they were using it to the full potential .
Access to care , particularly during public health precautions , is an essential factor contributing to one ’ s health . Health disparities are commonly noted for individuals and families living in rural or remote areas , especially in WV , where healthcare disparities are the highest in the nation . 6 , 21-22 Since feeding and swallowing contribute to overall quality of life , 1 integration of dysphagia services should consistently be integrated into healthcare plans for persons with disabilities . Since persons with developmental disabilities are disproportionately diagnosed with dysphagia , 2 accessible treatment modalities are essential to address the need for services .
In the promotion of increased patient accessibility , telehealth is an evidence-based healthcare modality for the assessment and treatment of feeding and swallowing difficulties . 7-9 , 15 Telehealth options have been supported by research examining the potential to provide a variety of services in these areas . 22 These approaches , however , often experience challenges that are slowly being addressed . 23 As noted in this study , addressing the limited experience of this provider base within WV is an initial step . Familiarity with telehealth across the lifespan and in situations of different need would also expand the knowledge and skills base of our SLP providers .
The findings from this study illustrate the need to incorporate telehealth or other means to reach families when not able to meet in person . The current public health precautions also require providers to learn new skills quickly and / or work with populations normally not within their comfort levels .
CONCLUSION
While the majority of SLPs in WV have been practicing for over 10 years , clinicians reported feeling underprepared to provide remote services despite years of experience . In addition , scholarly research has supported telehealth for decades 11 yet pervasive implementation of this modality is still lacking . Respondents who identified as having experience in feeding and swallowing continue to rely on traditional faceto-face intervention instead of instituting telehealth for provision of services to the most at-risk and vulnerable populations who may fit the criteria for telehealth .
To increase clinician proficiency and competence in telehealth as a feasible and easily accessible treatment modality , workplace infrastructures should provide technology training and support as well as continuing education to advance knowledge of evidence-based remote practices . Similarly , peer-to-peer consultation , multidisciplinary team collaboration , and self-directed exploration of dysphagia practices can improve overall feeding and swallowing services across WV .
Further research is warranted in the following areas : exploration of patient broadband / internet access , patient and clinician technology proficiency , patient perceptions of telehealth , and overall satisfaction of telehealth services from both patient and clinician perspectives . Investigating these areas would help develop protocols for best practices in telehealth and dysphagia management within speech language pathology across WV and potentially other rural areas with high rates of people with disabilities . Skilled implementation of telehealth can help bridge the accessibility gap for many rural and at-risk WV patients with disabilities and comorbidities such as dysphagia that affect quality of life .
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