Impact of Virtual Care on Speech-Language Services.

introductionCOVID-19 impacted care delivery in rehabilitation services including speech-language pathology. The purpose of this study was to examine speech-language pathologists'(SLPs) perspectives on the effectiveness of virtual care delivered during the pandemic in Canada, their experiences with therapy delivered virtually and their views on future models of care.

methodsWe carried out a cross-sectional survey with SLPs in Canada who had delivered virtual services to children during the pandemic. The survey questions were based on information collected in a previous study involving focus group interviews with SLPs. The survey elicited responses related to SLPs' perception of effectiveness, their experiences with virtual care including perceived barriers and facilitators to implementing virtual care, and their vision for future speech-language services. Quantitative responses were compiled descriptively, and qualitative responses were reviewed and categorized.

resultsSeventy-five SLPs returned completed questionnaires. A majority (57.4%) reported that virtual care was very/extremely effective and 33.3% somewhat effective. The main barriers to providing virtual services were limited access to technology (family), limited workspace for the session at home, and limited availability of the caregiver for sessions. Services for children with complex developmental needs were viewed as more difficult to deliver virtually. Several positive aspects were highlighted including caregiver engagement in sessions and better work-life balance. The majority (84%) of SLPs indicated they would prefer to continue to use virtual care by adopting a hybrid model of service, while 8% of SLPs favored virtual care only and 8% in-person care only.

conclusionsMost SLPs reported that speech-language services via virtual care were effective. Practitioners indicated a preference for a hybrid model of care for post-pandemic services. Further research is needed to better identify what components of virtual care enhance services to better adapt service models in the future. WHAT THIS PAPER ADDS: What is already known on this subject Virtual care has been provided in speech-language pathology for many years but primarily in select circumstances for children living in remote areas. Speech-language care dramatically changed in many countries due to the required lock-down during the COVID-19 pandemic. What this paper adds to the existing knowledge This study provides updated information about the perceptions of effectiveness of virtual care for children based on the unplanned experiences of speech-language pathologists in Canada who were forced to rapidly implement a new service model. The findings suggest that overall practitioners adapted quickly and judged their services to be effective. Positive aspects of care included improved caregiver coaching, greater caregiver engagement and better work-life balance for practitioners. Primary barriers included the family's access to technology and the challenges of delivering care to children with complex needs. What are the potential or actual clinical implications for this work? This study supports the feasibility and effectiveness of speech-language care delivered virtually to children. This service model may result in improvements in both caregiving coaching and caregiver engagement. Most practitioners prefer shifting their post-pandemic services to hybrid models of care.