Multiple Stakeholder Perspectives on Teletherapy Delivery of Speech Pathology Services in Rural Schools: A Preliminary, Qualitative Investigation

Abstract

The objective of this study was to investigate stakeholders’ views on the feasibility and acceptability of a pilot speech pathology teletherapy program for children attending schools in rural New South Wales, Australia. Nine children received speech pathology sessions delivered via Adobe Connect® web-conferencing software. During semi-structured interviews, school principals (n = 3), therapy facilitators (n = 7), and parents (n = 6) described factors that promoted or threatened the program’s feasibility and acceptability. Themes were categorized according to whether they related to (a) the use of technology; (b) the school-based nature of the program; or (c) the combination of using technology with a school-based program. Despite frequent reports of difficulties with technology, teletherapy delivery of speech pathology services in schools was highly acceptable to stakeholders. However, the use of technology within a school environment increased the complexities of service delivery. Service providers should pay careful attention to planning processes and lines of communication in order to promote efficiency and acceptability of teletherapy programs.

Human resources for health (and rehabilitation): Six Rehab-Workforce Challenges for the century

“…Care rationing may come as a result [79]. Particularly in Canada [72–74] and Australia [68, 70, 76, 77, 80, 81], a set of educational, recruitment and retention measures have been implemented to help supply rural or remote areas with the rehabilitation workers they need.…”

“…Home [89], community [59, 88, 90] or tele-based [69, 81, 91] forms of rehabilitation care delivery increasingly are used to improve access to care in underserved areas.…”

“…A third option is to develop remote services delivered by tele-means [25, 69, 81, 91, 129], even from outside the country. This strategy can also be used for training students, their educators [130–133] and even coaching frontline staff (peer-professionals, lower-level rehabilitation workers), volunteers or family members [25, 134].…”

“…While policies for universal rehabilitation coverage might be in place, supplying underserved areas may also require implementing (i) trans-disciplinary models of rehabilitation practice [75, 77, 111]; (ii) more accessible, locally shaped forms of rehabilitation service delivery (community-, home-, tele-based) [59, 69, 77, 81, 100] and finally (iii) response outreach programs that cut across institutional (public, private, NGOs) and traditional healthcare silos [69, 77, 81, 138, 139]. …”

Disparities in access to pediatric hearing health care

“…This same group has investigated methods to maximize remote cochlear implant testing environment to obtain accurate measures of cochlear implant function in children.. 72 Telemedicine can also be utilized to address unmet need for speech therapy services. 73 Delivery of remote speech therapy is highly acceptable to parents, 74,75 and the outcomes are comparable to in-person therapy. 76,77 Important areas to be addressed with expanding delivery of remote speech therapy include maintenance of patient relationships, interaction with parents and teachers, high fidelity technology, and ongoing training in telepractice for providers.…”