. Towey M. Speech therapy telepractice. In: Kumar S, Cohn E., eds. Telerehabilitation. Springer, London, 2013:pp.101-23.
14. 14. Bradford NK, Caffery LJ, Taylor M, Meiklejohn J, Smith AC, Langbecker D. Speech-language pathology services delivered by telehealth in a rural educational setting: the school’s perspective. J Int Soc Telemed eHealth 2018;6:e20.
15. 15. Carey B, O’Brian S, Onslow M, Packman A, Menzies R. Webcam delivery of the Camperdown Program for adolescents who stutter: a phase I trial. Lang Speech Hear Serv Sch 2012;43:370-80.
16. 16. Mashima PA, Doarn CR. Overview of telehealth activities in speech-language pathology. Telemed J E Health 2008;14:1101-17.
17. 17. Regina Molini-Avejonas D, Rondon-Melo S, de La Higuera Amato CA, Samelli AG. A systematic review of the use of telehealth in speech, language and hearing sciences. J Telemed Telecare 2015;21:367-76.
18. 18. Tucker JK. Perspectives of speech-language pathologists on the use of telepractice in schools: the qualitative view. Int J Telerehabil 2012;4(2):47-60.
19. 19. Lowe R, O’Brian S, Onslow M. Review of telehealth stuttering management. Folia Phoniatr Logop 2013;65:223-38.
20. 20. Overby MS. Stakeholders’ qualitative perspectives of effective telepractice pedagogy in speech-language pathology. Int J Lang Commun Disord 2018;53:101-12.
21. 21. Wales D, Skinner, Hayman M. The efficacy of telehealth-delivered speech and language intervention for primary school-age children: a systematic review. Int J Telerehabil 2017;9:55-61.
22. 22. Weidner K, Lowman J. Telepractice for adult speech-language pathology services: a systematic review. Perspect ASHA Spec Interest Groups 2020;5:326-38.
23. 23. Houston KT. Telepractice in speech-language pathology. Plural Publishing, San Diego; 2013.
24. 24. Tucker JK. Perspectives of speech-language pathologists on the use of telepractice in schools: quantitative survey results. Int J Telerehabil 2012;4:61-72.
25. 25. Sun H, Zhang P. The role of moderating factors in user technology acceptance. Int J Hum Comput Stud 2006;64:53-78.
26. 26. Dunkley C, Pattie L, Wilson L, McAllister LA. Comparison of rural speech-language pathologists' and residents' access to and attitudes towards the use of technology for speech-language pathology service delivery. Int J Speech Lang Pathol 2010;12: 333-43.
27. 27. Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly 1989;13:319-40.
28. 28. Freckmann A, Hines M, Lincoln M. Clinicians’ perspectives of therapeutic alliance in face-to-face and telepractice speech-language pathology sessions. Int J Speech Lang Pathol 2017;19:287-96.
29. 29. Akamoglu Y, Meadan H, Pearson JN, Cummings K. Getting connected: speech and language pathologists’ perceptions of building rapport via telepractice. J Dev Phys Disabil 2018;30:569-85.
30. 30. Irani F, Gabel R. Telerehabilitation: adult speech and swallowing disorders. In: Houston KT, eds. Telepractice in Speech-Language Pathology. Plural Publishing, San Diego; 2013: p.139.
31. 31. Büyüköztürk Ş. Questionnaire development. J Turk Educ Sci 2005;3:133-51.
32. 32. Alberta College of Speech-Language Pathologists and Audiologists (ACSLPA). Available at: www.acslpa.ca. Accessed May 15, 2020.
33. 33. Bullock DR, Vehe RK, Zhang L, Correll CK. Telemedicine and other care models in pediatric rheumatology: an exploratory study of parents’ perceptions of barriers to care and care preferences. Pediatric Rheumatol Online J 2017;15:55.
34. 34. Campbell J, Theodoros D, Hartley N, Russell T, Gillespie N. Implementation factors are neglected in research investigating telehealth delivery of allied health services to rural children: a scoping review. J Telemed Telecare 2020;26:590-606.
35. 35. Segrelles CG, López PD, Chiner E, Fernández FE, Granda-Orive JI. Acceptance of telemedicine among respiratory healthcare professionals. Eur Res Telemed 2017;6:147-55.
36. 36. Taylor OD, Armfield NR, Dodrill P, Smith AC. A review of the efficacy and effectiveness of using telehealth for paediatric speech and language assessment. J Telemed Telecare 2014;20:405-12.
37. 37. Valentine DT. Stuttering intervention in three service delivery models (direct, hybrid, and telepractice): two case studies. Int J Telerehabil 2014;6:51-63.
38. 38. Almojaibel AA, Munk N, Goodfellow LT, Fisher TF, Miller KK, Comer AR, et al. Health care practitioners' determinants of telerehabilitation acceptance. Int J Telerehabil 2020;12:43-50.
