UMaine’s Department of Communication Sciences and Disorders Offers New Telepractice Services

A new University of Maine training program for graduate students in Communication Sciences and Disorders (CSD) is expected to reduce the cost of providing speech therapy services, while reaching out to underserved children and adults in rural areas throughout Maine — or around the world.

The university’s Communication Sciences and Disorders Department has developed a Web-based speech therapy telepractice training program to give graduate students the competencies that are revolutionizing the delivery of health care worldwide. It is now accepting speech therapy clients who would benefit from the remote access of telepractice.

“We have created one of the first nationwide speech therapy telepractice training programs,” says Judy Walker, a UMaine CSD associate professor who developed the program in collaboration with colleagues in the Speech Therapy Department at Waldo County General Hospital (WCGH) in Belfast.

The UMaine program is one of only a few programs in the country that offers speech therapy telepractice training at the college level in an emerging service model for delivering health care through evolving technologies. Speech therapy telepractice involves almost no travel expense and expands the reach of therapy services to more people in Maine, where an overabundance of people in need of speech therapy is compounded by a severe shortage of speech therapists, Walker says.

“Telepractice is not only efficient in reaching people, but also cost-effective,” Walker says.

Nationally, at least one study estimates that telemedicine services provided via broadband Internet would save $700 billion nationally over the next 15 to 20 years, according to Walker.

The program uses a secure, password-protected Web-based platform that allows virtual face-to-face therapy between service providers and clients. Clients can be assisted by designated “e-Helpers” — family, friends or caregivers — according to Walker. All that is needed is a computer with a webcam and broadband Internet access, located in a private setting, such as a home, school, clinic or community center.

“In addition to overcoming barriers such as geography, weather and transportation, we can also bring in family members and caregivers to participate in the therapy from their own computers in any location,” Walker says. “With this service delivery model, anyone involved in a child’s or adult’s therapy program can actually view or participate in the session, regardless of where they are,” Walker says.

The UMaine graduate training program in speech therapy telepractice, based in the Madelyn E. and Albert D. Conley Speech, Language and Hearing Center in Dunn Hall, complies with American Speech-Language-Hearing Association guidelines for demonstrating competencies and skills in speech telepractice services, which standardizes the training of the UMaine graduates.

That’s important, according to WCGH Speech Therapy Department Director Michael Towey, who oversees the hospital’s 5-year-old speech therapy telepractice, on which the UMaine program is modeled. Competency standards have not been well defined nationally, says Towey, a UMaine alumnus and adjunct CSD faculty member assisting the university with its telepractice training curriculum.

Industry credentials reassure clients that telepractice therapists are competent, he says. Towey says the UMaine speech therapy telepractice training program is among the first to establish training standards for therapists at the college level.

Waldo County General Hospital’s speech telepractice program is provided by staff professionals, who have served people from Canada to Russia and Taiwan, in addition to more that 40 Maine communities between Kittery and Fort Kent. It is one of only a handful of speech therapy programs in the country with Training Program Accreditation from the American Telemedicine Association, according to Towey, and the only one that allows therapists to work with clients in home settings rather than at designated clinics, he says.

Walker along with Casey Monnier, a CSD staff speech pathologist and lecturer, and WCGH staff offered the first telepractice training class in August 2012 to 10 CSD graduate students, including Taylor Rodgers of Standish and Janet Ciejka of Brunswick. Following the class, Rodgers and Ciejka applied their new skills in two semesters of clinical practicum providing telepractice speech therapy to clients under the supervision of Walker and Monnier. A new cohort of 12 CSD graduate students are currently in a telepractice training class this month and will be involved in applying their new telepractice skills in clinical practicum during the next school year.

Prior to graduation, Rodgers had been providing speech therapy to a woman from southern Maine, who as the result of a stroke in April 2012, had difficulty finding the words to communicate with her family for much of the spring and summer. Speech therapy telepractice sessions began in the fall 2012, involving one adult daughter videoconferencing from Rhode Island, another daughter at her mother’s side in southern Maine, and Walker and Rodgers in Orono. Now, the woman can retrieve many nouns and other words (verbally or in writing using e-Tools) as Rodgers displayed digital materials that are unique to this client on the computer screen where all participants can see- bread, rice cakes, butter or milk, for example.

Therapy by videoconference is working better than the daughters expected, they say. Their mother is progressing faster as a result of more frequent therapy sessions and outside practice of activities involving the daughters and their mother between online sessions with Rodgers and Walker.

“I had a telephone conversation with my mother last week and I understood everything she was trying to say,” the southern Maine daughter says of her mother.

Therapy at home also ended a “convoluted and complicated” transportation problem when her mother was visiting a therapy clinic, says one daughter, a nurse.

“I was driving her to therapy two and three times a week, and we had to arrange transportation. I felt I was losing touch because I wasn’t there for all the sessions,” she recalls. It was worse for the daughter in Rhode Island, a school bus driver who can now participate in therapy sessions with her mother between her shifts at work. “Being so far away, I feel so much more involved now,” she says.

For the mother’s part, starting telepractice speech therapy “was wonderful,” she says. “It’s helping me.”

Rodgers, who recently received a master’s degree, is convinced the new telepractice skills will give UMaine speech-language pathologists an edge in the job market.

“I think it’s a really exciting opportunity the University of Maine makes available to us,” Rodgers says. “I have friends in speech pathology at other universities and they really don’t have anything like this, and this seems to be the future direction of speech pathology.”

The University of Maine, Madelyn E. and Albert D. Conley Speech, Language and Hearing Center is accepting new clients for speech therapy telepractice services this summer and fall. Telepractice is covered by many insurance plans, including MaineCare. For more information or to make an appointment, call the Conley Speech, Language and Hearing Center, 207.581.2006, or visit the telepractice website.

Contact: Margaret Nagle, 207.581.3745