Rural Speech Pathology For Children, By Video

Will satellite or mobile internet work for online speech therapy?

Online speech therapy works on satellite and mobile internet when the connection holds steady for the length of a call. In an Australian study of children's speech pathologists using telehealth during the pandemic, internet stability was the barrier that remained after three months of use (Sutherland and colleagues, 2021).

A few things help on a rural connection:

• Sit close to the modem, or plug the laptop in with a cable if you can.
• Ask the rest of the household to stay off streaming and downloads during the session.
• If your connection is better at some times of day than others, say so when a session time is being agreed.
• On some connections the sound arrives a moment late. Pausing before answering stops people talking over each other.

If the picture freezes or the call drops, rejoin the same call and the session carries on. How a session lost to the connection is handled is part of the terms explained before therapy starts.

Sharing one device between the family

Many rural households share one computer between work, school and everyone else. Book the device for session time the way you would book the car, and have it charged and logged in ten minutes early. A laptop or tablet works far better than a phone, because the screen is big enough for your child to see the activity and Dr Lauren to see your child's face.

Can online speech therapy work alongside a visiting or school-based service?

Online speech therapy does not have to replace a visiting speech pathologist, a school-based program or a therapy assistant your child already sees. It can run beside them, so your child is not waiting weeks between visits. Australian studies of speech therapy by video in rural schools, run with school staff and therapy assistants, found it workable, and found that regular communication between everyone involved helped (Fairweather, Lincoln and Ramsden, 2016 and 2017). Anything Dr Lauren shares with another service is shared only with your agreement.

Can a child on distance education have speech therapy in the school day?

For a child on distance education, the parent or home tutor who supervises lessons is often already at the table. That suits online speech therapy well, particularly for younger children who need an adult beside them. Session times are agreed with each family when a place is offered and depend on Dr Lauren's availability.

Can a travelling family keep the same speech pathologist?

Speech therapy while travelling is possible: a family on the road for a few months or a year can keep the same speech pathologist the whole way. Dr Lauren is the only clinician at Online Speech Therapy, so there is no handover and no starting again in each town. Sessions are set in Australian Eastern Standard Time all year, so check what a session time means in the time zone you will be in, and when daylight saving moves the clock. Plan sessions for days when you are staying put with a signal you have already tested, rather than a travel day.

What research shows about rural speech pathology and telehealth

Research on rural speech pathology by telehealth, most of it Australian, is encouraging but small. The table sets out the studies most relevant to rural families.

Study	Who took part	What it found
O'Callaghan, McAllister and Wilson, 2005	329 members of a rural and isolated parents' association	Families faced few and far-off speech pathologists, travel costs, no public transport, poor awareness of services and waiting lists
Fairweather, Lincoln and Ramsden, 2016	19 children in rural schools and early childhood settings, by low-bandwidth video	Children's speech and language skills improved, and parents found the service practical and acceptable
Fairweather, Lincoln and Ramsden, 2017	11 school leaders and therapy assistants in rural schools	Feasible and acceptable; technology glitches, workload and communication needed planning
Sutherland and colleagues, 2021	25 children's speech pathologists after a 3 month telehealth trial	Internet stability remained the main technology barrier
Wales, Skinner and Hayman, 2017	A review of 7 studies of primary school children	Telehealth and in-person groups improved by similar amounts on most measures; the evidence is limited but promising

These studies are small, and most were run with school programs rather than families at home. The fuller picture, including the randomised trials, is on what the research on online speech therapy shows. Some needs are better met in the same room; the guide to when online speech therapy suits a child, and when it does not lists them. Other questions families ask before choosing online therapy are answered in the guides for parents.

Paying for sessions from anywhere in Australia

Fees are the same wherever you live. Every child starts with an initial assessment ($590, $890 or $1,290), and sessions are $193, which is one hour of service: 45 minutes of therapy and 15 minutes of preparation and notes. Medicare rebates are available with a doctor's referral; the guide to Medicare, the NDIS and private health for video sessions explains how they apply. See fees in full.