Preparedness, Training, and Support for Augmentative and Alternative Communication Telepractice During the COVID-19 Pandemic

Abstract

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.

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

“…Telepractice may adversely affect the conversational flow and alter how clients and clinicians interact (Shaw et al., 2020), particularly when technology and connectivity prove problematic or inconsistent (Fairweather et al., 2016). In addition, telepractice impedes the use of hands‐on strategies typically employed during in‐person therapy (Biggs et al., 2022), leading to an increased reliance on caregivers during telepractice sessions. Caregivers must assist with tasks such as setting up the device, ensuring that the child is attentive throughout the session, and implementing strategies that would typically have been implemented by the SLT in an in‐person setting (Fairweather et al., 2016; Tambyraja et al., 2021).…”

“…Importantly, from a service user's perspective, although telepractice may promote access to services, telepractice can equally present barriers for marginalized groups, those who do not have access to technology and internet connectivity, and those without sufficient technological literacy (McGill & Fiddler, 2021). The use of technology is often reported as a barrier to telepractice implementation, for example: SLTs may struggle with selecting appropriate technology to use during assessment and intervention (Tambyraja et al., 2021); SLTs report a lack of experience and knowledge in the use of technology (Hines et al., 2019; Tambyraja et al., 2021); clients may have limited access to devices and internet data (Biggs et al., 2022; Hines et al., 2019) and limited knowledge of how to use them (Garbe et al., 2020); SLTs and clients may experience poor audio and video quality due to unstable network connections (Chaudhary et al., 2021); and clients (especially children) may require additional support when engaging and navigating technological devices used during telepractice (Biggs et al., 2022). Anecdotally, SLTs have described a loss of ‘connection’ with clients when engaging online.…”

“…Grillo, 2017; Hines et al., 2015; Pitt et al., 2018) and during the COVID‐19 pandemic (e.g. Biggs et al., 2022; Hao et al., 2021; Kwok et al., 2022; McCaslin, 2021; Patel et al., 2022; Tambyraja et al., 2021) have been conducted in Global North settings. Given the difficulties related to telepractice provision identified in resource‐rich areas of the world, it is important to explore the experiences of SLTs working in contexts that already face barriers such as those related to technological access and internet connectivity.…”

High-Tech Augmentative and Alternative Communication Devices: Observing Children’s Need for Help and Interaction with Caregivers

“…The authors also emphasized the need for AT providers to be better prepared and supported in the future, although barriers to access to AT resources existed long before COVID-19. Therrien et al (2022) and Biggs et al (2022) sought to understand the impact of COVID-19 on children, families, service providers and the delivery of AAC-related communication services. They believed that the global pandemic instigated a dramatic change in service delivery for students with communication disorders, including students with complex communication needs who used aided augmentative and alternative communication (AAC), such as speech-generating devices.…”

“…Therefore, recent research highlights the essential role of the family and access to quality AAC services for children during the pandemic and onwards (Puli et al 2021;Therrien et al 2022;Biggs et al 2022). According to these studies, it is believed that characterisation of the family environment and training tailored to the needs and skills of the users of augmentative communication systems and their carers in a (family) care context is an option that should be considered in order to bridge the gaps often overlooked by conventional methods.…”