On 19th March 2020, a week after the COVID-19 Pandemic was announced by WHO, the University of Technology Sydney reached out to its community and offered a free 1-hour seminar to speech pathologists in Australia to teach them about using telepractice in a speech pathology clinic. Within three days of sending a single tweet to advertise the training, more than 150 speech pathologists registered to find out about how UTS was using telepractice, and using the Coviu software platform. UTS has no financial interest in Coviu and receives no benefit for this presentation. Please acknowledge UTS and Dr Lucy Bryant (author) appropriately if using these materials for teaching others and use the resources to help your colleagues to provide services online.
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Telepractice Speech Pathology: The UTS Experience
1. UTS CRICOS 00099F
Speech Pathology Reaching Out at UTS
Telepractice Speech Pathology
The UTS Experience
Dr Lucy Bryant
SPROUTS Clinic Manager
Lucy.Bryant@uts.edu.au
2. We would like to acknowledge the Gadigal People
of the Eora Nation upon whose ancestral lands our
campus and clinic now stand. We would also like to
pay respect to the Elders both past and present,
acknowledging them as the traditional custodians of
knowledge for this land.
Acknowledgement
of Country
3. Acknowledgements, Declaration, and Sharing
• This presentation was developed and delivered by Dr Lucy Bryant, Lecturer in speech
pathology at UTS, March 2020
• Dr Bryant and UTS do not have any financial interest in COVIU and do not receive any
financial benefit from COVIU or any other product mentioned in this presentation
• Proper attribution and acknowledgement of resources developed by staff and students at
UTS should be preserved if materials from this presentation are shared
• This presentation was delivered for free in response to the COVID-19 pandemic
impacting on health sites and the provision of speech pathology services
• Please consider sharing any resources you develop for use during telepractice sessions,
so that other people can benefit at this extraordinarily difficult time
SPROUTS and Telepractice
4. Outline
Using Telepractice – The Evidence
COVIU Software
Help and Support
Assessment and Therapy Resources
Facilities and Hardware
SPROUTS and Telepractice
6. Telepractice in Speech Pathology
• Speech Pathology Australia – Position statement and guidance
• Search the SpeechBite database - telehealth in speech pathology
• Substantial and growing evidence that telehealth/tele-practice services are not inferior to
face-to-face sessions
• Some evidence that some clients are more satisfied
• Australian Stuttering Research Centre at UTS – Current NHMRC research investigating
telehealth interventions
• Loads of research – voice, dysphagia, speech, language, AAC … it's time for Australian
speech pathologists to implement!
• Let's stop talking about it, and just do it.
SPROUTS and Telepractice
7. Telepractice: stimulated by the COVID-19 Pandemic
• Useful during social distancing during the present pandemic
• removing the necessity of seeing the client in person;
• enabling services to continue when clinics close;
• reducing the number of people present in the clinic.
• Provision of services and its relationship to income and employment
• Your clients can receive a continuous service
• Access to new clients and new models of service delivery now and in the future
• Rural and remote
• Unable to travel
SPROUTS and Telepractice
8. Telepractice in Clinical Education: The SPROUTS
Experience
• It's easy to do – the clinical educator starts the call, and the student and client log in to
the same call.
• The client (teacher/parent), speech pathology student, and clinical educator in the call
can mute the audio and the camera.
• This means that the clinical educator on mute can observe while not being seen or
heard.
• Allows remote observation of the student's session, and growing autonomy.
• Allows collaborative service delivery, so the clinical educator can join the student in the
'online room'.
• The educator can jump into the session as needed to offer assistance and supervision.
