What is Teletherapy and is it effective?

An Examination of the Effectiveness of Online Speech-Language Therapy

Tele-Therapy Services

Tele-therapy is remote delivery of therapeutic interventions. It can be provided to clients through various telecommunications technology such as video conferencing applications or a tele-therapy platform such as Valeo.

In comparison to face-to-face therapy the affordability and convenience of tele-therapy is a huge draw for most clients. However, effectiveness of online therapy is one of the major concerns that clients might have when deciding upon which modality to choose.

Valeo Therapy

Valeo provides engaging direct online therapy services for children in need of help. Highly trained therapists at Valeo work with parents and caregivers to support children cope with various difficulties and challenges.

Valeo provides therapists and clients with a video conferencing platform, designed specially to cater to the needs of children and parents working with speech-language, communication, occupational and mental-health related difficulties.

Speech-Language Therapy

Speech language therapy entails assessment and treatment of speech, language, and communication delays and disorders. A speech language pathologist (SLP) uses specialised treatment strategies to treat some of the following common diagnoses:

  • Articulation disorders
  • Auditory processing disorder
  • Autism spectrum disorder
  • Receptive and Expressive language delays
  • Social language delays
  • Fluency issues / Stuttering
  • Developmental speech and language delays
Effectiveness of Online Speech-Language Therapy?

Tele-therapy has been successfully used to provide speech-language therapy to children all across the world. Various studies have been conducted to compare virtual provision of therapy to traditional face-to-face therapy and most of the evidence from research suggests that it is as effective as therapy provided in person. Not only is virtual therapy effective in achieving functional outcomes but it is also time and cost saving in comparison to other modalities.

In a recent study in Brazil, it was concluded that tele-health services have various advantages over traditional face-to-face therapy (Regina Molini-Avejonas et al., 2015). However, the study also recognised the barriers that still need to be overcome, such as technology, training, regulation, acceptance and recognition of tele-therapy as a viable practice by some professionals. For example, in the case of UK healthcare providers and families in some areas usually do not have the proper hardware or stable internet connections to successfully conduct virtual therapy sessions.  In addition to that some Speech and Language practitioners that still struggle with accepting virtual provision of speech-language therapeutic interventions despite evidence suggesting otherwise.

Mike R. Schoenberg et al conducted a study that compared 19 participants who received computer-based therapy with 20 participants who received face-to-face speech–language rehabilitation. The study compared the functional outcomes, costs, time spent on the two modalities. It was concluded that the computer-based tele-therapy program provided similar functional outcomes as face-to-face speech–language therapy (Schoenberg et al., 2008)

Furthermore, in a study conducted by Alison McCullough in Belfast on Viability and Effectiveness of Tele-therapy For Pre-School Children with Special Needs, it was concluded that tele-therapy is effective in achieving the desired results. In addition to that parents reported increased knowledge and confidence in developing their child's speech, language and communication skills with tele-therapy (McCullough, 2001)

Recent studies have shown that tele-therapy is not only used for provision of speech-language therapy services but also is being successfully used to deliver parent and teacher training for speech-language pathology.

Speech Therapy

Speech therapy most commonly involves improving articulation, fluency and production of sounds and words. An SLP usually teaches oral-motor placement in order to improve production of specific sounds. In addition to improving speech therapy can also entail reducing anxiety associated with speech.

Children who might benefit from Speech therapy

A child might be in need of speech therapy if they:

  • are highly inarticulate
  • have verbal apraxia
  • have a history of hearing loss or impairment
  • face cognitive or developmental delays
  • have oro-facial anomalies
  • have a disordered phonological system
How effective is online Speech therapy?

In a study by Grogan Johnson et al in 2013, outcomes of tele-therapy and face-to-face therapy for school-age students with speech sound disorders in Ohio school districts were compared. Speech therapy using computer-based speech sound interventions used live interactive videoconferencing mediums while conventional intervention was carried out in person. Pre- and post-intervention scores were compared to conclude that students in both service delivery models made significant improvements in speech sound production (Grogan-Johnson et al., 2013). Furthermore, students in the tele-health condition showed greater achievement of goals set before therapy. Therefore, live interactive videoconferencing is a more viable method for delivering intervention for speech sound disorders to children.  

In 2002 Brennan et al. reviewed patients with disorders such as articulation defects, stuttering, aphasia, dysarthria, and auditory and voice disorders. Speech therapy services were delivered to them via direct patient–clinician telephonic communications. The outcomes of the study were promising and it was established that tele-therapy is a viable method for improving access and frequency of services to patients especially the ones living in remote areas. Baron et al determined tele-rehab to be a feasible, effective, and appropriate method for providing remote SLP services. (Brennan et al., 2002)

Language Therapy

Language therapy is often categorised into expressive and receptive language therapy. Language therapy addresses vocabulary, ability to form sentences, listening skills, the ability to follow instructions, comprehending language and deficits in written language.

Children who might benefit from Language therapy

Children having issues with understanding and/or expressing language. Or children facing difficulties in using and comprehending language. These issues are not associated with speech, hearing or intelligence.

