After much research, planning and purchasing of state of the art equipment, LinguaCare Associates launched their Telespeech Program to reach underserved and unserved populations of children and adults through the use of telecommunications. Vickie Pullins, co-owner of LinguaCare Associates, Inc., began her research of the utilization of telecommunications entitled Telespeech by the American Speech and Hearing Association by attending a session at the ASHA convention in Miami, FL in 2006. She then continued researching and collaborating with other speech pathologists throughout the US currently using Telespeech to serve children and adults with communication and swallowing difficulties. Her research led her to discover the PolyCom equipment that is currently used by some school systems and the WV State Dept. of Education to complete distance learning classes to students. After trying the PolyCom equipment through the State Dept. of Education with students in Mingo County, WV, LCA decided to purchase their own equipment along with obtaining designated lines to increase sound and video clarity and to insure privacy of the communication.
Public School Pilot:
Vickie made contact with Mingo County and found that they were in need of additional services at Matewan Middle School and were willing to participate in the pilot program with LCA. Considerable onsite work was necessary prior to beginning the actual therapy program via Telespeech. After the preliminary onsite evaluations, training of assistant onsite, notification to parents, etc., the pilot was begun. The children loved the program and were disappointed if Vickie made an onsite visit and did therapy onsite instead of via Telespeech. At the end of the semester, questionaires were distributed to students, teachers and parents in regards to the program with favorable comments made by all. Children were found to progress in their treatment program much as if they were seen directly by a therapist onsite.
The routine for the program included Vickie placed in Hurricane, WV with her equipment (PolyCom HC4000) turned on and awaiting to be dialed by the school. When the connection was complete, Vickie was essentially present with her students while they were in a room at their school in Matewan. An aide was present to assist as needed, however, Vickie primarily ran the session much as if she were onsite. There was identical stimulus materials available to the children that Vickie had in her office. She could play barrier games to elicit speech or language tasks by utilizing a blackout “curtain” with her camera to allow her to manipulate her objects at her end and then “open” the curtain by opening her camera shutter and asking the students to determine what had changed. Students tended to pay good attention to these types of tasks. At the end of the semester it was clear that Telespeech is a viable venue for providing quality speech and language services to children.
Hospital Pilot:
After seeing how well the Telespeech program was working in the schools, the idea of expanding to hospital services was explored. LCA had been providing services to St. Joseph’s Hospital in Parkersburg, WV for a period of 3 years when a staffing change made the continuation of the services not possible by LCA after December 2007. St. Joseph’s had had difficulty finding services therefore when LCA approached them with the possibility of providing services via Telespeech, St. Joe was eager to participate. LCA purchased identical equipment to be placed at St. Joseph’s Hospital that was in their office in Hurricane. After working out technical “bugs” and completing training of staff to assist with the transportation and evaluation process, the program was up and running.
How it works:
Patients with orders for a swallowing evaluation are transported to a room with the equipment in place after indepth discussion with the nurse caring for the pt. in regards to history and physical information, chest x-ray information, current diet, observations from nursing and family re: swallowing performance, alertness levels, etc. is completed by the evaluating SLP. The connection is made to the speech pathologist in Hurricane by the assistant with the patient appropriately positioned for the evaluation. The assistant is then instructed by the speech pathologist regarding presentation of consistencies with the SLP making clinical observations of signs and symptoms of difficulties just as she would at bedside. Clinical reports are written and faxed to the facility to be placed in the patients chart along with necessary swallowing precautions and recommendations. During this pilot program, the patients are then seen the next day by another LCA speech pathologist for a swallowing assessment at bedside with results of the two evaluations checked for agreement (it should be noted that no discussion of the patient or the findings are given to the second SLP prior to the evaluation at bedside is completed). This is the process whereby a determination as to the efficacy of using Telespeech with swallowing patients is being made. Currently, the results are very favorable with agreement between the two evaluating SLPs. It is hoped as the pilot continues that a way to complete modified barium swallowing studies may also be developed via Telespeech, however, that pilot has not yet been initiated.
ASHA Recognition of LCA and Vickie Pullins:
Vickie Pullins was featured in the ASHA Leader, a professional monthly publication of ASHA, in June 2008 in a article featuring LCA’s Telespeech practice along with other Telespeech venues. She has become one of the pioneers in our field relating to Telespeech and will be presenting with other Telespeech pioneers at the ASHA Convention in Chicago in November, 2008.
