Speech–language pathology telehealth in rural and remote schools: the experience of school executive and therapy assistants

Abstract

Introduction: Difficulties in accessing allied health services, especially in rural and remote areas, appear to be driving the use of telehealth services to children in schools. The objectives of this study were to investigate the experiences and views of school executive staff and therapy assistants regarding the feasibility and acceptability of a speech-language pathology telehealth program for children attending schools in rural and remote New South Wales, Australia. The program, called Come N See, provided therapy interventions remotely via low-bandwidth videoconferencing, with email follow-up. Over a 12-week period, children were offered therapy blocks of six fortnightly sessions, each lasting a maximum of 30 minutes. Methods: School executives (n=5) and therapy assistants (n=6) described factors that promoted or threatened the program's feasibility and acceptability, during semistructured interviews. Thematic content analysis with constant comparison was applied to the transcribed interviews to identify relationships in the data. Results: Emergent themes related to (a) unmet speech pathology needs, (b) building relationships, (c) telehealth's advantages, (d) telehealth's disadvantages, (e) anxiety replaced by joy and confidence in growing skills, and (f) supports. Conclusions: School executive staff and therapy assistants verified that the delivery of the school-based telehealth service was feasible and acceptable. However, the participants saw significant opportunities to enhance this acceptability through building into the program stronger working relationships and supports for stakeholders. These findings are important for the future development of allied health telehealth programs that are sustainable as well as effective and fit the needs of all crucial stakeholders. The results © GC Fairweather, MA Lincoln, R Ramsden 2017. A Licence to publish this material has been given to James Cook University, http://www.jcu.edu.au 2 have significant implications for speech pathology clinical practice relating to technology, program planning and teamwork within telehealth programs.

Speech-language Pathology Services Delivered by Telehealth in a Rural Educational Setting: the School’s Perspective

“…13 Communication between all stakeholders was also recognised by school staff as essential for program success. 14 In our study, lack of communication regarding the program negatively influenced the satisfaction of some teachers. These findings highlight the importance of stakeholder engagement and clear communication when implementing such a program.…”

“…13 Another study showed a telehealth speech-language pathology program was acceptable to school executive and therapy assistants, but highlighted the need for a greater understanding of how to implement such programs. 14 Understanding the perceptions and experiences of school staff members is integral to ensuring program sustainability and determining scalability to other schools. This study aimed to explore the implementation requirements of a telehealth speechlanguage pathology program from the perspectives of staff at a rural Australian school.…”

Rural and remote speech-language pathology service inequities: An Australian human rights dilemma

“…Whilst evidence exists on the importance of a clinical vision and purpose for telehealth and clinician and management ownership of these services (Bradford, Caffery, & Smith, 2016), limited evidence exists on: the role of communities in the codesign of these alternative services; service capacity to adapt to current and changing community needs; the depth of relationships between external service providers, local services and communities; and whether communities feel a sense of ownership and control of these services (Bywood, Raven, & Butler, 2013). Healthcare that lacks face-to-face interactions can be considered a second best option for rural and remote service recipients and providers (Bradford et al, 2016;Fairweather, Lincoln, & Ramsden, 2017). In the absence of face-to-face services, individuals, families and communities can feel obliged to accept healthcare alternatives despite preferring direct interactions and engagement with their healthcare providers (Bywood, Raven, & Butler, 2013).…”

Efetividade da Telessaúde em pacientes com distúrbios dos sons da fala: uma revisão sistemática

“…Contudo, há carência de estudos voltados para terapia das AFI via telessaúde, recurso que ainda não está totalmente estabelecido. Por essas razões, as informações ainda são incipientes em relação ao desempenho dos indivíduos à telessaúde, às abordagens terapêuticas e às metodologias tecnológicas utilizadas para viabilizá-las, uma vez que os estudos nessa temática ainda estão em desenvolvimento (Fairweather et al, 2017).…”