Children with language related difficulties might struggle with:

1. Forms of language

  • Phonology (patterns of sounds in a language)
  • Morphology (how words are formed and their relationship to other words in the same language)
  • Syntax (set of rules, principles, and processes that govern the structure of sentences in a given language)

2. Content of language

  • Semantics (meaning of words and phrases)

3. Function of language

  • Pragmatics (how words are used in context)
How effective is online Language therapy?

In a review of different studies from 2001 to 2014 conducted by Molini-Avejonas et al participants satisfaction with the use of tele-therapy for language related difficulties was assessed. The vast majority of the papers reviewed by Molini-Avejonas et al reported that they perceived remote therapy to be as valuable as that delivered directly by a Clinician for language related problems. (Molini-Avejonas et al 2015)

In addition to that in 2013, Gabel et al included 71 participants in a study of the use of tele-health with children with speech, language, pragmatic, stuttering and/or voice disorders. When the functional outcomes of the interventions delivered via tele-practice were measured and it was determined that tele-health service delivery model is a viable option for speech-language therapy delivery to school-aged children. (Gabel et al., 2013)

Social-Communication Therapy

Social communication therapy helps children who struggle to use their language in a socially appropriate manner. It can be used to increase a child’s understanding of rules of social language. Social communication therapy teaches children how to use language appropriately to express themselves and understand others.

Children who might benefit from Social-Communication therapy

Children who face difficulties with social interactions and social cognition e.g.  difficulties with context, rules of social interactions, emotional competence. Some conditions that social communication therapy might be needed for are:

  • Aphasia
  • Autism spectrum disorder (High-functioning autism)
  • Learning disabilities
  • Specific language impairment
  • Stroke or brain injury
How effective is online Social-Communication therapy?

In a study conducted by McCullough in 2001 direct intervention via video conferencing for children with Down's syndrome and their parents were evaluated. Information on parent’s and therapist’s feedback on the use of technology, as well as information about the children’s communication skills development goals was collected. The results demonstrated that parents and therapists felt more confident and had increased knowledge about how to support the children effectively. In addition to that all children made adequate progress towards their communication goals as set by their SLP.  (McCullough, 2001)

In 2014 a research involving children and parents of children with a diagnosis of Autism spectrum disorder (ASD) was conducted to check the viability of parent training and child’s therapy via tele-practice. Results showed that the strategies parents had learned in virtual coaching sessions helped them a lot in supporting their children. Moreover, all children showed substantial reductions in problematic behaviour and had improved communication skills during the treatment trials (Lindgren et al., 2016).

Conclusion

Advancements in videoconferencing and networking technologies in the current times presents us with opportunities to deliver different services to people in the comfort of their homes. Tele-therapy is a great way to provide speech-language therapy services to patients at home or at school with greater ease and effectiveness. Research conducted to assess the effectiveness of virtual therapy services have shown promising results in favour of such delivery models for speech-language therapy.

Valeo is such a platform designed by therapists to make your lives easier as it promises to provide quality speech-language therapy to your children through interactive and engaging video-conferencing platform in the comfort of your homes.

References:
  1. Brennan, D., Georgeadis, A., & Baron, C. (2002). Telerehabilitation Tools for the Provision of Remote Speech-Language Treatment. Topics In Stroke Rehabilitation, 8(4), 71-78. https://doi.org/10.1310/u7kv-dy7u-q6qp-lvbp
  1. Gabel, R., Grogan-Johnson, S., Alvares, R., Bechstein, L., & Taylor, J. (2013). A Field Study of Telepractice for School Intervention Using the ASHA NOMS K-12 Database. Communication Disorders Quarterly, 35(1), 44-53. https://doi.org/10.1177/1525740113503035
  1. Grogan-Johnson, S., Schmidt, A., Schenker, J., Alvares, R., Rowan, L., & Taylor, J. (2013). A Comparison of Speech Sound Intervention Delivered by Telepractice and Side-by-Side Service Delivery Models. Communication Disorders Quarterly, 34(4), 210-220. https://doi.org/10.1177/1525740113484965
  1. Lindgren, S., Wacker, D., Suess, A., Schieltz, K., Pelzel, K., & Kopelman, T. et al. (2016). Telehealth and Autism: Treating Challenging Behavior at Lower Cost. PEDIATRICS, 137(Supplement), S167-S175. https://doi.org/10.1542/peds.2015-2851o
  1. McCullough, A. (2001). Viability and Effectiveness of Teletherapy for Pre-School Children with Special Needs. International Journal Of Language & Communication Disorders, 36(s1), 321-326. https://doi.org/10.3109/13682820109177905
  1. Regina Molini-Avejonas, D., Rondon-Melo, S., de La Higuera Amato, C., & Samelli, A. (2015). A systematic review of the use of telehealth in speech, language and hearing sciences. Journal Of Telemedicine And Telecare, 21(7), 367-376. https://doi.org/10.1177/1357633x15583215
  2. Schoenberg, M., Ruwe, W., Dawson, K., McDonald, N., Houston, B., & Forducey, P. (2008). Comparison of functional outcomes and treatment cost between a computer-based cognitive rehabilitation teletherapy program and a face-to-face rehabilitation program. Professional Psychology: Research And Practice, 39(2), 169-175. https://doi.org/10.1037/0735-7028.39.2.169