39. 39. Kowitlawakul Y. The technology acceptance model: predicting nurses' intention to use telemedicine technology (eICU). Comput Inform Nurs 2011;29:411-8.
40. 40. Rho MJ, Choi I, Lee J. Predictive factors of telemedicine service acceptance and behavioral intention of physicians. Int J Med Inform 2014;83:559-71.
41. 41. Zailani S, Gilani MS, Nikbin D, Iranmanesh M. Determinants of telemedicine acceptance in selected public hospitals in Malaysia: clinical perspective. J Med Syst 2014;38:111.
42. 42. Hines M, Lincoln M, Ramsden R, Martinovich J, Fairweather C. Speech pathologists’ perspectives on transitioning to telepractice: what factors promote acceptance? J Telemed Telecare 2015;21:469-73.
43. 43. Jahromi ME, Ahmadian L. Evaluating satisfaction of patients with stutter regarding the tele-speech therapy method and infrastructure. Int J Med Inform 2018;115:128-33.
44. 44. Crutchley S, Campbell M. Telespeech therapy pilot project: stakeholder satisfaction. Int J Telerehabil 2010;2:23-30.
45. 45. Grogan-Johnson S, Schmidt AM, Schenker J, Alvares R, Rowan LE, Taylor J. A comparison of speech sound intervention delivered by telepractice and side-by-side service delivery models. Commun Disord Q 2013;34:210-20.
46. 46. Carey B, O’BrianS, Onslow M, Block S, Jones M, Packman A. Randomized controlled non-inferiority trial of a telehealth treatment for chronic stuttering: the Camperdown Program. Int J Lang Commun Disord 2010;45:108-20.
47. 47. Lewis C, Packman A, Onslow M, Simpson JM, Jones M. A phase ii trial of telehealth delivery of the lidcombe program of early stuttering intervention. Int J Med Inform Am J Speech Lang Pathol 2008;17:139-49.
48. 48. Halpern AE, Ramig LO, Matos CE, Petska-Cable JA, Spielman JL, Pogoda JM, et al. Innovative technology for the assisted delivery of intensive voice treatment (LSVT LOUD) for Parkinson disease. Am J Speech Lang Pathol 2012;21:354-67.
49. 49. Mashima PA, Brown JE. Remote management of voice and swallowing disorders. Otolaryngol Clin North Am 2011;44:1305-16.
50. 50. Theodoros DG, Constantinescu G, Russell TG, Ward EC, Wilson SJ, Wootton R. Treating the speech disorder in Parkinson’s disease online. J Telemed Telecare 2006;12 (Suppl. 3):S388-91.
51. 51. Tindall LR, Huebner RA, Stemple JC, Kleinert HL. Videophone-delivered voice therapy: a comparative analysis of outcomes to traditional delivery for adults with Parkinson’s disease. Telemed J e-Health 2008;14:1070-7.
52. 52. Higgins WJ, Luczynski KC, Carroll RA, Fisher WW, Mudford OC. Evaluation of a telehealth training package to remotely train staff to conduct a preference assessment. J Appl Behav Anal 2017;50:238-51.
53. 53. Iacono T, Dissanayake C, Trembath D, Hudry K., Erickson S, Spong J. Family and practitioner perspectives on telehealth for services to young children with autism. Stud Health Technol Inform 2016;231:63-73.
54. 54. Parmanto B, Lewis AN Jr, Graham KM, Bertolet MH. Development of the telehealth usability questionnaire (TUQ). Int J Telerehabil 2016;8:3-10.
55. 55. Cassel SG, Edd AJH. A pedagogical note: use of telepractice to link student clinicians to diverse populations. Int J Telerehabil 2016;8:41-8.
56. 56. Malandraki GA, McCullough G, He X, McWeeny E, Perlman AL. Teledynamic evaluation of oropharyngeal swallowing. J Speech Lang Hear Res 2011;54:1497-505.
57. 57. Perlman AL, Witthawaskul W. Real-time remote telefluoroscopic assessment of patients with dysphagia. Dysphagia 2002;17:162-7.
58. 58. Hill AJ, Miller LE. A survey of the clinical use of telehealth in speech-language pathology across Australia. J Clin Pract Speech Lang Pathol 2012;14:110-7.
59. 59. Burns CL, Ward EC, Hill AJ, Kularatna S, Byrnes J, Kenny LM. Randomized controlled trial of a multisite speech pathology telepractice service providing swallowing and communication intervention to patients with head and neck cancer: Evaluation of service outcomes. Head Neck 2017;39:932-9.
60. 60. Ferguson J, Craig EA, Dounavi K. Telehealth as a model for providing behaviour analytic interventions to individuals with autism spectrum disorder: A systematic review. J Autism Dev Disord 2019;49:582-616.