Medical providers are increasingly relying on telehealth services to ensure patients' needs are met - by meeting patients where they are. It's been used by nurses, psychologists and therapists too. FOCUS Fort Myers is now among the first providers in Southwest Florida to offer online speech therapy for kids.
Sometimes called virtual therapy or teletherapy, it's any therapy that can be conducted via technological device (iPad, phone, computer, laptop, etc.). FOCUS began offering online speech therapy services sporadically about 18 months ago. Recently, we established our Teletherapy Department, consisting of two pediatric speech therapists who exclusively operate remotely.
"The same diagnoses and conditions that can be treated in our clinic can be treated effectively via teletherapy," said Haley Ott, FOCUS speech-language pathology assistant and director of the Teletherapy Department.
The process is similar to a Face Time call, except it's through a secure, HIPPA-compliant app.
"It's fairly simple from there," FOCUS SLP and TD department founder and executive director Emmi MacIntyre Ring explained. "We provide our clients with a meeting code, the client enters it into their device, and we pop up on their screen and utilize a variety of online platforms to target their therapy goals. It's an evidence-based and supported administration of therapy services that we've found to be extremely convenient and effective for our clients at FOCUS."
Some local schools contract with companies that strictly offer teletherapy services. However, only a small number of private therapy clinics offer it - for now.
In many regions - including Southwest Florida - the need for speech therapists is greater than the supply. The new Advanced Report on Telehealth and Telemedicine Market Analysis Forecast indicates that by 2026, the global market for all telemedicine is expected to exceed $185 million.
The cost for speech teletherapy is the same as an in-clinic visit, and it's covered in FOCUS' contract with Medicaid. We also extend this service to private pay clients, and are working to expand availability for patients in other insurance networks.
Therapists don't need any special training for telehealth services except for use of the app. If there are parent concerns about how attentive a child will be in online speech therapy, we encourage quiet observation of a session or two in the background. After the first few, though, kids usually make more progress when given space to connect one-on-one with their therapist - even from a distance.
Effectiveness of Teletherapy for Speech
Because telehealth is relatively new in the medical field, researchers are still gathering data and anecdotal evidence that will provide definitive proof of its effectiveness. Still, early impressions are that online speech therapy could be a game-changer for many kids who might otherwise be limited in the early intervention services they could receive.
One study found that kids receiving speech teletherapy outperformed control groups and national benchmarks in expressive and receptive language, social pragmatics and articulation skills.
Research published in the spring 2017 edition of the International Journal of Telerehabilitation concluded: "The evidence presented showed that telehealth is a promising service delivery method for delivering speech and language intervention services to school-age children. This alternative service delivery model has the potential to improve access to SLP services for children living in geographically remote areas, reducing travel time and alleviating the detrimental effects of communication difficulties on education, social participation and employment."
In other words: We KNOW that early speech and language communication skills are a strong indicator of a child's future success. The sooner we can treat speech and language deficits, the better off that child will be long-term. Online speech therapy is a way to extend the same services to kids who might have a difficult time to make it to the office everyday.
"The therapy we're offering isn't different - the mode of delivery is," explained Ott. "Many therapists believe that teletherapy is especially beneficial and a superior method for children in schools because it allows for a FULL session, without having to take time out of a session to transport students. More minutes means more progress."
It's also important to note that while screen time for young kids is generally frowned upon, teletherapy is different. While most television and online games deprive kids of key social interaction, the whole point of speech teletherapy is engaging them.
"Teletherapy is led and directed by a licensed, certified clinician, working specifically on therapy goals in a way that is tactical and motivating for each child and their needs," MacIntyre said.
Parent Feedback on FOCUS Online Speech Therapy Program
Parents come to FOCUS Fort Myers from all over Southwest Florida because we are one of the most trusted providers of speech, occupational, physical and ABA therapy in the region. But teletherapy is still fairly new, so it's understandable parents and even some providers would approach it with healthy skepticism. Ott said the primary concern initially is, "What if my child doesn't pay attention?"
