The AACcelerate Program at CI Pediatric Therapy Centers in Madison, Wisconsin is a high-frequency speech language and occupational therapy program designed to provide extensive evaluation, featuring matching, and AAC immersion to clients with complex communication and access needs
TELEHEALTH & TELE-AAC As telehealth has grown in popularity and utilization in the fields of SLP and OT, there is growing evidence about both its ef- ficacy and barriers to implementation across settings. The Amer- ican Speech and Hearing Association (ASHA) and the American Occupational Therapy Association (AOTA), which govern prac- tice for SLP and OT practitioners, state that practitioners can use the telehealth platform to provide evaluation, consultation, and intervention within their scope of practice, (AOTA, 2018; ASHA, 2020). Research across both professions has demonstrated that as long as telehealth services are performed with clinical reasoning and consideration of ethics similar to those used in in-person care, treatment is just as effective over the telehealth platform, (Baker & Jacobs, 2012; Hwang et al., 2016; Worboys et al., 2017). Research also indicates that unique benefits of the telehealth model include improved access to healthcare spe- cialists and specialty programs, and increased interprofessional collaboration and information sharing through remote consul- tation and training, (Cason, 2012). The utilization of telehealth has also resulted in improved access to care, removing many geographic, socioeconomic, and medical fragility barriers by al- lowing intervention to happen in the client’s own home, (Gard- ner, Bundy, & Dew, 2016; Hinton, Sheffield, Sanders, & Sofronoff, 2017; Levy et al., 2018). In the area of AAC intervention for SLPs, telehealth began with pioneers in the field introducing tele-AAC and establishing its efficacy. Tele-AAC allowed services to be ex- panded to individuals located in more rural areas. For OT practi- tioners, teleconsultation was frequently used in the early years of its implementation in the area of assistive technology (AT), and continues to be a frequent use of this platform today for AT
evaluation and adjustment in areas such as prosthetics, seating and positioning, and home safety and accessibility, (Schein, et al., 2008; Whelan & Wagner, 2011). In order to provide high-quality AAC and AT services over the telehealth platform, the therapist must develop competence in the specialized areas of AAC and AT, as well as telehealth. In the areas of AAC and AT, this includes the knowledge of and ability to use and troubleshoot a variety of low- to high-tech devices and equipment. When therapy is occurring on a virtual plat- form, additional planning is required to train treating therapists and establish confidence with the use of the AT equipment, the telehealth platform, and the interfacing of these two technolo- gies. During synchronous (real time) services, it is necessary to make accommodations for the clinicians to see both the child and device/equipment on the telehealth platform. Practitioners may have intervention activities shared on the screen from their computer, but need to demonstrate quick troubleshooting of technology interfacing in order to navigate switching between screen shares, or multi-tasking by sharing both the virtual activ- ity and modeled communication system through a split screen function. In addition, tele-AAC typically requires an e-helper, in order to best support an individual with complex communi- cation needs. This caregiver assists with interventions such as equipment setup, ensuring access to technology, and facilitat- ing continuous adjustment of the equipment and modeling lan- guage through coaching from the therapist. When considering therapeutic intervention in the area of AAC and AT over the telehealth platform, the therapist training needs are magnified. To provide best practice in these niche areas you must consider the importance of therapist training, observation,
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