I began using teletherapy out of necessity. Now I use it for better outcomes. As a speech-language pathologist I specialize in speech, language, and oral feeding for those with the diagnosis of Down syndrome. I have dedicated the last 10 years of my career to helping those with motor speech disorders be better understood when using oral language and improve feeding development and safety. Understanding and identifying learning strengths and relative weaknesses has led me to develop strategies and identify environments that foster learning as well as speech and language success. The two strengths or preferences I use most are visual learning and personally relevant meaning. Assuming the absence of severe visual or auditory impairment, people with Down syndrome learn best when they can see what is being taught auditorily. For example, an activity on an iPad or computer screen will be more enticing than a lecture without visual references. Research is also showing that information presented visually is remembered better for immediate and later use. The combination of visual, auditory, and meaningful content creates a therapeutic model that appeals to people with Down syndrome. Or anyone, really. We all learn better when multiple teaching styles are presented and when we like and identify with the content as well as the context in which it’s taught.
Benefits of Telepractice for those with the diagnosis of Down syndrome when targeting motor speech and short-term memory:
Initially, technology is very appealing due to its associated use for entertainment and communication with distant family and friends. It also allows the client/patient to see their own face on the screen while viewing their communication partner in real time. Successful therapy combines interest and motivation to achieve high repetition of tasks needed for motor speech practice. Because technology is more appealing and can be tailored to individual interests and abilities. It provides an environment that remains authentic (usually at home or school) and stimuli materials
Caters to Learning Strengths
Those who learn best from repetitive visual presentation (e.g., discrete video modeling) learn and master skills faster when picture and video
More Efficient and Evidence-Based
The recommendation for shorter and more frequent sessions for those with motor speech disorders such as Childhood Apraxia of Speech, fluency, and voice disorders, etc. are often not possible for families and therapists to implement due to time, travel, and cost. Telepractice, however, can reduce those barriers and offers additional billing options. Consecutive repetitions of spoken utterances
Video modeling, a technique using a video demonstration to encourage skill acquisition and maintenance, has been used widely to teach thousands of skills through watching and listening to others as they learn, master skills, and finish tasks. Children and adolescents learn best from their peers and will talk, play, learn, move, and even eat better when with peers or by simply watching them. Programs like Copy-Kids (copy-kids.com) and
Visual communication systems such as sign language, picture exchange systems, and Augmentative and Alternative Communication (AAC) voice generated devices are used to supplement or replace spoken language. These are somewhat successful because they access the person’s strengths of visual and kinesthetic learning to supplement speech clarity problems and support language skills. Telepractice can incorporate these alternative communication strategies along with
Teletherapy can also prevent and eliminate some undesired behaviors experienced in longer, child-directed, and play-based therapies. Sessions should be very simple with one to three goals that are targeted each session with a high frequency of repetitive practice. Updated or new goals are added only when mastery is achieved. Children
Specialty and Bilingual services are easier to acquire thanks to telehealth and telepractice. Services are not as dependent on location as they used to be. The time and cost associated with specialty services are quickly being eliminated with the emergence of better technology and billing options. Bilingual services continue to expand but are still not representative of the populations that need bilingual services. Telehealth is being utilized to address the shortage of SLPs and bilingual SLPs in schools, hospitals, clinics, and early intervention with great success.
Most services for those with Down syndrome tend to cater to children. While this is extremely important for every child with Down syndrome there is also exciting work being done for adolescent and adult populations. Age expectancy has improved dramatically thanks to medical research and practice and most people with Down syndrome will live into their 60s or more. Unfortunately, therapeutic speech and language services have not advanced as quickly. For the first time in my career I am doing more work for older persons than children. Each week we learn better ways to offer services and improve skills that promote independence and improve quality of life for those with Down syndrome. Telehealth is extremely important for this population because there are very few professionals or clinics with speech and language services dedicated to teens and adults with Down syndrome. Bilingual services for this population is also dire. We have begun doing community outreach programs targeting independence skills such as speaking, reading, technological communication, shopping, and cooking. We are also incorporating programs, groups, and clubs to target daily life skills such as communication using computers, tablets, and phones. Most teens and adults are not using these devices appropriately or at all despite having access to each. Successful independence is hinges on two things: speech clarity and/or access and use of communication technologies and the ability to manage the tasks of daily living.
For more information about how teletherapy services are working for those with Down syndrome, please contact me!