Evolution of Telehealth Technology, Evaluations, and Therapy: Effects of the COVID-19 Pandemic on Pediatric Speech-Language Pathology Services

Purpose: Telehealth services experienced exponential growth during the COVID-19 pandemic. This survey examined the resulting evolution in the technology, connectivity, implementation of services, and attitudes of pediatric speech-language pathology clinicians using synchronous videoconferencing. Method: The Telehealth Services: Pediatric Provider Survey participants were 259 speech-language clinicians in a variety of employment settings from across the country and abroad. Analyses identified telehealth barriers eliminated and those that persisted during the pandemic, advantages, and disadvantages of remote delivery of evaluation and treatment services, the most common telehealth technology used by clinicians and their clients to access care, and clinicians' predictions about the optimization and future of telehealth. Results: Elimination of regulatory and insurance hurdles allowed children from varying socioeconomic backgrounds living in rural, suburban, and urban areas access to teleheafth. Telehealth technology shifted from computers with external hardware and specialized software to commercially available equipment, such as handheld portable devices with built-in audiovisual components and publicly available videoconferencing platforms. However, connectivity of these devices continued to be problematic, and lack of technology prevented some children from accessing care. Judgments about the appropriateness and effectiveness of evaluations and treatments varied based on the age and communication disorder of a child. Although some participants expressed uncertainty about the effectiveness of telehealth compared with in-person care, telehealth was widely recognized as a viable delivery method. Conclusions: Although clinicians reported many advantages of telehealth, some barriers identified reported prior to COVID-19 still persist. Clinicians anticipate that new developments have the potential to continue improving telehealth service delivery, bolstering the viability of telehealth long after the COVID-19 pandemic is gone.