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

Abstract

BackgroundThe 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.AimsTo explore the experiences of South African SLTs (N = 45) who implemented telepractice services during the COVID‐19 pandemic.Methods & ProceduresSLTs 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 & ResultsWe 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 & ImplicationsTelepractice 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 ADDSWhat 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.

Impact of the initial COVID-19 response in the UK on speech and language therapy services: a nationwide survey of practice

“…Similar concerns around access and suitability of telehealth have been raised by SLTs in terms of patient safety in relation to dysphagia and risk of choking though this issue is less reported in the literature (Malandraki et al, 2021). Nonetheless, the uptake of telehealth in speech and language therapy inevitably increased during the pandemic in the UK (Charlton et al, 2023;Jayes et al, 2022;Patel et al, 2022;Puttasiddaiah et al, 2023;Southby et al, 2021) and globally (Furlong and Serry, 2023;Gallant et al, 2023;Shahouzaie and Gholamiyan Arefi, 2022).…”

“…, 2023; Southby et al. , 2021) and globally (Furlong and Serry, 2023; Gallant et al. , 2023; Shahouzaie and Gholamiyan Arefi, 2022).…”

Experiencia de fonoaudiólogos sobre la atención por telepráctica a personas adultas y mayores durante la pandemia por COVID-19 en Chile

“…La evidencia existente sobre el uso de la telepráctica durante la pandemia es, en su mayoría, sobre las experiencias y perspectivas de los fonoaudiólogos. La telepráctica durante la pandemia ha sido valorada positivamente por fonoaudiólogos en varios países, a pesar de lo desafiante que ha significado acceder a las tecnologías (Boey & Lefevere, 2022;de Cerqueira Oliveira et al, 2020;Gallant et al, 2023;Peh et al, 2023;Vrinda & Reni, 2020). Algunos estudios destacan el aumento de la confianza en su uso (Peh et al, 2023) y otros señalan la importancia del contexto y la preferencia por formatos híbridos (Kwok et al, 2022).…”

“…La implementación de telepráctica requiere de un rol activo por parte de la/os cuidadores. En la experiencia de fonoaudiólogos y estudiantes de Sudáfrica en la atención a niños durante la pandemia se observa que puede constituir tanto una ventaja por la posibilidad de que se involucren más en los procesos terapéuticos como una desventaja al no siempre contar con su disponibilidad (Gallant et al, 2023;Watermeyer et al, 2022). Las fonoaudiólogas chilenas, que implementaron telepráctica en contexto educativo, reportaron que la incorporación de padres fue un desafío constante (Mora-Pino et al, 2023).…”

“…Otro aspecto abordado en la literatura son las condiciones socioeconómicas de la población para el acceso y continuidad de la atención por telepráctica debido a la relación directa entre condiciones materiales y conexión a internet (de Cerqueira Oliveira et al, 2020). El acceso a internet y dispositivos electrónicos es limitado, a diferencia de lo que ocurre en países desarrollados (Gallant et al, 2023). También, se describe que es necesario que los espacios físicos sean adecuados para que las sesiones permitan implementar la terapia (Gallant et al, 2023).…”