Difficulties in speech and language development are reported frequently among children. According to American Speech-Language-Hearing Association, the prevalence of language difficulties in preschool-age children was estimated between 2% and 19%.1 Among school-age children, the prevalence of language impairment ranged from 3.1% to 23.0%.2 Language impairments at a young age, such as in the first three years of life, have a negative impact on children’s academic life and their adulthood and are related to social, emotional, and behavioral problems. Thus, early identification and thorough and specific assessment and treatment are crucial.1 Access to speech-language pathology (SLP) services, however, may be limited for many children and their families, particularly those residing in rural and remote areas.
Telehealth is a means of providing healthcare services (diagnosis and/or treatment) remotely using communications technologies such as interactive video, audio, computer and other more advanced technologies.3 The term of telehealth is often used interchangeably with telemedicine, telerehabilitation and telepractice. It is different from the conventional in-clinic models and is particularly important for patients in the remote or rural areas, who usually have limited access to the healthcare services due to the distance, costs, shortages of speech-language pathologists, or parents’ commitment to work.2,4,5 Telehealth has been widely used in various areas of medicine, such as heart disease, stroke, diabetes, psychiatric problems, dermatological disorders, and speech-language disorders or impairments.4,6,7 This model may enhance the quality of care by optimizing the timing/intensity/sequencing of interventions and allowing more frequent interactions with patients, thus may be associated with more favorable outcome for them. In addition, a unique benefit of telehealth is that the SLP services to be delivered to the patients in their own environment, such as the home, in a local community, school or workplace.8 The clinical evidence on the effectiveness of telehealth in children with speech-language disorders is uncertain.2,4,6 With over 80% of Canadian population now using the internet and the rapid growth in various forms of technology,9 it is necessary to examine the impact of delivering speech pathology services directly into the everyday lives of people with speech-language disorders via telehealth.
The purposes of this review were to identify the evidence regarding the clinical effectiveness and cost-effectiveness of telehealth for the delivery of SLP services to children with speech and language disorders or impairments and to summarize the recommendations from evidence-based practice guidelines regarding the use of telehealth in the target population.