SPROUTS and Telepractice
10. Physical Space for Telepractice
• Use the space you already have
• A clinic room
• An office
• At home - anywhere that is quiet, private and has a computer
• Consider a screen or blank backdrop without distractions
• Space demand is smaller – just you sitting (or standing) at a computer
• All your resources are online
• Where they can’t be online, use a document camera to show them
SPROUTS and Telepractice
11. The SPROUTS Clinic Space at UTS GSH – 100 Broadway
SPROUTS and Telepractice
Large Clinic Room Small Clinic Room Reception Area
12. Hardware for Telepractice
• A computer with a webcam and a microphone
• We use a standard HP laptop
• Clients use similar laptops
• Could also access using a tablet computer if needed
• We sometimes use a second monitor and split screen configuration
• Connect second screen with a VGA or HDMI cable
• In “display settings” – change to split screen
• Allows us to use a shared screen and see it and the client at the same time
(typically when sharing a screen in a video call, you can only see one or the other)
SPROUTS and Telepractice
13. Supporting others (colleagues, clients):
Tips to 'move to online' for sessions
• This presentation includes resources that will help you to teach your colleagues
• Use the resources as needed to show your clients (have a practice run)
• Clients need Internet and computer + reassurance: "we can troubleshoot to help you"
• Provide a handout to clients - picture + written guides "follow these steps to connect"
• Have a phone back-up connection to ring and help to "get back online"
• Teach tech 'operational competency' and 'strategic competency' + resilience
• Planning for steps to take if connection is lost
• Draw upon the motivation and benefit of (a) not travelling, and (b) being able to self-isolate.
SPROUTS and Telepractice
15. Why ?
• Chosen for privacy, strong tech support, and ease of use
• Created within the CSIRO through research into telehealth
• Fully compliant with Australian privacy principles
• Encrypted software to ensure confidentiality and privacy
• All call content (video and audio) is encrypted
• AWL servers located in Sydney
• For more information https://help.coviu.com/en/articles/412368-privacy-security-of-data
SPROUTS and Telepractice
16. Internet Requirements for - Bandwidth
• Connectivity – requires a sustained internet connection
• Scalable connection
Means the capacity of the call (available bandwidth) will vary depending on what is
available
• A minimum bandwidth of 700Kbps upload and download to establish connection
• COVIU will use a maximum bandwidth of 1Mbps if it is available
• Minimum bandwidth of 350Kbps to hold a quality video call**
** For a 2-party call. Add an extra 350Kbps upload & download per additional caller
SPROUTS and Telepractice
17. Internet Requirements for - Data Usage
• Based on a 3-person call (client, CE and student SP)
• At maximum bandwidth
30-minute session = 675 MB
60-minute session = 1.35 GB
• A minimum bandwidth
30-minute session = 237 MB
60-minute session = 473 MB
SPROUTS and Telepractice
18. How to Access for Sessions
• Clinics will need a license – See the COVIU website
(starting at $19.95 per user per month)
• Clients don’t need any special software – runs through the web browser
• An email is sent to clients with a customisable link
• Clients MUST use Google Chrome
• Feedback from clients has been very positive
SPROUTS and Telepractice
19. How to Access for Clients
SPROUTS and Telepractice
• After accessing the room link
• Client will “join as guest”
20. How to Access for Clients
SPROUTS and Telepractice
Position the client’s face here.
Make sure the webcam is
working.
Click here to take the
photo. This is
compulsory to enter the
therapy room.
Enter the client’s
name here.
• Client takes a headshot
• Enters name
Additional layer of security so
you can see who is logging-in
• Then clicks “continue”
21. How to Access for Clients
SPROUTS and Telepractice
• Client directed to online waiting
room
• Customisable wait music
• Client waits here for the clinician
(as they would in a physical
clinic)
22. How to Access for Clients
SPROUTS and Telepractice
• Client name and image will
appear here
• “Accept” or “Decline”
Additional security – only people
you accept to the room can
enter your session.
