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abstract: The purpose of this study is to evaluate the effects of parent training in the Enhanced Milieu Teaching with Phonological Emphasis (EMT+PE) intervention program, using a secure internet-based conferencing software (telepractice), on parent strategy use and child speech and language outcomes for children with repaired cleft lip and/or palate (CL/P). Three participant dyads composed of a parent and child participated in this study. Children ranged in age from 21 to 27 months at the beginning of this study and all had a diagnosis of nonsyndromic CL/P. Participating dyads received three in- person training sessions and three weekly telepractice intervention sessions. Assessment and intervention sessions were administered by a trained Speech Language Pathologist (SLP) and a graduate SLP student clinician. Parents demonstrated a positive intervention effect by significantly increasing their use of EMT+PE intervention strategies during training. Based on preliminary results, parents were able to maintain their increased use of strategies following the conclusion of intervention as well. Telepractice proved to be a valid service delivery model for conducting early intervention sessions and for supporting the early speech and language development for children with CL/P. / Dissertation/Thesis / Masters Thesis Communication Disorders 2020

Service delivery and the access to specialized instructions to consumers, encounters many barriers within the profession of speech-language pathology. This state of affairs is largely due to the disparate distribution of speech language services (ASHA, 2005). This restricted access, or an inability to access services, is a result of a number of factors, which include lack of clinicians, insufficient number of facilities in geographic area, and transportation issues (ASHA, 2004e). As a result, students who require specialized reading instruction are not afforded the opportunity to access the necessary treatment. It is essential that the literacy needs of all children be addressed, including those who require specialized instruction (Foorman & Torgesen, 2001; Allington, 1994). Technology, specifically telepractice, is a potential solution to address this dilemma. The purpose of this study is to investigate the reliability and validity of systematic multisensory reading treatment for students who have been identified with a delay in foundational reading skills, addressing foundational reading skills via an internet-based video conferencing system. The results will establish the groundwork for the efficacy, reliability, and validity of internet-based video conferencing as a means of service delivery for foundational reading skills. The foundational reading skills targeted in this study are letter naming knowledge (LNK), letter sound knowledge (LSN) and decoding.

There is a national shortage of school-based Speech Language Pathologists (SLP). Schools located in rural and geographically remote areas are often impacted by the shortage, and as a result students with an autism spectrum disorder may not receive services that are mandated by their Individual Education Plan. This study examined the use of telepractice as a method of delivery of speech and language services to individuals with autism spectrum disorders in rural areas. A quasi-experimental, single-subject, time-series design was employed. The treatment conditions were manipulated. A counter-balancing methodology was used to control for order effects in this study. Inter-observer agreement on student progress and outcomes were determined by two other master-level clinicians. Progress was measured using pre/post intervention assessments and intervention data. A statistical analysis and comparison of the two service delivery methods (telepractice and traditional on-site) was conducted using the Improved Rate Difference and a Tau-U method. Group comparison was conducted using the Pearson's Correlation . A non-directional critical value for all parametric and non-parametric analysis was set at á = .05. If the null hypothesis was rejected, then there was a statistical difference between the progress students made when receiving telepractice as compared to on-site services. If the null hypothesis was not rejected, there was not a statistical difference between the progress students made when receiving telepractice as compared to on-site services Comparison at the group level resulted in a finding of non-significance between the two conditions. Findings at the individual level resulted in three out of the six participants demonstrating a finding of non-statistical difference between the on-site and telepractice conditions. For the remaining three participants a statistical difference was noted. When comparing the means of the outcome data between the two conditions, two participants responded more favorably to telepractice intervention, while the other responded better to on-site intervention. Overall, these findings suggest that a telepractice service delivery method is an effective and valid way to provide interventions to students with ASD

