Telepractice

 

One of the ways in which CSLOT serves our clients is through the use of telepractice. Telepractice allows our clinicians to use telecommunication technologies, such as video-conferencing, to treat clients and support families in reaching their therapy goals. Schools, medical centers, rehab hospitals, community health centers, outpatient clinics, universities, clients’ homes, residential health care facilities, childcare centers, and corporate settings (ASHA, 2013a, para. 4) all use telepractice.

What is a telepractice therapy session? 

Telepractice is a mode of delivering services, not a separate form of practice. A telepractice video visit involves the application of video-conferencing technology to deliver services, and can serve as an alternative to an in-person clinic visit. To participate in a telepractice video visit, one would need a device with a camera and an internet connection, such as a smartphone, tablet, laptop, or desktop computer.

Is telepractice as good as in person? 

The standard of care is the same irrespective of whether the client is seen in-person or via a telepractice video visit. In 2021, a study was published that compared in-person and telepractice service delivery for children. When comparing children who received in-person therapy and telepractice therapy, both groups of children “demonstrated positive outcomes as a result of treatment. The results of our analysis of these select cohorts suggest that there is either no significant difference in treatment outcomes between traditional in-person interventions or, in a few instances, a small improvement in outcomes with telepractice services.” It is important to note that “these findings strengthen those reported by similar studies (Gabel et al., 2013; Grogan-Johnson et al., 2011) with the added robustness of expanded sample size and added controls against confounding interactions. These findings are also consistent with Coufal and colleagues’ (2018) examination of telepractice outcomes in the category “speech-sound production.” Finally, these findings support the emerging broader consensus that telepractice, across a wide spectrum of professions and interventions, is comparable with in-person delivery.” (Musaji, et al., 2021).

My child will not sit still for a telepractice session, now what?

It is to be expected that a person attempting to interact and engage with a child through a screen, during a video visit, would not be able to hold that child’s attention. What does engage a child enough to learn, is someone who is in person with the child, doing actions, sounds, gestures, games, playing, and engaging with the child. Responding to that child in the moment and in real time. Therefore, through training and instruction from the clinician, the parent is taught to be the main facilitator of engagement, the person who is in-person with the child, is with the child the most, and who knows the child best. By having the parent as the main facilitator of engagement, this leads to better outcomes for the child.

If my child can pay attention to a telepractice session, do I have to join them?

The parent must actively participate in all therapy sessions, regardless of whether services are provided in-person or via telepractice. Parent engagement is agreed upon, supported, and viewed as a value for continuation of services by our payor sources as well. Best practice incorporates parent coaching in order for the parent to demonstrate the skills taught to them by the treating clinician, and carry those skills over into the child’s everyday life. Let’s do the math. If a clinician acts as primary intervention agent, seeing the child for one 60-minute session per week, that would result in a total of one hour of therapy per week. If the parent acts as the primary intervention agent, and spends the most time with the child during the week during meal times, dressing routines, bathing routines, driving, etc., the child is receiving upwards of 30 hours of therapy per week.

Are the video sessions private? 

CSLOT uses video platforms Google Meet and Zoom, which are in compliance with HIPAA Regulations.

Where in the home should we join the session from? The kitchen table? 

Check if your server speed is adequate. Reduce the number of devices on your WiFi network while you are on the video visit. A light source in front of you and your device will allow for greater visibility, as opposed to a light source located behind you and your device.

The treating clinician will help identify the most appropriate space within your home for the specific activity or goal you are working on at the moment. The clinician will also guide you on how to manipulate different environments and materials to serve the child’s learning.

Musaji, I., Roth, B., Coufal, K., Parham, D., & Self, T. (2021). Comparing in-Person and Telepractice Service Delivery for Spoken Language Production and Comprehension Using the National Outcomes Measurement System. International Journal of Telerehabilitation Vol 13, No. 1, pp. 1-13.

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