were 124 providers who completed the initial survey representing 37 of the 55 counties in WV . Respondents were between 24 and 65 years of age and had practiced as a SLP in WV from one to 25 years . The majority of respondents had been practicing for 10 or more years ( 62.9 %). Slightly over 75 % were working full-time ; one-third ( 37.9 %) were working at two or more locations ( e . g ., early intervention , schools , outpatient clinics ). Most of the respondents were serving as clinicians or independent providers with certificates of clinical competency and / or state licensure ( 77.4 %).
NATURE OF PRACTICE
When asked to describe their average workload and specialties , 28.5 % of respondents noted speech activities , 32.6 % reported language , 19.9 % reported feeding / dysphagia services , and the remaining activities included social communication , literacy , voice , managerial , and other activities related to cognition . Most respondents took a life-span approach , noting their patient populations included a diverse range with 24.8 % serving school-aged ( 5-12 years ) children , 22.4 % serving older adults ( 65 years or older ), and 19.9 % serving toddlers ( 1-3 years ). On average , 70.9 % of providers reported that patients travel less than 30 minutes for their services ; 30.2 % noted it took between 30 minutes to one hour for their patients . Only one quarter ( 25.1 %) of respondents used email or telephone calls to follow-up with services or check progress . Thirty-seven percent of respondents spent three or more hours per week traveling to provide services .
FEEDING / DYSPHAGIA SERVICES
Percentage of Respondents
100 80 60 40 20 0
FIGURE 1 : Percentage of Respondents Using Types of Telehealth
One-third of respondents ( 38.1 %) had provided pediatric feeding / dysphagia services for two to 10 years . Those respondents who provided feeding / dysphagia services commonly served children between two months and four years ( 28.9 %) or older adults ( 65 years or older ; 24.6 %). Common feeding services included caring for individuals with development of oral motor skills / diet progression ( 66 %), behavioral or problem feeding ( 50 %), pharyngeal dysphagia ( 39 %), and tube feeding / non-nutritive feeding ( 31 %). Respondents reported faceto-face in clinic consultations and home visits as the most common setting for delivery of service . When asked why access is most typically denied if feeding services are warranted , 50.6 % of respondents noted it was due to a lack of clinicians with pediatric feeding experience ; 32.9 % noted other reasons including lack of referral resources or knowledge ; 19.8 % reported insurance denial ; and 15.4 % reported the client is not eligible for services for other reasons .
TELEHEALTH
88.2
47.1
Teleconferenceing to patient homes Teleconferenceing with audio only Teleconferenceing to other health sites
Forty-six respondents continued to complete questions about telehealth during a COVID precaution period . Most had been providing telehealth services for feeding issues in the past six months ( 89.9 %), while a smaller group had been using that platform for two years ( 9.1 %). A majority of respondents were providing these services to school-aged children ( 63.6 %) or neonates and infants ( 54.5 %) and focusing largely on development of oral motor skills ( 90.9 %), transitional feeding ( 81.8 %), or behavioral feeding issues ( 81.8 %).
Thirty four percent of respondents had direct access to telehealth and teleconferencing equipment . Figure 1 provides information on the telehealth modalities used most frequently by survey respondents in this study . Specific equipment included access to the following : videoconferencing to patient homes via secure network ( 88.2 %), teleconferencing to patient homes with audio only ( 47.1 %), videoconferencing to other health sites ( 38.2 %),
Respondents
38.2 41.2
Teleconferenceing to patient homes via unsecure network
and videoconferencing to patient homes via unsecure network such as Skype or Facetime ( 41.2 %). Fifty-five percent noted they did not have technical support for telehealth or teleconferencing equipment in their workplace ; 41.1 % noted they had no documented guidelines , and 41.2 % did not have telehealth resources for clients . However , 73.5 % of respondents had access to telehealth training opportunities within their workplace recently , such as online modules . Telehealth services were provided by private insurance ( 45.5 %), grant funds ( 45.5 %), private pay ( 18.2 %), or other funding ( 18.2 %).
Various forms of teleconference software were initially used in the period based on experience during meetings and training . Over time , providers started to use this equipment ( and explore secure forms of this type of equipment ) to deliver speech and language services to clients . Table 2 provides the reported frequency in which this equipment was used for these purposes . Provider confidence using this equipment varied across respondents . Given a Likert scale to describe confidence , providers were more confident using the equipment for meetings ( mean = 3.8 ) and for trainings ( mean = 3.3 ) followed by health management ( e . g ., consultations , appointment scheduling ; mean = 3.2 ) and delivering speech and language services ( mean = 3.0 ).
All respondents felt teleconferencing and
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