"This is 100 percent understandable, and is a concern of ours as well," Ott said. "However, you can apply this question to your child in most situations - including at school and during in-clinic therapy sessions. In school, your child isn't paying attention ALL the time, and in-person therapy at FOCUS isn't always smooth-sailing either. Most children need frequent breaks in order to attend, and online speech therapy is no different."
Elliot Warford, 8, of Fort Myers, has been a speech teletherapy patient for several months now.
"We love teletherapy so much," his mother Crystal Warford said. "It's a more controlled, one-to-one session, as opposed to in the clinic, where there are sometimes distractions. He loves that Haley incorporates games, and he feels more in control when he gets to choose which games to play. And of course for us, it's convenient to be able to cook dinner while he's in therapy."
Teletherapy may not be an option for every child, but we also know for some kids, it can be every bit as effective as in-person sessions. Sometimes children are more engaged in teletherapy sessions than in-person sessions because they get access to functional screen time.
This service makes a big difference for working parents and families constantly ferrying back-and-forth to other appointments and commitments. It increases access to providers, allows for greater transparency (every session can be recorded) and children enjoy it.
"It's a great way to incorporate education with something they like and aid in increasing their development," Ott said.
Andrea Cappuccilli's daughter has been attending speech therapy, occupational therapy and physical therapy at FOCUS for the past several years. Recently, the 7-year-old started doing some of her FOCUS speech therapy sessions online from home.
"Our primary purpose for speech therapy is to work on voice and breathing exercises so that her respiratory system can get stronger," Cappuccilli explained. "Teletherapy at home gives her a solid chance of improving these skills, while allowing her to avoid exposure to illnesses like the flu or RSV that can easily put her in the hospital for weeks."
And her daughter loves it.
"She knows she's doing therapy, but being on a screen - which kids are already all about - makes it seem cool, and like it's on HER terms."
FOCUS offers pediatric speech therapy and online speech therapy for kids in Fort Myers and throughout Southwest Florida. Call (239) 313.5049 or Contact Us online.
A Pilot Telerehabilitation Program: Delivering Early Intervention Services to Rural Families, Fall 2009, Jana Cason, International Journal of Telerehabilitation
While slime itself – slippery, gooey, smooshy, somewhere between liquid and solid – has a lot to offer in terms of sensory integration, the simple process of making it in a therapy session can give children a lot of practice in key skills we’re working to develop.
(And the lessons “stick” because, well – slime is cool!)
We encourage parents to try this – and other simple experiments – at home to get their kids talking!
You my notice in the FOCUS waiting room that our Fort Myers speech therapists sometimes form some basic signs with our hands while we’re speaking to some of our patients. But it’s not exactly sign language. What we’re doing in those instances is using a speech-language therapy technique known as “sign-supported speech,” sometimes referred to as SSS.
Sign-supported speech is a form of simultaneous communication (SimCom), which was originally formed for the benefit of those who are deaf or hard-of-hearing. However, the method has also proven an effective way for our Fort Myers speech therapists to teach speech and language to children with language delays and disorders.
Recent research published in the Journal of Speech, Language and Hearing Research found that when speech therapists used sign-supported speech for word learning when working with children who have a developmental language disorder, it had a positive impact on the child’s linguistic and cognitive development.
There are lullabies that promise pretty horses and twinkling stars and some over-the-rainbow places where dreams-come-true. But pediatric music and speech therapy researchers have learned that lullabies may hold another promise: Better health for premature babies.
Recent analysis shows a parent who sing to preemies still receiving treatment in neonatal intensive care unit (NICU) can:
- Soothe a child amid scary new sensations and hospital noises, bonding parent-to-child.
- Regulate breathing and improve oxygen absorption for those who haven’t yet developed reflexive breathing.