There is a growing population of individuals using Augmentative and Alternative Communication (AAC) in need of evidence-based intervention from highly qualified personnel. However, not all speech pathology programs offer AAC coursework and/or practicum opportunities, and practicing speech-language pathologists (SLPs) report low levels of confidence and expertise in working with individuals using AAC. Therefore, there is a need to develop more innovative pre-professional training programs to better equip the next generation of SLPs with the knowledge and skills necessary to provide high-quality, evidence-based AAC interventions. Telepractice is emerging as an inventive way to provide both direct and indirect intervention services, and could theoretically be used to support pre-professional training by providing clinicians the opportunity to engage in direct services with individuals using AAC concurrently while receiving supervision from a skilled mentor. A thorough review of the literature revealed limited information and data regarding tele-AAC for direct and indirect service delivery. This investigation examined the feasibility and effectiveness of utilizing telepractice to train pre-professional clinicians regarding AAC interventions while in the context of service delivery both on-site and via telepractice. A single-subject, multiple baseline design was employed to examine the impact of real-time supervisory guidance offered via telepractice to pre-professional clinicians (Active Consultation) on the performance of the clinicians and the clients in each service delivery condition. Data was gathered on the number of target language acts modeled by the clinicians and generated by the clients when Active Consultation was provided. The results supported the use of telepractice for supervision, and as a service delivery method for AAC users.

The impact of the COVID-19 pandemic required the use of remote technologies for society and the workforce to function under quarantine conditions. The literature on telepractice services for individuals with ASD has proliferated during the past decade, especially during the past two years. Still, many publications on the topic lack scientific merit. This study utilized a quasi-experimental, single-subject, multiple-group, time-series design to investigate whether telepractice SLP services are at least as effective as the traditional, face-to-face delivery model. Twenty-one students with autism spectrum disorder were included in this study. Additionally, 22 speech-language pathology graduate students and four SLP school professionals assisted in conducting this research. This investigation was organized into a two-phase research design (AB and BA) whereas phase A corresponded to intervention services being delivered using telepractice and phase B corresponded to the same intervention services being delivered on- site. Students were assigned to either Group 1 (AB) or Group 2 (BA). The participants in this study were treated individually and outcome data were aggregated into a final summary of treatment outcomes. Outcome data for each student included percent accuracy achieved on IEP goals as well as percent assistance required in working on respective IEP goals. For all 21 participants, change over time was examined through single-subject graphs which display composite percent accuracy and assistance throughout both intervention phases. Visual analysis of the data reveals that many participants showed no notable difference in percent accuracy achieved between telepractice and on-site services, but that most students appeared to require less assistance when participating in telepractice services. For a subset of 15 participants, summary statistics and paired samples t-tests were calculated to determine mean differences in student performance for percent accuracy and percent assistance for each mode of service delivery. Paired samples t-tests revealed that there was no difference in students’ response accuracy to treatment stimuli between the intervention conditions. However, paired samples t-tests supported the finding that telepractice services do not require the clinician to provide students with as much assistance as needed on-site. Additionally, results from satisfaction surveys completed by participants suggested that telepractice is a socially valid treatment delivery for students with ASD. Overall, results from this study suggest that telepractice services are an effective alternative to in-person SLP services. This finding has positive implications for clinical decision making and treatment planning for individuals with ASD.

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The primary purpose of this study was to craft and validate a set of core competencies necessary for an e-Helper to possess. A review of the literature guided the creation of the initial competencies. Following expert review, the competencies were revised and formatted into an online survey which was sent to respondents in four target groups: (a) school administrators who had adopted telepractice as a service delivery model; (b) SLPs experienced in telepractice within a school setting; (c) current e-Helpers, and (d) scholars experienced in telepractice. Sixty percent (21 out of 35) of the competencies were rated as “important” by 76-100% of respondents. The remaining competencies could be more or less important dependent on workplace requirements.

The rising rate of the autism spectrum disorders (ASD) has resulted in challenges for teachers in public schools, concerning the delivery of evidence-based practices for superior outcomes. Thus, school districts are in need of professional learning options that can be efficiently and effectively delivered to improve the procedural fidelity of interventions. The purpose of this study is to demonstrate the effectiveness of using telepractice to teach autism teachers how to contrive motivating operations to teach manding to students with ASD. By utilizing multiple baselines across participants design, four autism teachers in public schools received intervention support through an online module along with video models as well as direct performance feedback from autism specialists via video-conferencing. The primary dependent variable was the percentage of correct responses from the instructional procedures of task analysis, and the secondary measure was the subsequent rate of student mands. Data were analyzed both visually (i.e., through the study of behavioral patterns) and statistically (i.e., analysis of effect size). Results indicate that telepractice increased accuracy of both teacher and student target responses.