In the Classroom

Moving Mountains:  College launches telepractice training for future speech-language pathologists

In rural states like West Virginia, there are consistent limitations in access to healthcare providers, and this problem extends beyond physicians and nurses to include allied health professionals like speech-language pathologists. West Virginia is currently experiencing a shortage of speech-language pathologists, and moreover, those who do work in West Virginia’s most remote areas are often geographically prohibited from traveling to different treatment sites.

“The problem we are running into in West Virginia is that we have a high need for speech-language pathologists, especially in the schools and rural areas, but there aren’t enough speech-language pathologists in the state,” said Tracy Toman, a clinical supervisor in the Department of Communication Sciences and Disorders. “When you’re in these rural areas it’s very difficult for one person to travel all of these different schools when you have a mountain between the schools.”

Toman, who began her role at CEHS in August 2018, is spearheading the College’s effort to train future speech-language pathologists to meet these needs. With Toman’s arrival, graduate students in the Speech-Language Pathology Program will have access to placements that allow them to provide speech therapy for remote clients, in addition to placements in more traditional school and clinical settings.

According to Toman, a telepractice session looks very similar to a standard speech therapy session – the major difference is that the speech-language pathologist is not in the same room as the client. Instead, the clinician connects with the client through a computer and facilitates the therapy session.This new facet of the Speech-Language Pathology Program is reflective of a larger trend in in the health care industry known as telemedicine, in which healthcare providers connect with clients using telecommunication technologies to remotely diagnose and treat a variety of conditions.

In the fall 2018 semester, Toman, who is a speech-language pathologist and CEHS alumna, began working with a company called Integrated Speech Solutions to provide telepractice sessions to students at two elementary schools in Braxton County, West Virginia. Neither of these schools had access to a speech-language pathologist at the time. Through this experience, Toman was able to learn more about the ins and outs of telepractice and establish a caseload for graduate students to begin working with in the spring 2019 semester.

“It’s nice to be on the forefront of the research, and I’m trying to find out what works best with telepractice,” Toman said. “That has been a challenge, but it’s also been very exciting. I knew I wanted to be on the forefront of technology and to get my foot in the door there.”

Now, Toman is training graduate students in telepractice with the clients she worked with in Braxton County Schools. The clients, who are elementary school students, each participate in three 10-minute sessions per week. Facilitators at the schools take the children out of their classrooms and into a room with a computer to connect with the graduate student clinician for the sessions.

“Most of the time in the sessions, we are working on articulation,” said Tara Boszczuk, a speech-language pathology graduate student clinician. “We try to get through as many drills as we can within those 10 minutes because research has shown that shorter, more frequent sessions per week is more effective.”

The existing literature on telepractice largely focuses on individuals with articulation issues, so current CEHS graduate students primarily work with children who struggle in this area. While some individuals who need the help of a speech-language pathologist have more severe disabilities that limit their ability to sit in front of a computer, telepractice sessions work well for school-aged children with certain speech impediments, as well as other homebound clients.

“It’s a new way of providing therapy, and it can be much more efficient,” Boszczuk said. “I think it’s a really great way to have students come in, sit down and focus for 10 minutes. It’s usually just one client per session, and so it’s just me and them, one-on-one. We’re able to get a lot done.”

Because telemedicine is an emerging field, research on how to perform more complex therapies is ongoing.

“So far, there has been research on best practices for telepractice for clients with articulation issues, but what we’re really interested in at the University is the language side, which takes a little bit longer than a 10-minute session,” Toman said. “We’re trying to figure out which programs and techniques are most beneficial for those children who have language delays that are affecting their academics or English language and reading fluency issues across the board.”

Though there is still a clear need for speech therapy provided in traditional, in-person settings, the addition of telepractice training to the Speech-Language Pathology Program provides students with additional skills that both enhance the students’ hirability and meet the state’s needs.

“I think that the telepractice component really gives our students a competitive edge,” Toman said. “There are not a lot of universities that are starting to change in this aspect, but I can see that the field is moving in this direction. Programs like this will be a desirable location for graduate students, and it will make them better and more prepared clinicians to go out into the world.”