- Boost a baby’s nutritional intake, imperative for those with immature oral-facial muscles struggling to suck and swallow
Speech Therapy Pros: Preemies – All Babies – Need Your Voice
At our FOCUS Fort Myers speech therapy, occupational therapy and physical therapy clinic, we treat many children born prematurely, as they are at much higher risk of neurodevelopmental difficulties. The earlier we intervene the better, but encourage parents to start first. Even the simple act of talking regularly to your child from a young age can do wonders.
For a premature baby, lullabies serve much the same purpose – but with power that extends beyond just speech and language development extending to objectively improved odds at survival for babies born at 37 weeks or earlier.
A 2013 study published in Pediatrics found that a parent’s lullabies or even just humming – gentle and rhythmic – played to the backdrop of low guitar strings reduced stress levels and promoted bonding, as evidenced by:
- Regulated babies’ heartbeats;
- Promoted longer, deeper periods of sleep;
- Improved weight gain;
- Shorter hospital stays;
- Better long-term cognitive development and function.
Down syndrome, the most common chromosomal disorder in the world, affects 1 in every 700 children, or about 6,000 annually, a figure representing a 30 percent increase since the 1970s, according to the CDC.
Our Fort Myers speech therapists routinely treat children with Down syndrome, who frequently experience challenges to speech and language development. At minimum, speech is usually delayed, though many can be taught effective sign language to help with communication the first few years and beyond.
Most children with Down syndrome can benefit from speech therapy
Exact challenges and goals for speech therapy often vary depending the severity of certain physiological traits inherent in those with Down syndrome as well as whether they have co-occurring other conditions (to which they are prone) like hearing and vision problems, epilepsy and autism.
Early Intervention Speech, Occupational, ABA Therapy Preparing Wave of People With Autism for Workforce
As rates of autism diagnoses climb steadily, roughly 500,000 teens with autism are poised to enter the workforce over the next decade, according to advocates at Advancing Futures for Adults with Autism. Yet the majority of those people with autism struggle to land their first job, and 4 in 10 won’t work at all in their 20s. The spectrum is incredibly broad, so each comes to the table with their own strengths and challenges, but there is no question those who receive early intervention ABA therapy, speech and language therapy and occupational therapy fare much better long-term.
Last year, the U.S. Centers for Disease Control and Prevention updated autism prevalence rates by 15 percent to 1 in 59 children. That’s more than double what the rate was in 2000. Part of this has to do with improved awareness, earlier diagnoses and improved treatment models. Research published in the journal Frontiers in Public Health indicated early diagnosis (before 24 months, as early as 12 months) leads to earlier eligibility for intervention services (like ABA therapy), and other evidence-based research has indicated clear indication early intervention is causally related to better prognoses – including success in education and employment.
The AFFA reports that while most adults with autism want to work, fewer than 60 percent can land a job. The Americans With Disabilities Act prohibits employment discrimination on the basis of disability. Yet an adult deprived of early intervention therapies as a child has missed out on a critical development window to address significant challenges associated with everyday function and independence. This isn’t to say it’s ever entirely “too late” to initiate intervention strategies, but our ABA therapy team members know it’s most effective when it starts before age 5 (and the earlier the better).
Premature babies (aka “preemies”) born earlier than the 37th week of pregnancy, are more likely to survive today even compared to the 1990s – and they are more likely to have less severe disabilities. That’s according to research published in the British Medical Journal. Globally, about 15 million babies every year are born before the 37th week, placing them at higher risk for conditions like cerebral palsy, delayed language, speech and motor skills. Study authors further concluded preemies who receive early intervention therapy have a much better chance of catching up to their peers.
Preemies are already starting out behind the curve. The earlier a baby is born, the higher the risk of serious illness and disability. The U.S. Centers for Disease Control and Prevention reports preemies who survive those early weeks and months in the NICU (neonatal intensive care unit) may still struggle with breathing trouble, intestinal/digestive problems (including feeding and swallowing) and developmental delays. About half of all children born more than eight weeks early or at a very low birth weight develop problems with language, learning and executive function.
