An exploration of the feasibility, reliability, and acceptability of telehealth for students with diverse learning needs

Abstract

Telehealth offers a way of providing services to children and adults whose needs cannot be met by traditional, face to face methods. In rural and remote areas, the reasons for access difficulties may include geographical barriers, unacceptable travel times, and costs, for both clinicians and clients. In urban areas, challenges may also exist in the form of accessible services, parking and/or transport difficulties and managing other children. In a country like Australia, with its small population concentrated in cities along the coastal fringe, telehealth is a logical solution to service inequalities in more sparsely populated areas. Yet, the uptake of telehealth in speech pathology remains modest, with barriers including costs, technological concerns and capability, and cultural considerations preventing clinicians and clients alike from using these models. These barriers apply particularly to the use of telehealth to administer formal, standardised language assessments. The research described in this thesis explores the role of telehealth in speech pathology service provision. Two studies looked at use of telehealth to administer standardised language assessments to children with diverse learning needs, including those with complex reading difficulties and those with autism spectrum disorder. These studies were designed to reflect realworld situations, using off the shelf technology and equipment, in regular clinical settings (including schools and hospitals). The research found that standardised language assessments via telehealth were feasible and reliable for a range of children, including whose experience with telehealth had not previously been researched, such as children with autism. The assessments were able to be delivered in real world settings by clinicians with minimal experience or training in telehealth, and both parents and children were positive about the experiences of telehealth. The final study of this thesis explored the experiences and attitudes of parents towards telehealth. The overall finding of this study was that parents who were naive to telehealth tended to be more cautious about embracing it but could see the potential benefits regardless of their own geographical location or their child’s diagnostic status. This thesis, therefore, adds to the body of knowledge regarding telehealth, confirming that services, including standardised assessments, are not only feasible and reliable but also acceptable to both parents and children.