The process of telepractice implementation during the COVID-19 pandemic: a narrative inquiry of preschool speech-language pathologists and assistants from one center in Canada

Background Many professional services were pressed to adopt telepractice in response to the global coronavirus SARS-CoV-2 (COVID-19) pandemic. The need to adopt a new service delivery approach quickly created different implementation challenges. This study explored the lived experiences of frontline clinicians who successfully transitioned their in-person speech-language therapy services to telepractice through an implementation science lens. Methods The study was conducted in partnership with one publicly funded program in Ontario, Canada that offers services to preschoolers with speech, language and communication disorders. Sixteen frontline speech-language pathologists and assistants at this organization shared their lived experience transitioning to telepractice during the pandemic during videoconference interviews. A narrative inquiry approach was used to analyze interview transcripts to identify the processes (or steps) this program took to implement telepractice and to understand the facilitators and barriers to telepractice implementation during the pandemic. Results The following six stages were identified from clinicians’ narratives: abrupt lockdown; weeks of uncertainty; telepractice emerged as an option; preparation for telepractice; telepractice trials; and finally, full implementation of telepractice. The stages of events offered significant insights into how government public health measures influenced clinicians’ decisions and their processes of adopting telepractice. In terms of barriers, clinicians reported a lack of knowledge, skills and experience with telepractice and a lack of technological support. The organization’s learning climate and team approach to transitioning services were identified as the main facilitator of implementation. Conclusions Findings suggest a need for better coordination of public health measures and professional services, which would have eased clinicians’ stress and facilitated an earlier transition to telepractice. Fostering an organization’s learning climate may improve organization’s resilience in response to emergency situations.

Tele-Ethics in Communication Disorders: Asking the Right Questions, Finding the Right Answers

Purpose: A hypothetical case is used to illustrate legal and ethical issues involving the decision to replace the traditional in-person service delivery model with telepractice in schools beyond the context of the initial COVID-19 health emergency. In this clinical focus article, the reader follows Maria, the lead speech-language pathologist (SLP) in the district, as she determines the feasibility of continuing telepractice in her district now that students and clinicians are returning to schools. First, she considers the support needed to implement this service delivery model within the school setting given the anticipated changes to the rules and regulations governing lawful and ethical provision of telepractice after the health emergency ends. Next, she decides if telepractice is warranted in the district by considering the rationales behind the requests. Faced with balancing school, student, and clinician needs, Maria uses an ethical decision-making model to determine if requests for telepractice, tied to health safety concerns and potentially influenced by implicit bias, reflect legal, ethical, and/or moral issues driven by fear or unconscious discriminatory motives. Conclusions: The health emergency gave SLPs working in schools the unique opportunity to experience the benefits and utility of telepractice. Following the return to schools, continuation of telepractice services will require support and training of SLPs. Many factors must be considered including equivalency of services, technology, and protection of privacy as they relate to the changes to the laws and regulations governing telepractice after the health emergency allowances end. Of primary importance is the selection of telepractice to address student needs, not to avoid specific schools because of their characteristics or location. An ethical decision-making model can be used as a framework to guide service delivery model decisions that balance the needs of the student, the clinician, and the district.

Stress and Anxiety Among Parents of Children With Communication Disorders

Parenting is a wonderful and rewarding experience, but in the case of parents of children with communication disorder, this experience is often accompanied with high levels of stress, due to difficulties, frustrations, and challenges that these parents face in everyday life. This chapter was carried out to find the status of stress in parents of children with communication disorder and also to find the levels of stress among mothers as well as fathers, and the level of support system available. The results revealed that most of the parents experience stress and anxiety in bringing up their child with communication disorder, although the stress being more in the mothers. Gender of the child also played a crucial role in determining the levels of stress. The results highlighted the fact that parents of children with autism spectrum disorder have a higher level of stress followed by parents of children with intellectual disability, multiple disability, and hearing impairment.

Changing Socio-Cultural Models and Policy Programs in Rehabilitation of Persons With Communication Disorders

The history of rehabilitation of communication disorder has journeyed from magical-religious conceptualizations through biological-medical approaches to the contemporary rights-based paradigm, wherein the person-in-environment is emphasized. The understanding of its nature and characteristics, classification, etiology, treatment, social perception, and practices, including law-making about the affected persons, have all moved in tandem with the temper of the times. This chapter attempts to outline the salient course of these changes under two sections: (1) changing models and paradigms and (2) impacts on policy programs in areas of health, education, economy, housing, and social security with special reference to the Indian sub-continent. Illustrative domains of social change in areas of education are specifically highlighted with appropriate case vignettes. The endnote raises oncoming challenges, issues, and problems related to communication disorders in the emergent dynamic socio-cultural matrix for generation next parents and children.

Sibling Disposition Towards Children With Special Needs

The background research leading to this chapter probed into the nature of disposition and dominant patterns of feelings displayed b typically developing siblings towards children with special needs arising out of communication disorders. The resultant findings may contribute of facilitation of constructive relationship between them. A survey type of research design was adopted for the purpose of collecting relevant data from primary caregivers of 34 children with communication disorders resulting from either sensory impairments, or neurodevelopmental disorders. An emotional-behavioral rating scale including 10 common dispositions of siblings towards children with special needs had been developed for the purpose following review of relevant literature. The caregiver-participants were to rate the frequency of manifestation of the emotions of behaviors described on a four-pointing rating scale of never, sometimes, often or always. Other relevant information like number of siblings, order of birth, gender of children with special needs, as well as educational and socio-economic status of the caregivers were collected. Analysis of the data revealed feelings of concern and care predominantly prevalent among siblings of children with special needs. Nevertheless, there is scope for further shaping the positive dispositions into constructive behaviors that support optimal development of children with special needs.

