Speak Out June 2020

their appointments. This quickly changed to 100% telehealth the following week. “I had honest conversations with clients around symptoms and risks. Most families, especially our immune compromised clients were so supportive about the changes. But some families questioned me as their other therapists were not moving as fast and suggested that it is just a “flu”. They asked if they could instead visit my house if I closed the clinic or could I come to their house like their other therapists?” “Telehealth brings it challenges for anyone – both experienced and new clinicians. We got parents to send in assessment videos of their kids eating that we viewed together (sharing the screen for our supervision Zoom meetings), we took videos of my own kids and sent them to clients (so parents knew how to take footage for a feeding assessment, use a chewy oral tool, new feeding strategy etc). Videos became the new tool we used to manage new clients and current clients – it worked brilliantly!” “We moved from an entire face to face practice to a 100% telehealth in the span of a weekend and some families will stay this way moving forward. It was wonderful to see how much older kids loved making dinner for their family and for younger primary kids, how relaxed (instead of looking so tired after school doing therapy) they were making breakfast or an afternoon tea snack in their own kitchen. It really helped build their cooking self-care skills in their own kitchen!” “We now have new clients from all around Australia, the silver lining is that this process has given me confidence that we can continue to support kids with their feeding difficulties in all areas, not just Newcastle and the surrounding region. I think I will always prefer to at least meet the families for the initial assessment in person, there are some finer details around swallowing that I don’t think you can get over Telehealth.” “Telehealth taught us one really important lesson that we will take and move forward – the value of parent coaching. We were already doing it with some of our families but through the social isolation time, the families that coped the best with mealtimes and feeding therapy were the ones who were coached in sessions prior to COVID especially for the families with kids who have ASD (level 3). So parent coaching is now mandatory for every family, it is essential that we build a parent’s confidence and ability to problem solve with feeding issues that crop up from day to day. “The one thing I didn’t anticipate was the exhaustion of telehealth for us and for the parents of our clients. I have been doing clinical sessions all of my life so moving it all to sitting in front of a computer really pushed eye strain and headaches for me. My patients (their parents) also had a lot more prep pre sessions with games that I sent them prior to set up and food prep so we were ready to go when the session started – they were all such troopers! But at the end of the day, we were all safe and worked through something that we have never had to do before – what an achievement! And how strong and close did we all become as a profession both nationally and internationally. I am proud to be a speech pathologist.” Carly Veness Babble and Munch Speech Pathology, Melbourne “About 80-90% of our clients made the transition to Telehealth, and for many of them it has been a successful way of working, or a different way that is still meeting similar needs using new methods. Some clients preferred to wait until face-to-face services resume. Other clients have been able to access our service via Telehealth where they wouldn’t have been able to without that option.

“Telehealth has been very successful and we found a number of positives. We have families who would usually travel from all around Melbourne, Victoria and even interstate to attend our service, now we can reduce travel time and also potentially offer a service from anywhere in Australia that has internet access. As we work in the clinic setting, it has been lovely to participate remotely in home mealtimes and also to meet a lot of new family members who are also working from home (who could also join in therapy). Some children and families have even found the switch to Telehealth as more successful for them than face-to- face services. “We completed a risk evaluation for our client group, and the majority of our work could be considered ‘higher risk’ for droplet/airborne transmission of virus particles. This work would be difficult to do with full social distancing precautions to best prevent the risk of coronavirus spread. While we already worked with a very high level of infection control precautions in the clinic before COVID, many of our therapies would be impractical to carry out face-to-face with the degree of PPE that would be recommended at this stage to protect all involved (the children, families, staff and our community at large). We also work with a number of children with compromised immune systems or other cardiorespiratory conditions who we very much wish to protect. Finally, some of our staff also work in hospitals with vulnerable babies and children themselves, and prevention and protection against virus transmission goes both ways. We are going to continue to monitor the situation and make adjustments as needed, as everyone is doing. We all have individual decisions and considerations to make, even with similar types of therapy. With that said, we are all in this same uncertain, uncomfortable boat together! “The longer I run a private practice, the more I learn about resilience! Navigating a business through the COVID pandemic has certainly been an extreme exercise in resilience, taking deep breaths, and also learning to ‘let-go’ of the things that may be less important and being okay about that (or trying to be!). I have also enjoyed the slower pace of working from home. “The silver lining of the COVID pandemic for Babble & Munch is that we have developed a Telehealth service that we have used with babies and children from 3 weeks old and up! I’m excited by being able to offer this service to those who don’t live locally or don’t have access to a feeding therapy service in their area. We will definitely keep that way of working as an option for families.”

Silver linings While the pandemic has been tough for everyone it has enabled many people to reflect on personal attributes and find ways to better their practise and the service they can offer clients. Amelia Bayliss Lisa Forbes Speech Pathology, Sydney “One of the most wonderful discoveries has been how open and receptive many new and old clients have been. Working with adults who are in the older population

group, there is often a misconception that they might not cope with the technology component, but my experience has debunked that myth. I think it’s important to give everyone a chance even those who you think might not connect over telehealth.” “I dived into the research and resources available around telehealth so I could be better equipped with working in this arena. I completed

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June 2020 www.speechpathologyaustralia.org.au

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