Positive Outcomes for Speech Telepractice as Evidence for Reimbursement Policy Change

Abstract

Oklahoma has a large population living in rural areas where it is difficult to fill school speech-language pathologist (SLP) positions. To meet this need, telepractice has been used in rural Oklahoma school districts since 1999. Medicaid policies have allowed schools to receive reimbursement for speech therapy provided by onsite therapists; however, reimbursement for speech telepractice was excluded. The current project measured the effectiveness of a speech telepractice program so this policy could be revised. Speech and language skills of 578 children, grades PreK–12, were followed over one of two school years and were rated using Functional Communication Measures (FCM) established by the American Speech Language and Hearing Association (ASHA). Our data show that 67–87% of the children advanced by one or more levels on three common FCM scales. These changes are similar to, or greater than, what was reported in a large sample of students compiled by ASHA's National Outcomes Measurement System (NOMS) with clinicians who worked onsite in schools. Average weekly treatment time was also less in our teletherapy practice than what was reported in the reference database. Therefore, the current study demonstrates that speech telepractice is an effective and efficient method of delivery for the school age population.

Comparing In-Person and Telepractice Service Delivery for Spoken Language Production and Comprehension Using the National Outcomes Measurement System

“…Studies involving school-aged children reported that telepractice services are effective, reliable, and efficient (Boisvert & Hall, 2019;Coufal et al, 2018;Grogan-Johnson et al, 2010;Grogan-Johnson et al, 2011;Short et al, 2016). Coufal and colleagues (2018) specifically looked at speech-sound production outcome measures between traditional speech-language pathology service delivery and telepractice.…”

“…Recent studies refute these concerns. Telepractice service delivery modalities are implemented relatively easily and efficiently (Grogan-Johnson et al, 2010;Short et al, 2016). Boisvert and Hall (2019) reported that with appropriate introduction and training, stakeholders adopted telepractice modalities enthusiastically and with positive post-intervention perceptions.…”

“…As a result of COVID-19, telepractice has become a more prevalent approach to ensuring the continuity of speechlanguage pathology services. The most commonly provided services target intelligibility, speech-sound production (i.e., articulation and phonology), and early language abilities, including language comprehension and production (Gabel et al, 2013;Short et al, 2016).…”

Professional skills of speech therapist in special education centres of Punjab, Pakistan

“…According to Short et al (2016), more general variables found in different speech or language therapies can also contribute to positive outcomes. For example, in speech or language recovery study, the clinician's role is often underestimated or ignored, despite evidence that clinics are an important component of comparative field therapy.…”

“…Strange factors can be compared to speech language pathology, particularly in relation to additional individuals. Many speech therapists have unique elements within the physician-user relationship regarding their treatment, specific to the length of the care plan, and the client's expectations of performance have an overall outcome (Short et al, 2016). The implicit clinical centre of experienced practitioners can help form these perspectives, but the goal is not always to capture these wellknown elements through speech and language action.…”