As our FOCUS Fort Myers therapy team can explain, early intervention therapy involves a combination of separate but interrelated services, tailored to meet the specific needs of each child, with the core aim of helping a child develop skills that will allow them to reach their full potential. This generally includes some combination of speech and language therapy, feeding therapy, occupational therapy and physical therapy. Although many preemies benefit from this therapy up to age 5 and sometimes beyond, commitment to therapy now reduces the struggles preemies will face down the road.
Our FOCUS Fort Myers speech therapists must admit: We were a little heartbroken upon learning there would be no more Sweethearts Conversation Candy Hearts this Valentine’s Day (MISS U!). In addition to the fact they can be used in a bunch of fun kids’ speech-language therapy exercises, we had a great idea for a special speech therapy line: TALK 2 ME. I LUV SPCH. WORD UP. LETS LINGO. I HEAR U. SLPZROCK. Not to worry, though – our speech therapists have other ways of making you talk…
In the spirit of spreading the love (despite being candy heart-less), our speech therapists are sharing some of our favorite positive affirmations for kids. Positive affirmations are the kind of declarations that go a step beyond praise and shine a light on something that is special and inherent in that child. Instead of simply, “Nice work!” we say, “You are a hard worker!” Instead of, “Good job on that one!” we say, “You are so brave to try new things.” Rather than just, “Cool picture!” we might say, “You have such a creative mind!”
Praise and compliments obviously are great too, but positive affirmation is more specific. It shines a light on something that is both inherent and special to that person. It acknowledges the challenge and validates the effort. Positive affirmation can help a child gain the confidence to keep going – even when it gets hard. Research shows that children who receive regular positive affirmations will believe, internalize and be motivated by it. In speech therapy, we often see them excel farther and faster.
The positive affirmation boost is backed by extensive research. One analysis published in the Annals of Behavioral Medicine found that children with cancer who practiced self-affirmation were overall more optimistic and coped better, achieved goals faster and ultimately had better health outcomes. Another study by psychology professors Carnegie Mellon University found that when people are under pressure, they can actually improve their ability to problem-solve by using positive self-affirmations. And a brain scan study published in the journal Social Cognitive and Affective Neuroscience established that people who practice self affirmation had higher activity levels in areas of the brain associated with reward.
Many of our FOCUS pediatric speech therapists were initially drawn to this field in part because we share a love of language. Sure, some of us are self-professed grammar nerds and logophiles, but in working with kids with special needs, we’ve seen that the real beauty of language is the way it facilitates communication and sparks connections. That’s a universal truth of language, but in helping children overcome speech delays, receptive language deficits or phonological disorders, we’ve come to appreciate language on a whole new level.
In stacking the developmental blocks for communication, social interaction and connection, one of the best (and easiest) things any parent can do: Read bedtime stories. This is especially true for kids with special needs, for whom language doesn’t come easily. Frequent storybook sessions help children learn new words, recognize the importance and subtle differences of tone, inflection and pitch, explore complex feelings and confusing interactions in a safe space and better grasp the intricacies of the world around them.
Most children – even if some have shorter attention spans – love bedtime stories. (Although story time can be anytime, bedtime is ideal – especially if you’re child is antsy – because you’re more likely to have a captive audience just before bed, as opposed to morning or mid-day, unless they still nap. Plus, many parents who work find it difficult to nail down a story time routine in the morning rush or simply can’t swing it on their lunch hour.) Making stories-and-snuggles part of the nightly groove works best for most, gives kids something to look forward to and a chance to wind down. And, as most parents of kids with special needs know, having a routine is a lifeline.
Even if your child doesn’t seem to understand the stories, follow along or pay much attention, research shows they still glean advantages from the one-on-one time, routine and mental exercise. Most speech, ABA and occupational therapists would argue children who struggle with expressive and receptive language skills may even need those bedtime stories more than most.