Telehealth Reflections


By Gabrielle Nicoll and Cheryl Ye

What a year. Like many teams, businesses and industries across Australia (and the world), 2020 has caused us to take a massive pivot in our service delivery. Our Speech Pathologists have now been conducting therapy online via Telehealth for most of the last 10 months, and it has been a huge learning curve for all of us.

There have been many positives:

1. Opportunities for parent training

It has been wonderful being able to guide parents to play with their little ones in the home environment. Parents are empowered to do language therapy using the toys and resources they have at home! For the little ones, parent training is the way we use Telehealth. So if you have a little person who cannot “stay” on screen, know that Telehealth can still be an extremely effective way to do speech therapy.

2. Kids show us what is important to them

We have met their pets and siblings, watched them play with their favourite toys, and seen the decorations in their rooms. It allows us to get to know all the children we work with a little better.

3. It has forced us to be creative

We have been exploring and experimenting with new ways to target our children’s goals, instead of using the same resources we are most comfortable with.
Many school aged children also really enjoy computer games and apps. Telehealth has allowed us to incorporate some of the things they really enjoy as motivators. We can also look up their favourite show, or toy, or game, quite quickly and share it with them. This has been a good way to build connection.

4. Fewer barriers to accessing therapy

While technical difficulties can be irritating, there are so many benefits to having therapy in the home. No bad traffic or parking, fewer last-minute cancellations because someone got held up at work or school, and siblings can still be looked after without anyone having to leave the house.

Some of the challenges we’ve encountered include:

1. No control over the environment

Because we are not there in the room, it can be tricky to direct a child’s attention and focus. For example, if the child is fixated on a toy they’re playing with, we can’t put it to the side, or clear the clutter from their room. We have had kids turn off their cameras, crawl under the desk, or leave for a ‘bathroom break’ and never come back!
Solution: Important for the parent to be around to be a telehealth helper and keep an eye on their child’s engagement.

2. Technical difficulties

This one speaks for itself! The internet cutting out, laptops dying, headphones breaking and other mysterious Zoom-related ailments can make therapy really tricky. Solution: it is important to ensure your internet works, and your devices are fully charged. Technical difficulties are quite rare, and we rarely experience Zoom-related ailments (they have definitely gotten a lot better with their technology).

3. Screen time

It has been hard for both kids and clinicians to adjust to almost their entire lives happening online. It has really emphasised the importance of movement breaks and time away from screens.
Solution: give your children regular breaks from the screens.

It will be interesting to see how Telehealth changes Speech Pathology and Health service delivery overall. There are pros and cons, and it is likely to be extremely well-suited to most families. For the little ones and those who cannot engage online, it will be important for speech therapy sessions to be about parent training so that parents take the role of the therapist at home (which should be the case anyway!). And in a post-lockdown world, we are already seeing a really interesting mix of Telehealth and in-clinic sessions!

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