Telemedicine or telepractice conjures up images of people receiving medical services through their televisions or streaming live through their desktops, laptops or tablets. But what is it exactly? And is it right for you or your child?
ASHA (the American Speech-Hearing-Language Association) defines telepractice as “the provision of health services over a telecommunications network.” ASHA prefers the term telepractice to telemedicine as the latter evokes images of therapy provided only in or through health care settings. In fact, telepractice can be delivered to clients in their homes or in schools.
In practice, telemedicine uses high-speed interactive video and remote connection applications to provide speech language and hearing services to clients living in underserved areas. This effectively means that you or your child can be sitting in front of a computer receiving speech therapy or audiology services from an speech language pathologist or audiologist who may be many miles away or even in a different state!
What are the advantages to this? For one, clients living in underserved regions, such as rural areas where they may have to drive several hours to see licensed professionals, can simply sit in front of their computers and receive services—as could clients or patients with mobility problems (such as those with Parkinson’s Disease/Disorder). And theoretically, at least, telepractice could help busy parents reduce the amount of time spent driving their children to therapy services.
Other benefits include the nature of the therapy itself. Sessions delivered via a computer screen can be just as engaging, or perhaps, even more so to Millenials and children who have grown up with technology.
Research has shown that diagnoses and assessments performed remotely by speech language pathologists are equivalent to those conduced in traditional face-to-face settings. More research is needed, however, regarding the efficacy and cost effectiveness of therapeutic services delivered remotely.
Because of the advantages, telepractice is being used to assess and treat a wide range of speech and language disorders, including articulation, autism, fluency disorders, receptive and expressive language disorders and voice disorders, among others.
Telepractice would seem to be the cutting edge wave of the future, but it is not necessarily right for every child or adult. Some factors to consider include the individual’s visual ability (e.g., to see material on a computer monitor), manual dexterity (e.g., ability to operate a keyboard if needed), and ability to sit for a while and maintain attention in front of the computer.
The client’s/patient’s support services also need to be considered, including the availability of the necessary technology (hardware, software and peripheral devices), an appropriate environment for the telepractice (e.g., a quiet room with minimal distractions, appropriate lighting, etc.) and the ability of the client, caregiver or facilitator to follow directions to operate and troubleshoot telepractice technology.
As a speech language pathologist, I find myself thinking about times when I put gloved fingers with or without flavored tongue depressors into children’s mouths to move their tongues, lips or jaws to elicit speech sounds. In theory, a nursing assistant, speech language pathology assistant (in states where SLPAs are allowed), interpreter, family member or caregiver who is present at the remote site can do this. However, not all facilitators or family members are adequately trained or comfortable to provide these services under the coaching of a speech language pathologist.
Finally, there are insurance reimbursement issues with telepractice. According to ASHA, “Mandates require health insurers, subscription plans and health maintenance organizations to cover the cost of health care services provided through telepractice on the same basis as those provided through in-person visits. However, ASHA notes that of state requirements regarding reimbursement for telepractice services vary.
Joanne Summer, MA, CCC-SLP, a speech-language pathologist based in Morristown, NJ, has helped hundreds of children improve their speech sound production and language skills. She founded Well Spoken Speech Therapy, LLC, in 2014 after spending 12 years providing therapy to children (K-5) in the New Jersey public school system. In private practice, her clients also include younger children and adolescents. In addition, she treats people of all ages who stutter or otherwise find it difficult to speak fluently—an area in which she has received extensive specialized training.