Experiences of South African speech–language therapists providing telepractice during the COVID‐19 pandemic: A qualitative survey

• Published in: International journal of language & communication disorders Vol. 58; no. 5; pp. 1468 - 1480
• Main Authors: Gallant, Agnetha, Watermeyer, Jennifer, Sawasawa, Cynthia
• Format: Journal Article
• Language: English
• Published: United States Wiley 01-09-2023; Wiley Subscription Services, Inc
• Subjects: Affordances; Allied Health Personnel; Attention; Attitudes; Barriers; Caregivers; Competence; COVID-19; Digital literacy; experience; Foreign Countries; Medical personnel; Needs; Pandemics; Pediatrics; Polls & surveys; Program Effectiveness; qualitative; Speech Language Pathology; Speech-language pathologists; Teleconferencing; Telemedicine; telepractice; teletherapy; Therapy; South Africa; COVID-19; teletherapy; telepractice; experience; qualitative; speech-language pathology
• ISSN: 1368-2822; 1460-6984
• DOI: 10.1111/1460-6984.12872

Background
The COVID‐19 pandemic necessitated that speech–language therapists (SLTs) make a radical change to provide services to their clients safely via telepractice. For many practitioners, telepractice was an unfamiliar mode of practice that had to be implemented under emergency conditions. Limited literature on SLTs’ experiences of implementing telepractice in the Global South during this time is available.
Aims
To explore the experiences of South African SLTs (N = 45) who implemented telepractice services during the COVID‐19 pandemic.
Methods & Procedures
SLTs across the country were invited via professional bodies to participate in an online qualitative survey distributed in 2021. Data were analysed using thematic analysis principles.
Outcomes & Results
We describe participants’ reports of their current telepractices, discuss their perspectives on accessibility to telepractice for SLTs, clients and caregivers, and working with specific diagnoses, and consider the support needs of SLTs to enhance telepractice services. Most participants work in private practice or school settings with primarily paediatric caseloads. They reported telepractice as a positive experience and felt it was effective, although they judged that some clients were not well served by telepractice. SLTs felt underprepared for the rapid switch to telepractice and the flexibility required, especially given the limited availability of guidelines given the pandemic crisis. Greater preparation is required for telepractice sessions and more attention needs to be paid to supporting caregiver involvement online.
Conclusions & Implications
Telepractice involves various barriers and facilitators, many of which seem common across Global North and South contexts. Support is required to enhance current telepractices in terms of computer literacy, technical education, different telepractice methods and caregiver coaching. Our findings have the potential to enable the development of support, training and guidelines to improve SLTs’ confidence in providing telepractice whilst delivering quality services in an accessible and safe manner.
WHAT THIS PAPER ADDS
What is already known on the subject
Many SLTs had to transition quickly to telepractice service provision during COVID‐19, with limited existing guidelines and support. Although there is some literature available on SLTs’ experiences of implementing telepractice in the Global North, perspectives from the Global South during this time are limited. It is important to understand experiences, barriers and facilitators to telepractice provision to provide tailored support to practitioners.
What this paper adds to existing knowledge
Telepractice provides a viable alternative to in‐person therapy for specific clients and contexts. Telepractice presents both benefits and barriers for effective clinical practice across Global North and South contexts. Greater preparation is required for telepractice sessions and more attention needs to be paid to enhancing caregiver involvement online, especially since many practitioners are likely to continue offering telepractice services post‐pandemic.
What are the potential or actual clinical implications of this work?
Clinicians felt underprepared for the rapid switch from service delivery mode to telepractice. Greater support, training and guidelines for students and practitioners are required to enhance current practices and ensure practitioners are equipped to provide effective telepractice in the future. In particular, support should cover technological aspects, caregiver coaching and online assessment options, especially for paediatric clients.