Is In Person or Virtual Better for Speech and Voice Therapy?
Is In Person or Virtual Better for Speech and Voice Therapy?
What the research says about online speech language pathology services
Over the past four years, the majority of speech-language pathology services shifted to a virtual delivery model to accommodate people’s health and comfort with in-person services. Speech-language pathologists (SLPs) have been using a mix of in person and virtual services for a long time. For example, at Toronto Adult Speech Clinic, we have been offering a telehealth voice therapy and speech therapy option since we opened in 2017. Although our clients reported many ways that this was a beneficial for them- it is true that traditionally, it has been thought that in person therapy is “better.” This has been felt to be true as the “norm” for many healthcare-related services. So, the sudden shift to virtual therapy understandably left some people feeling unsure about the efficacy of telehealth speech and voice therapy over in person services.
The best part of any sudden shift in a “norm” is that research often catches on. This was no different when it comes to comparing in person or virtual speech language pathology services. Prior to 2020, there were some studies being done on virtual voice therapy and speech therapy- enough to create a few clinical trials. Most notably, in 2015, a systematic review including approximately 70 studies relating to speech, language, and voice therapy services reported that in about 85% of the cases, telehealth service delivery had some advantages over non-telehealth (in person) services. This same collection of studies reported a variety of factors that influence the efficacy of services such as the quality of technology, training of speech-language pathologists, and of course the general comfort level and acceptance of virtual services by clients and clinicians. Since then, many more studies have reported similar findings for a variety of services from speech therapy, voice therapy, communication training with a wide range of populations.
This leads to the second best part of any sudden shift from a “norm,” which is that there is more exposure and experience with this change- especially if this is necessitated as the only viable option for a period of time as it was with many restrictions to in-person contact and masking for in person services. Exposure and experience when it comes to telehealth services created a better understanding and comfort that facilitated a short-term increase in access to speech and voice therapy. It also pushed researchers in speech, voice, and communication fields to spend more time investigating the benefits of virtual therapy, comparisons to in person therapy, advancements in technology, and the establishment of best practices for the field of speech-language pathology.
So what does the research say?
Benefits of Virtual Voice and Speech Therapy
Research over the last 15 years has identified some key benefits of virtual speech-language pathology services:
Increased access to specialists- clients are less limited by the geographic location of their clinicians. Speech-language pathologists are a regulated profession and our governing body allows us to be registered to practice anywhere in Ontario despite being located in Toronto. As a practice focusing solely on providing services to adults, offering virtual services has been reported as a huge benefit to our clients at Toronto Adult Speech Clinic. Clients no longer have to go into clinic spaces designed for children because it’s the closest physical location or work with clinicians who have a preference and comfort in working with younger populations. They also have more options to choose from: anyone in Ontario! This results in clients getting the best quality of speech and voice therapy for them.
Virtual therapy can be as effective (and sometimes more effective) as in person therapy- clinicians and clients report objective and subjective outcomes that are similar between in person therapy and virtual therapy. Not only are speech and voice goals achieved to a similar standard and satisfaction rate- people appreciate the increase in flexibility now that they don’t have to set aside travel time, parking, or pay additional fees for in-home/on-site services. With this increase in flexibility, adherence to certain areas of services such as voice therapy has also been observed to increase, which can improve overall outcomes from therapy. At Toronto Adult Speech Clinic, this has translated to our adult clients completing more sessions towards their goals and attending sessions more consistently. From our perspective, the recommendations we make based on literature and best practices about how to create the lasting changes our clients want are often easier to achieve. In essence- more flexibility creates more opportunities for our adult clients to implement consistent changes in a way that fits their unique schedules and needs.
Advancements in technology have created more safe, secure, and adaptable telehealth options- with the necessitation of access to telehealth platforms for therapy, technology has been developed to better meet the unique needs of online speech and voice therapy. There are more virtual options that comply with privacy standards that traditionally have been thought to only be possible in person. Standards and access to quality internet connections, audio settings for sounds beyond simple speech, and cameras in some places has also improved, making virtual calls run more smoothly and to a higher standard. Platforms like we use at Toronto Adult Speech Clinic like tasc.doxy.me have created opportunities to have secure virtual therapy calls without having to download software or constantly update a specific program. This makes it easier for people who are less-experienced with technology to access our services, while still being able to trust the security of their personal health information.
More research into the efficacy of virtual therapy has created standards of best practice across the field of speech-language pathology- as regulated healthcare professionals, all speech-language pathologists that deliver speech, language, and voice therapy services are held to a certain standard of practice by a regulatory body. In Ontario, this is known as CASLPO. Their role is to ensure the quality of our services and the safety of our clients. With a lack of the ability to provide our services in person for a period of time and more people delivering their services online, in 2020 CASLPO released a guideline of standards for virtual services based on research and evidence-based practice. You can read it here. Ultimately, this means that as a practice that uses virtual care, Toronto Adult Speech Clinic is adhering to the virtual care best practice guidelines to ensure our clients are receiving the highest standard of speech and voice therapy. And it means that this standard is evaluated on a regular basis (yearly) to ensure that our clients can trust that our virtual therapy is being implemented with the same attention to quality as our in person services.
As speech-language pathologists who take pride in the standard of care we provide to our adult clients, we continue to hold ourselves to our highest standard when it comes to our virtual care. Offering speech therapy, voice therapy, and communication training online is a great option for many people- and it’s also true that some people may simply prefer an in-person approach. Not everything different is “less than.” And in some cases, based on a client’s goals and lifestyle, virtual care may be the best option. Hopefully, articles like these can help better inform clients about the benefits of virtual therapy so they can get where they want to be with their voice and communication in a way that will truly work best for them- whether that’s in person or virtually (or a combination of both!).
If you want to learn more about our virtual care options you can read more here.
If you have any questions or would like to speak to a speech-language pathologist about how virtual care can support you with your goals, contact us.
