The Benefits of Using Telepractice for Speech Sound Disorders
As telepractice becomes more widely available as a method for serving individuals with communication impairments, family members may wonder if it is a good fit for their child. One of the most commonly-addressed conditions that is addressed through telepractice is the area of Speech Sound Disorders. Caretakers who are considering telepractice may ask, “What are the benefits of pursuing treatment through telepractice?” “Are there any limitations?”
First of all, it’s helpful to understand what Speech Sound Disorders are: In children, this type of impairment generally falls into two categories: Articulation and Phonology.
A child with an Articulation Impairment experiences difficulties with the movement of their speech mechanism, (e.g., their tongue or their lips). It might be that there is some weakness, difficulty with range of motion, or the movement may be out of sync with other movements. (This is different than motor planning issues, which we will cover in another article on Apraxia of Speech.) An example of an Articulation Impairment would be those kids who have a hard time making the /s/ sound.
Phonological Impairments are related to the child’s ability to recognize and follow the patterns and rules of speech production. A child with a Phonological Impairment may struggle to produce all the consonant sounds when there are two (or more) next to each other, (like when a child says “boo” instead of “blue”). It could also include children who regularly substitute sounds in one part of their mouth for sounds that are produced in another, (such as a child who makes /t/ and /d/ sounds in place of /k/ and /g/).
In both cases, treatment usually involves helping the child to hear when sounds are made correctly or incorrectly, demonstrating how to make the sound, and learning the patterns and rules of production. It is also important to get a lot of practice making correct sounds in different structures, (like syllables, words, and sentences), as well as in different settings, (with the speech-language pathologist, other adults, friends).
A speech-language pathologist (SLP) in a school will generally help their students work on speech sounds in as many settings as possible. This might include working with the child one-on-one, in a group with other children, in the classroom, or by consulting with teachers and parents and sharing strategies that they can work on. Unfortunately, the individual follow-up a school SLP can provide in a variety of settings may be limited by their caseload size and other constraints. At first glance, a telepractice SLP may seem even more limited in their ability to provide practice in various settings. However, home-based services let the SLP directly into the child’s family environment. A telepractice SLP can involve siblings, friends, and parents in therapy activities. Caretakers also have the ability to directly observe the strategies that the SLP is using, and follow those that are appropriate after the session.
It is also very important for a telepractice SLP to be able to accurately hear the sounds a student is making, observe the child’s motor movements, and clearly model correct movements. Again, this may appear to be an area where in-person therapists have the advantage. However, a growing body of research shows that telepractice SLPs can provide comparable services given proper equipment, audio/video quality, internet connection, and support from on-site adults. For this reason, it’s important for parents to consider the equipment, systems, and technical support that an organization offers when considering at-home services for their child.
I mentioned evidence that supports treatment of Speech Sound Disorders through telepractice. The existing research is fairly recent, but all very positive. Grogan-Johnson and her group, (2011), provided computer-based speech sound treatment to children in both on-site and telepractice settings. They saw that both sets of children made comparable gains. Two additional studies by Grogan-Johnson, (2010 & 2013), provided direct speech sound treatment to children in both on-site and telepractice settings. The 2010 study even switched the service method halfway through the study, (that is, the telepractice group started receiving on-site services and vice-versa). Both studies showed that children made comparable progress, no matter what setting they were in.
Telepractice holds a lot of potential for helping children with Speech Sound Disorders. Not only is there growing evidence that children can receive the same level of services as they would in an on-site session, but there may be some distinct advantages in being able to connect practice to different settings and people!
If you’re a therapist or special education school professional looking for a better way to work, check out here!
Grogan-Johnson, S., Alvares, R., Rowan, L., & Creaghead, N. (2010). A pilot study comparing the effectiveness of speech language therapy provided by telemedicine with conventional on-site therapy. Journal of Telemedicine and Telecare, 16, 134-139.
Grogan-Johnson, S., Gabel, R., Taylor, J., Rowan, L., Alvares, R., & Schenker, J. (2011). A pilot exploration of speech sound disorder intervention delivered by telehealth to school-age children. International Journal of Telerehabilitation,3(1), 31-42.
Grogan-Johnson, S., Schmidt, A. M., Schenker, J., Alvares, R., Rowan, L. E., & 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.