first published in 2002
Online speech therapy is not new
Telehealth is ubiquitous since the public health emergency. By now, most people have had a successful doctor’s appointment via their home computer or smartphone. But what about online speech therapy as a rehabilitation tool for ongoing speech therapy visits? Naturally, most people would have some questions regarding its effectiveness and whether or not it’s a good fit.
For some background, telehealth or telepractice, for speech therapy has been around for many years. Telepractice was officially recognized as an appropriate and approved method of delivery for speech therapy in 2005 by the national accrediting board of speech pathologists (ASHA). The global pandemic of the past two years has merely catapulted this delivery model to the mainstream. Learn more from ASHA's beautifully made youtube video about telepractice.
This virtual method of providing speech therapy has many names: telepractice, teletherapy, telehealth, and remote or virtual therapy. They all mean the same thing—accessing speech therapy from the comfort of your home via a computer or tablet or similar device. Here, we will call it simply teletherapy and focus on speech therapy for adults.
What are the benefits of teletherapy?
o The most obvious benefit of teletherapy is comfort. This mode allows you to participate from the comfort of your home, in your socks! It’s the same quality medical appointment but it doesn’t require the hassle of a commute, a search for parking, or wait time. What would be time lost to travel is gained back.
o Teletherapy delivers care to populations in need. This includes underserved populations due to a rural location or those with physical limitations or the elderly patient who is homebound. And currently with Medicare’s approval, teletherapy is providing access to people who are at higher risk of contracting a severe case of COVID-19 and need to quarantine as much as possible.
o Another benefit to teletherapy is better carry over of your speech goals! Sometimes patients associate their target voice or the communication patterns that they are learning with the speech therapy office they practice in regularly. They associate their visits to the office with these goals and “turn on” their voice when they enter the therapy office but then have difficulty transferring these goals to the outside world and other conversational partners. Some therapy programs must spend the last few sessions focusing on what is known as “carry over” before they can call it successful. Because teletherapy is done in the home and with your loved ones nearby or even participating and maybe facilitating, goals are more easily incorporated to other situations and partners. This means greater success sooner!
o Your speech therapist can incorporate your home environment and family members into a more meaningful therapy session. (See below about the importance of a patient-centered approach) How wonderful to have that support automatically built into your sessions because you are already in familiar surroundings!
Ok, but is telepractice as effective as in-person therapy?
The answer is mostly yes, but it depends. This is an area of research that has been ongoing for over 15 years. Studies tend to focus on a specific type of speech therapy—aphasia therapy after a stroke, voice therapy for Parkinson’s disease, dysphagia (swallowing) therapy, stuttering therapy, etc. These studies repeatedly support the effectiveness of virtual therapy. In fact, the research is helping the field fine-tune telepractice by finding what tests or treatments are best delivered in person. Additional studies have helped clinicians adapt their practices to include more technology not just in the therapy session, but even between sessions.
But the field has also identified situations and conditions that are best served in person. This is described further below in “What you should know about teletherapy.” If you find a knowledgeable and experienced speech pathologist, you will be well guided through this process in determining if teletherapy or online speech therapy is not a good fit for you or your loved one.
Now that teletherapy is more widely used, even more studies are being conducted and the field continues to increase its knowledge and perfect this delivery model.
What you should know about teletherapy
Teletherapy does not work for everyone. Some people did not grow up with technology and learning to use a virtual platform, such as Zoom or Teams, on top of having a recent stroke may just prove to be too much to tackle. But it is worth checking to see if the technological barrier can be overcome with a facilitator. Is there a relative that is able to set up the videoconference, orient you to the simple settings or even be present for the duration of the session to be backup support?
Even if you have the tech savvy skills, some aspects of speech therapy are best delivered in person. For example, if you need voice therapy, it has been found that, in an effort to make the sound more pleasing to the listener, most of the virtual platforms distort the actual audio. Therefore, the data your SLP is trying to analyze will not be accurate. In this case, it is recommended to complete a voice assessment in person and then you can complete the ongoing therapy remotely.
Another situation where in-person therapy may be best is in the case of advanced dementia. This is partly because the virtual platform is so foreign and creates a layer of confusion. Additionally, the latest research and development of cognitive therapy for dementia has moved toward a person-centered approach. This means therapy should be specific and meaningful to the patient and family and his/her surroundings. For this reason, it may be best to have the speech therapy visits in your home. Only then, can the speech pathologist form a complete understanding of what the patient’s life situation is like, what the specific communication needs are in order to deliver the high quality of care you deserve.
Still have questions? Talk to a speech pathologist. Describe your specific situation and any concerns or potential barriers. Chances are your questions and concerns about online speech therapy are not unique to you. The speech pathologist you select to work with for this important communication, swallowing or cognitive goal should be a good fit. Asking questions beforehand is a good way to interview and see how well supported you feel before entering any speech therapy program. Find a speech pathologist that takes the time to help you navigate teletherapy or will let you know when it is not a good fit.