Telehealth language assessments using consumer grade equipment in rural and urban settings: Feasible, reliable and well tolerated

Abstract

Introduction Telehealth can be an effective way to provide speech pathology intervention to children with speech and language impairments. However, the provision of reliable and feasible standardised language assessments via telehealth to establish children's needs for intervention and to monitor progress has not yet been well established. Further, there is limited information about children's reactions to telehealth. This study aimed to examine the reliability and feasibility of conducting standardised language assessment with school-aged children with known or suspected language impairment via a telehealth application using consumer grade computer equipment within a public school setting. Method Twenty-three children (aged 8-12 years) participated. Each child was assessed using a standardised language assessment comprising six subtests. Two subtests were administered by a speech pathologist face-to-face (local clinician) and four subtests were administered via telehealth. All subtests were completed within a single visit to the clinic service, with a break between the face to face and telehealth sessions. The face-to-face clinician completed behaviour observation checklists in the telehealth and face to face conditions and provided feedback on the audio and video quality of the application from the child's point of view. Parent feedback about their child's experience was elicited via survey. Results There was strong inter-rater reliability in the telehealth and face-to-face conditions (correlation coefficients ranged from r = 0.96-1.0 across the subtests) and good agreement on all measures. Similar levels of attention, distractibility and anxiety were observed in the two conditions. Clinicians rated only one session of 23 as having poor audio quality and no sessions were rated as having poor visual quality. Parent and child reactions to the use of telehealth were largely positive and supportive of using telehealth to assess rural children. Discussion The findings support the use of telehealth in the language assessment of school-aged children using a web application and commercially available computer equipment. This reliable and innovative service delivery model has the potential to be used by speech pathologists to provide assessments to children in remote communities.

Speech and language screening for children with medical complexity: A comparison of telepractice and in-person methods

“…Two of these studies randomly allocated participants to an in-person-or telepractice-led condition, and these studies also randomly allocated SLP roles (34,35). The other studies did not use randomisation to allocate participants or assign SLP roles (33,(36)(37)(38)41). …”

“…Three papers included a parent satisfaction survey (33,38,41). (40) and Guiberson (39) had reasonable samples of 82 and 62 participants respectively.…”

“…The remaining papers completed comprehensive assessment via telepractice using both formal and informal tools (33)(34)(35)(36)(37)41). All of the formal speech and language screeners and assessments used in the studies are validated tools (185)(186)(187)(188)(189)(190)(191)(192)(193)(194).…”

“…All of the formal speech and language screeners and assessments used in the studies are validated tools (185)(186)(187)(188)(189)(190)(191)(192)(193)(194). Four papers examined language screening/assessment (35,(39)(40)(41), three papers examined speech screening/assessment (33,34,36), and two papers considered both speech and language screening/assessment (37, 38).…”

“…There is a growing body of research that supports telepractice for speech pathology service delivery (32), however, only one study to date has investigated the use of telepractice for screening or assessment with CMC (33). There is also limited evidence to support telepractice speech and language screening among the broader paediatric population (34)(35)(36)(37)(38)(39)(40)(41). Thus, the overall aim of my thesis is to investigate the role of telepractice for remote speech and language screening of CMC.…”