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Supplemental material, sj-docx-1-jtt-10.1177_1357633X221074499 for Beyond forced telehealth adoption: A framework to sustain telehealth among allied health services by Emma E Thomas, Monica L Taylor, Elizabeth C Ward, Rita Hwang, Renee Cook, Julie-Anne Ross, Clare Webb, Michael Harris, Carina Hartley, Phillip Carswell, Clare L Burns and Liam J Caffery in Journal of Telemedicine and Telecare

Additional file 1. Interview questions.

Purpose: This study aimed to investigate the interrater reliability of pediatric feeding assessments conducted via synchronous (real-time) telepractice. Secondary aims were to investigate parent and clinician satisfaction.Method: The eating and/or cup drinking skills of 40 children (aged 4 months to 7 years) were simultaneously assessed by one speech-language pathologist (SLP) leading the appointment via telepractice and a second SLP present in the family home. A purpose-designed assessment form was used to assess (a) positioning, (b) development, (c) oral sensorimotor function, (d) prefeeding respiratory status, (e) observation of eating and drinking, (f ) parent–child interaction, (g) overall feeding skills, and (h) feeding recommendations. The telepractice SLP completed a postappointment satisfaction questionnaire, and parents completed five questionnaires specifically investigating perceptions of and satisfaction with the telepractice feeding appointment.Results: Agreement for all assessment components except intraoral examination (palate integrity and tonsils) was > 85%. All appointments were able to be conducted via telepractice, and for 90% of these (n = 36), clinicians agreed that telepractice was an effective service delivery method. Parents reported high levels of satisfaction with telepractice, with 76% reporting that the telepractice appointment was similar to a traditional in-person appointment.Conclusion: Study results demonstrated that synchronous pediatric feeding assessments conducted in family homes via telepractice were feasible, reliable, and acceptable to both clinicians and parents.Supplemental Material S1. Telepractice Assessment Form. Raatz, M., Ward, E. C., Marshall, J., & Burns, C. L. (2021). Evaluating the use of telepractice to deliver pediatric feeding assessments. American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2021_AJSLP-20-00323

Purpose: Access to speech-language therapy services for children with communication difficulties is limited in vulnerable countries within the Majority world, such as Small Island Developing States. The use of information and communication technology (ICT) has been identified as a possible solution to provide equitable access to services in Minority world countries. This study explored ICT-related conditions in remote schools of the Maldives, a Small Island Developing State, in order to identify potential service delivery approaches.Method: A mixed methods approach was used, involving (a) an online survey of 107 teachers, (b) observational data from four schools, (c) interviews with 31 teachers and the four principals of participating schools, and (d) 13 relevant online documents. Content analysis was used to analyze and integrate data from all sources.Results: Teachers’ access to ICT devices and fixed broadband Internet varied across schools. The government had limited funds to provide adequate fixed broadband Internet for them. However, favorable prospects were also discovered, including high access to 4G mobile broadband Internet in islands, high levels of confidence among teachers to use ICT, a variety of ICT uses currently employed by teachers, and the presence of financial aid for students with special education needs.Conclusions: The findings of the study support the potential for using mobile broadband Internet, available ICT devices, and teachers as agents of service delivery in remote schools to enhance speech-language therapy service delivery in the Maldives. The creation of relevant digital educational content for teachers could further support children with communication difficulties in the country.Supplemental Material S1. Teachers survey: sections related to this study. Supplemental Material S2. Education and ICT milestones and actions in the Maldives.Zahir, M. Z., Miles, A., Hand, L., & Ward, E. C. (2021). Information and communication technology in schools: Its contribution to equitable speech-language therapy services in an underserved small island developing state. Language, Speech, and Hearing Services in Schools. Advance online publication. https://doi.org/10.1044/2020_LSHSS-20-00100

Purpose: Alternative service delivery approaches are required to provide support for children with communication difficulties in underserved communities. Schools have a unique set of assets that can be utilized to provide this support. This study explored what the education sector and classrooms in the early years of schooling offer as support for children with communication difficulties in an underserved Majority World country, the Maldives. The objective was to identify opportunities to enhance support provided for these children.Method: A qualitative multimethod approach was used involving (a) 520 min of classroom observational data from four remote schools, (b) interviews with four special education needs teachers, and (c) an interview with a Ministry of Education official. Classroom observational data were analyzed using the Communication Supporting Classroom Observation Tool. Deductive content analysis was used to analyze the interview data.Results: The support system aimed to reflect the Inclusive Education Policy of the Maldives. The Ministry of Education official and teachers raised concerns regarding lack of allied health services such as speech-language therapy in schools. Teachers frequently used certain communication supporting interactions such as imitation in classrooms. Missed opportunities to enhance communication were observed, including limited use of some interaction features such as modeling language, limited planned opportunities for children to interact in class, and limited resources in the environment to develop communication in Grade 1 and 2 compared to preschool.Conclusion: Findings suggest building capacity among teachers and training teachers on identified classroom communication support areas to enhance support for children with communication difficulties.Supplemental Material S1. Interview guides. Supplemental Material S2. Support system developed by the Ministry to cater for children under their inclusive education policy.Zahir, M. Z., Miles, A., Hand, L., & Ward, E. C. (2021). Opportunities to enhance children's communication development at school in underserved communities. Language, Speech, and Hearing Services in Schools. Advance online publication. https://doi.org/10.1044/2021_LSHSS-20-00148

Purpose: Conducting and interpreting videofluoroscopic swallow studies (VFSS) is a complex, multi-dimensional task, requiring post-qualification training to develop knowledge, skill and competence. Speech-language pathology (SLP) managers must continually ensure staffs are adequately trained to deliver safe and effective VFSS services. However, VFSS training is resource intensive, variable in content and not consistently accessed universally. This study examined managers’ perceptions of a new VFSS eLearning programme and its impact on VFSS training and service delivery. The eLearning programme incorporated theoretical and procedural aspects of VFSS, accessed free of charge by speech-language pathologists working in a large public health service in Queensland, Australia. Method: Twenty-two SLP managers participated in semi-structured interviews, which were evaluated using inductive content analysis. Result: Four themes were identified relating to eLearning benefits: (1) design and content facilitated widespread uptake, (2) enhanced training opportunities, (3) increased clinical skill and workforce capacity and (4) benefits and efficiencies for SLP services. A fifth theme described contextual considerations for using the programme. Conclusion: This study contributes information about the benefits of eLearning for delivering consistent, accessible VFSS training, in a resource-efficient manner. Managers perceived the eLearning programme as a valuable resource to supplement practical VFSS training, to ultimately support VFSS service provision.