Mothers as Advocates of Social Inclusion for Children With Communication Disorders

Social inclusion is based on acceptance and belonging irrespective of any status, disability, or disadvantage. The ability to communicate empowers humans in their quest for social inclusion. However, children challenged by communication disorders struggle to form friendships and make inroads into social groups. Mothers, the primary caregivers in most instances, with their intimate knowledge of their children, are considered the best advocates. This study set out to identify strategies that mothers engage in to pave the way for successful social inclusion of children with communication disorders. An online survey was conducted in different geographical locations. Mothers with children aged 6-13 years who had received speech therapy or are currently receiving speech therapy were invited to participate. Data were analyzed using a mixed methods approach. Outcomes suggest that all mothers believe in social inclusion despite facing a range of inclusion and exclusionary practices. Undeterred by these responses, mothers advocate for social inclusion by engaging in a range of strategies.

Designing a Master's program in speech therapy education in the context of interaction with stakeholders

Introduction. The relevance of the study is due to the need to match the requirements of stakeholders to the level of preparedness of a graduate of a master's degree. The purpose of the research. The research is aimed at the development and scientific substantiation of the master's degree program in the field of speech therapy support for persons with communication disorders of various categories in terms of interaction with stakeholders. Methodology and research methods. The Master's program is based on the principles and provisions of practice-oriented and competence-based approaches that ensure the formation of students ' professional competencies and practical skills in solving real professional problems, both in practical classes and during industrial practice on the basis of stakeholders. The research used methods of design, content analysis, questionnaires, mathematical statistics (descriptive statistics, factor analysis). The results. The mechanism of designing the master's degree program is based on the inclusion of stakeholders in the process of forming professional competencies of graduates, the development of its structure, content and areas of implementation (educational process, scientific work, practice, final qualification work, career guidance). The conducted research with the participation of stakeholders (56 people: speech therapists, speech pathologists, psychologists, rehabilitologists, managers) allowed us to determine the four-factor structure of knowledge, skills and labor actions (professional competencies) necessary for a speech therapist when working with people with communication disorders of various categories: ability to plan and implement the content of correctional and developmental classes (percentage of dispersion – 29.4); the ability to design an adapted basic general education program and a special individual development program (percentage of dispersion – 24.5); the ability to implement speech therapy support in the rehabilitation work system (percentage of dispersion – 18.9); the ability to plan and conduct applied scientific research in education, including the diagnosis of persons with communication disorders of various categories (percentage of dispersion – 7.8). Practical significance. The results obtained can be used by the heads of universities focused on the development of interaction with stakeholders, can help to encourage the introduction of practices and strategies that take into account the influence of stakeholders in the development of management decisions and the organization of effective training of teachers in the master's program. They may be of interest to speech therapists-practitioners, scientific supervisors of master's programs.

A Study on the Current Status and Needs of Counseling Curriculum in Communication Disorders in Korea

Objectives: Counseling is an essential component of the treatment of communication disorders. Clinicians and students in the field have reported a necessity for the incorporation of counseling courses into speech-language pathology practice. Thus, the purpose of this study was to examine the current status of a counseling curriculum in the field of communication sciences and disorders, and to present the professors’ and speech-language pathologists’(SLP) perceptions of the counseling curriculum.Methods: A web-based questionnaire regarding the current status and need for the counseling curriculum was developed and distributed to professors in undergraduate and graduate programs and to SLPs in clinical settings. Responses from a total of 66 professors and 121 SLPs were collected and were used for the analysis.Results: Overall, 66.7% of undergraduate programs and 26.9% of graduate programs offer a counseling course within the department. Also, 100% and 85.1% of professors in undergraduate and graduate programs reported the need for counseling education and training in the field of communication disorders respectively. A strong majority of SLPs (95.7%) also felt counseling courses are needed. By clinical areas, SLPs working in language development disorders reported the highest need (25.4%) for counseling courses, followed by neurological disorders and fluency disorders.Conclusion: The results show that the need for counseling programs was high among professors and clinicians. Thus, the implementation of a systematic and adequate counseling curriculum in the field of communication disorders is suggested.

Tutorial: The Speech-Language Pathologist's Role in Return to Work for Adults With Traumatic Brain Injury

Purpose: Return to work (RTW) is a major life participation metric used for persons with a traumatic brain injury (TBI). Speech-language pathologists (SLPs) have clinical expertise in the cognitive-communication aspects of TBI. This clinical focus article aims to support the clinical practice of SLPs by summarizing key interprofessional vocational rehabilitation (VR) models and illustrating the role of the SLP throughout the RTW process with a case study. Method: This clinical focus article was written by the Academy of Neurologic Communication Disorders and Sciences TBI Research Group along with a VR expert. Authors engaged in deliberative, agenda-based discussions beginning with a literature review based on previous systematic studies. Discussions explored relevant VR and SLP practices. Results: This clinical focus article presents key VR models in parallel with SLP assessment and treatment to illustrate best practice patterns in an RTW field with a dearth of SLP-specific literature. We summarize general VR approaches and four evidence-supported VR models for adults with TBI. We highlight how a model of interprofessional assessment can assist with planning and communication of important work-related concerns. We illustrate how the chronological model of work return can assist with developing goals and planning treatment. Conclusions: SLPs play an important role in identifying, managing, and collaborating with an RTW team following TBI. A working knowledge of VR models can assist with improving the dialogue between SLPs and VR professionals and can inform practice when working with persons with TBI who have work return as a goal.