1. Telepractice in the University Speech and Language Clinic:
A Student Clinician's Perspective
Steven Gianakas, B.A. (expected May 2015) and Ann Bilodeau, M.S./CCC-SLP
College of Communication Department of Communication Sciences & Disorders Indianapolis, Indiana
Indiana Speech-Language-Hearing Association Convention 2015
Abstract
Results
The client's speech intelligibility to an unfamiliar listener increased from 60% to 90% over 8 weeks of therapy. The client also improved his articulation of all problematic phonemes as shown in the graph. The client improved his eye contact with a conversation partner from 50% to 90%.
During week 6, family noted significant functional communication gains. After attending a wedding, the client's mother informed us that the rest of the extended family was surprised at the improvement of his intelligibility and confidence her son exhibited in conversational settings.
Telepractice is becoming more prevalent as a service model for those providing services in the communication sciences and disorders field. This case study shares the experience and perspective of a student clinician providing speech therapy to a 6-year-old boy via telepractice—a novel opportunity not only for the student and client but also for the university. Selection, preparation and methods will all be discussed as well as outcome. In addition, a review of the use of telepractice status in the 7 Indiana universities in Indiana with speech-language pathology and audiology programs will be provided with suggestions for future training.
Background
Conclusion
The client and his family had been receiving services from our clinic for over two years, but the family moved to a new town. In addition, the mother has young children and driving to clinic was cumbersome. The client and his family still expressed interest in receiving therapy at the beginning of the year. We decided because of his particular articulation issues & the distance, speech therapy via telecommunication would be the best route.
The client had previously received services from our clinic because of a mild phonological processing disorder characterized by stopping. His mother noted that the client’s grandfather and other family members had a difficult time understanding his speech. She also reported her concern that her son had issues maintaining eye contact with his conversation partner.
Telepractice can be a useful and effective form of therapy
Viable form of therapy when distance or other limitations to services are an issue
Provides same services as in person therapy
Convenient for client and client’s family
Encourages facilitator/parent training for carryover
Useful for implementation in clinic training programs- future model
Recommended Methods
Testimonial
Work surface for client
Proper equipment positioning
Quiet Setting
Supportive client facilitator
Short interactive activities
Use quality headphones
Strong Internet connection is critical
Computer with video capabilities
Use a secure video calling service
"Telepractice therapy allowed our family to get (our child) help during a period of time when we otherwise wouldn't have been able to get the help. Our one car status, combined with multiple moves to a new city and the birth of a child, made traveling to the clinic unrealistic. (Our child) is now consistently speaking without having to ever repeat himself. We are grateful for the generosity of everyone involved.”
- client’s mother
Challenges
Telepractice Status: Indiana Practicum Training in the University Setting
Audio and visual delays due to variable internet connection
Diminished hearing quality due to computer speakers and microphone
Distractions (siblings, friends, spinning desk chair!)
Client/Parent not always prepared necessitated spontaneous change in lesson plan; required high flexibility
Materials needed to be prepared and sent to client prior to session
In November 2014, an informal survey of the seven CSD university programs located in Indiana revealed that Butler University appears to be the first program in which students are providing services via telepractice. Two or three schools plan on utilizing this therapy model within the next year. The remaining three schools reported no plan for use of telepractice in the immediate future.