SLP Grad Students Gain Telepractice Experience

Clarion Mendes, clinical assistant professor in the Department of Speech and Hearing Science, recalls the period in March following Governor JB Pritzker’s stay-at-home order as one of dizzying activity. “Within a very short period of time, less than 10 days, we had to completely upend our service delivery model for speech language pathology and audiology,” she said. “We’re a training program, so it is our duty and responsibility to provide opportunities for clinical experiences to our students.”

The answer was telehealth practice, the use of virtual platforms for clinical sessions. Telepractice is not a new concept. Even in the absence of a pandemic, it is a rapidly growing area of healthcare, and many telehealth training programs have been developed in speech-language pathology—for licensed clinicians. Considered a more advanced clinical skill than in-person evaluations and interventions, it typically is not addressed in speech and hearing science graduate programs. In fact, up to the time of the pandemic, the State of Illinois did not allow students to participate in telepractice models of service delivery. This presented a significant problem, since students are required to have at least 400 hours of clinical experience by the American Speech-Language-Hearing Association (ASHA), the certifying body for clinicians.

“A lot of us worked on creating public awareness and made a lot of phone calls to stakeholders within the state and around the country to get a variance passed that enabled students to continue to gain clinical experience through telepractice,” Ms. Mendes recalled. “We also had the good fortune that we were installing a new electronic medical records system at the time the pandemic hit, which made it dramatically simpler to maintain continuity of care.”

In order to make telepractice work, clinical staff also had to set students up with software to facilitate online sessions, digital activities to replace the tangible three-dimensional objects typically used in in-person sessions, and high-quality digital assessment tools. Alumni helped as well.

“When we were starting this initiative and unsure of where it was going, alumni were our biggest cheerleaders,” she said. “In some cases, they were individuals who could no longer see their clients because of shutdowns, and they sent us a lot of referrals.”

It was an enormous undertaking, but one that had significant benefits. Clients who previously may have had difficulty finding speech-language pathology services in their area, some of whom drove for several hours to reach the University of Illinois clinic, now had access to help.

“It also allowed us to see the impact of the therapy in the client’s natural environment,” Ms. Mendes said. Attendance was better as well, she added, saying, “Even if they were feeling a bit under the weather, they could pop into sessions in pajamas and nobody would be the wiser.”

After a hectic spring and summer, “we have felt out our rhythm and achieved a great flow,” she said. So she was able to work with Speech and Hearing Science professor Keiko Ishikawa to develop a training module on telepractice for Dr. Ishikawa’s class, Assessment and Management of Voice Disorders. Their innovative approach combines traditional lectures about telepractice, technology, and the legal, regulatory, and privacy issues involved with the use of standardized clients—students of voice in the School of Music and students in the Acting Program in the College of Fine and Applied Arts who were formally trained to simulate voice disorders. This approach enabled SLP students to sharpen their telepractice skills before interacting with actual clients.

“I don’t see telepractice going away,” Clarion Mendes said. “I am so impressed by and proud of our students and our department for moving ahead and really changing the landscape of how we’re providing services. It’s tremendous.”