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Transitioning Speech-Language Assessment to a Virtual Environment: Lessons Learned

If there is any silver lining from the COVID-19 pandemic, it is the acceleration of the move to the virtual environment in healthcare and medicine. Clinical practice, as early proponents of telehealth had hoped, has turned out to be very adaptable to online interaction. Assessments are practical, treatments, especially in collaboration among professionals, are efficient, and patients are very pleased with outcomes and overall convenience. All of this is true for oromyofunctional practices (including ours, here at BreatheWorks).

Routine virtual interaction for speech-language pathologists does have its challenges, however, and these are the subject of a paper published last year in Language, Speech and Hearing Services in Schools (Werfel KL, et al., 2021 Jul 7;52(3):769-775. doi: 10.1044/2021_LSHSS-20-00149), on ‘Transitioning Speech-Language Assessment to a Virtual Environment: Lessons Learned From the ELLA Study’. Practical concerns had arisen for the authors of this paper when, having been conducting a longitudinal investigation of language and literacy in schoolchildren with hearing loss, they were debarred suddenly from physical visits and had to shift to an online setting. They made the shift, and were able to complete the study. In this article they enumerate the problems, and the benefits, they discovered along the way.

There was parental cynicism over suitability of the virtual environment. Parents were also wont to help their children during testing. Sometimes background distractions at home were considerable. There were technological limitations, notably in ways of assessing that involved writing. Not every family was able to complete all measures. Not every family returned test booklets.

But a meaningful dataset was reached, which should be of interest to SLPs. This had been managed before in telepractice with children with hearing loss in a general way. Validated studies have shown, for example, that children receiving early intervention through telepractice score the same as or better than children receiving in-person services. Validation of the ELLA study results showed very high test–retest reliability (.715–.955) for speech and language measures (articulation, vocabulary, morphosyntax), and even better (.854 to .950) for print measures (alphabet knowledge, conceptual print knowledge). Test–retest reliability for phonological processing measures varied. Phonological awareness reliability was high (.925), but phonological memory and phonological recoding were low, with the exception of digit span (−.102 to .786). Low test–retest reliability tended to occur in timed measures, and from this the authors were able to recommend some caution to SLPs in choosing testing measures for online assessments in their own practice settings.

MyoNews from BreatheWorksTM is a report on trends and developments in oromyofunctional disorder and therapy. These updates are not intended as diagnosis, treatment, cure or prevention of any disease or syndrome.

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