• Will also ring to alert clinician
that client is waiting
This can be muted
23. How to Access for Clients
SPROUTS and Telepractice
• Client will enter once accepted,
and have a clear view of their
clinician
24. Some features of
Some things to look at during the demonstration…
• Share your screen, a document or a file
• Use a whiteboard as a shared creative space
• eLr – interactive Extra Language Resources
• Book sessions
• Take payments
• Customise for your clinic - branding
SPROUTS and Telepractice
25. : Other Information to Note
• You will need to register each user / team member / clinician
• It comes at a price – currently (Mar 2020) starting at $19.95 / month
• Each clinician receives their own virtual room
• Shared rooms – limited available (but this may change to one per clinician)
SPROUTS and Telepractice
27. Assessments
• Online versions of some tests through Pearson Q-Global
• Limited tests available
• CELF-5
• PPVT 4 & 5
• Using a document camera
• Client can use pencil function or arrow function to point where needed
• Scanning stimulus items is generally a breach of copyright
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28. Adapting for COVIU
• Flashcards and games
• Create in PowerPoint
• 1 card per slide
• Save as a PDF
• Allows easy progression through items
• Allows client to draw on pages to interact
• Select, draw, add, erase, type
• Some interactive element is key to engaging the client
SPROUTS and Telepractice
29. Creativity and Design for Therapy
• Come student favourites
• Flash cards
• Board games – race to the finish, snakes and ladders
• Noughts and Crosses
• Complete the picture (Mr Squiggle-style)
• Active games and movement – to “wake up the brain”
• Simon says
• Dancing or stretching
SPROUTS and Telepractice
30. Creativity and Design for Therapy
• Some examples
• Flash cards
• Board games – race to the finish, snakes and ladders
• Noughts and Crosses
• Reading and listening comprehension activities
• Speech sounds and minimal pairs
• Assembling S-V-O sentences
• Visual schedules to help the client through the session
SPROUTS and Telepractice
31. For Adult Clients
• Sharing documents – that provide explanation
• Using the whiteboard for orthographic cuing
• Screenshare for video examples
• Similar strategies for picture cards, written information, stimuli as with children
SPROUTS and Telepractice
33. Some Interesting Blog Posts from COVIU
• Allied health telehealth reimbursements
https://blog.coviu.com/2020/03/09/what-telehealth-rebates-exist-for-allied-health-
practitioners/
• Telehealth usage in speech pathology
https://blog.coviu.com/2020/01/08/is-your-speech-practice-ready-for-2020/
• 5 step guide to marketing your digital practice
https://blog.coviu.com/2019/03/19/how-to-market-your-digital-practice-in-5-easy-steps/
• Coronavirus and telehealth
https://blog.coviu.com/2020/03/03/telehealth-keeping-healthy-people-safe-during-
coronavirus-outbreak/
SPROUTS and Telepractice
34. Where to go for Help from COVIU
• COVIU support
Website online chat
https://help.coviu.com/en/
• COVIU Frequently asked questions
https://help.coviu.com/en/collections/88269-faqs
• COVIU provides a course:
https://coviuacademy.thinkific.com/courses/speech-pathologists-a-complete-guide-to-
embracing-telehealth
SPROUTS and Telepractice
35. Some Evidence for Telepractice
• Evidence resources for telepractice from The Informed SLP
https://www.theinformedslpmembers.com/free-telepractice-research-reviews
• Speech Pathology Australia Position Statement on Telepractice
• Try Google – Telepractice in Speech Pathology
SPROUTS and Telepractice
36. Resources from UTS
• Some examples available to you from the SPROUTS Clinic students
• Email Bronwyn.Hemsley@uts.edu.au for a link to the Cloudstor for additional download
materials
SPROUTS and Telepractice
37. UTS CRICOS 00099F
Dr Lucy Bryant – SPROUTS clinic manager
Lucy.Bryant@uts.edu.au
SPROUTS and Telepractice
Editor's Notes
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Clients often need support to connect to therapy services online at home, but once supported and connected, report enjoying sessions and the usual benefits of therapy.
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Compared to something like zoom – has a higher bandwidth capacity, not scalable, so higher downloads (600 kbps for high quality video)
BRONWYN – add the access instruction page to cloudstor for attendees.
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