"My son has come so far this year with his speech! His improvement was shocking to his father and I! He still needs work, but he loved the telepractice and with his improvement it is wonderful."
Parent response from Parent Satisfaction Survey
Background
Speech-language services in Ohio's public schools are typically provided by an on-site speech-language pathologist (SLP) who provides intervention on a weekly basis to small groups of children with communication disorders. The acute shortage of SLPs in Ohio has resulted in some school districts being unable to provide the services needed for students with communication impairments. In an attempt to eliminate the shortage, the Ohio Department of Education (ODE) formed a task force made up of stakeholders (representatives from Ohio's universities with speech-language pathology programs, the Ohio Board of Speech-Language Pathology & Audiology [OBSLPA], the Ohio Master's Network Initiatives in Education [OMNIE], the Ohio Speech-Language-Hearing Association [OSHLA], the Ohio School Speech Pathology Educational Audiology Coalition [OSSPEAC] and the Ohio Speech-Language Pathology and Educational Audiology Supervisory Network). Within six weeks, the group developed a program consisting of eight initiatives, which were then funded by the Ohio Department of Education (Boswell, 2007). One of the initiatives, a pilot telepractice project, provides speech-language intervention services to students in rural school districts throughout the state using live interactive video conferencing. The purpose of the pilot telepractice project is to collect data measuring the progress of students who receive telepractice services and attempt to determine if children make similar amounts of progress in speech-language intervention services delivered via telepractice as compared to a more traditional service delivery model.
Telepractice is a term commonly used in the fields of speech pathology and audiology to refer to a service delivery model in which assessment and therapy services are provided over a telecommunications network (ASHA, n.d.) The potential for telepractice to provide access to speech-language intervention services for underserved populations is recognized in the American Speech Language Hearing Association (ASHA) Position Statement on Telepractice (ASHA, 2005) as well as recent research (Lewis, Packman, Onslow, Simpson, & Jones, 2008; Polovoy, 2008). There are also descriptions and reports of telepractice applications in educational settings (Forducey, 2006; Madsen & Shellsey, 2005). These reports provide descriptions and satisfaction survey results but do not included specific data on the outcome of providing intervention services via telepractice. Two recent articles report the results of telehealth delivery of the Lidcombe Program of Early Stuttering Intervention to young children who stutter and their families (Lewis et al., 2008; Wilson, Onslow, & Lincoln, 2004).
Results suggest that the telehealth delivery of the Lidcombe Program is an efficacious treatment for preschool children who are unable to access the traditional clinic-based version of the program. The Lidcombe Program, when delivered via telephone, resulted in additional time in intervention for the child/parent and additional time by the SLP in delivery of services and in listening to recorded speech samples of the children. Sicotte, Lehoux, Fortier-Blanc, and Leblanc (2003) found that six school-age and adolescent children who stuttered improved their fluency and maintained improved fluency over a six-month period using stuttering intervention provided by interactive videoconferencing. They concluded that assessment and treatment of stuttering in children and adolescents is successful using telepractice (Sicotte et al., 2003).
A pilot study investigating the assessment of childhood speech disorders on-site and via videoconferencing resulted in high levels of agreement in scoring for single-word articulation, speech intelligibility, and oral-motor tasks between the online and the on-site speech-language pathologists (Waite, Cahill, Theodoros, Busuttin, & Russell, 2006). Waite, Theodoros, Russell, and Cahill (2009) recently conducted an online assessment of children ages 5 to 9 years with suspected language impairment using a multimedia presentation of the four core subtests of the Clinical Evaluation of Language Fundamentals (CELF-4). Simultaneous on-line and face-to-face scoring revealed no significant difference between the two delivery models. The presenters concluded that online assessessment using a mulitmedia presentation may be a valid method for assessing language impairment in young school-age children.
The purpose of this article is to briefly summarize the outcomes of the first two years of implementation of speech-language intervention services delivered via live interactive video conferencing. The speech-language services were delivered to rural school districts in Ohio.
