Increasing student services in speech therapy with digital technology: a reality at the CSS des Patriotes

By Josée Beaudoin, collaborator, Networked school

The pandemic has brought forward new ways of providing services to students in the public school system. Remote speech therapy has proven to be more than conclusive, making it possible not only to provide services but also to improve existing practices. At a time when waiting lists are stretching for school speech therapy, is the key at hand?

Kathleen Roy, speech therapist for more than twenty years in Montérégie, began her career as a violinist and teacher, graduating from the Vincent-d'Indy School of Music and the University of Montreal. She had to opt for a second career and chose to complete a bachelor's and master's degree in speech therapy afterwards. "Music and speech therapy have similarities in fact, it's about communication, language, voice too," she says.

Kathleen's leitmotif, like that of many speech therapists, is to help young people experiencing language difficulties as much as possible. Because these difficulties leave traces for life if they are not taken care of enough: learning disabilities, low self-esteem, strained social relations, isolation, behavioral problems to compensate for the difficulty in communicating, etc. And the arrival of the pandemic has amplified the urgency of offering these services to students, everywhere in Quebec.

Kathleen Roy, who was not particularly keen on the use of digital technology, quickly developed an approach for remote speech therapy, in the context where she had to be teleworking. She thought about the choice of tools, having to quickly appropriate other ways of intervening. “I got out of my comfort zone, that's for sure, but it was the right thing to do so that the services were accessible and met the needs of young people,” she explains.

The Center de services scolaire des Patriotes thus created a telespeech therapy service dedicated to schools where no speech therapist was present on the premises. This service, offered by Kathleen Roy, was operational five (5) days a week in 2020-2021, and it is still operational in 2021-2022 in addition to the services offered in person. It is a sort of one-stop shop for student assessment and follow-up services. Tools and platforms are used with online material. Kathleen Roy has developed totally remote work processes with students from 8 schools this year.

“Remote speech therapy has been done for a long time in the private sector, particularly in France and also in Quebec in private clinics. Why not introduce it into the public sector? I am originally from the Côte-Nord, where distances do not always facilitate the provision of services to students. Much more can be done remotely; every half hour or hour of travel for the speech therapist means reduced services for the students. »

Go further with students

The results observed are astonishing, not only in terms of service capacity, but also in terms of clinical effects. On the one hand, young people are receptive to this mode of intervention and their motivation is there. There is increased attention among students and the opportunity to devote more time to speech therapy exercises and follow-ups between meetings. 

On the other hand, and this is an aspect particularly noted by Kathleen Roy, remote speech therapy is an asset for going further with students because observation in the living environment makes it possible to improve the evaluation. The case of a very shy child in class made it possible in remote intervention from home (and with parents) to understand the origin of language problems more quickly and thus accelerate support for the student. 

The case of an autistic child made it possible to intervene much better in the remote link, by discovering that the child had much more potential, and thus to adjust the follow-up accordingly. And of course, we must not neglect the facilitated link with parents in remote intervention, which is much appreciated because it offers a lot of flexibility.

Kathleen Roy also stresses the importance of structures in support of remote practice. For the youngest students (kindergarten and first cycle), collaboration with the special education technicians (TES) was required so that they accompanied the student to the school premises provided to meet the speech therapist remotely, and can manipulate the computer if necessary. 

The mandate of the school speech therapist is to evaluate and support students, of course, but also to carry out prevention, promotion and collaboration activities, coaching and knowledge transfer to teachers. Remote practice saves time to devote to all of these roles, for the benefit of students.

What are the limitations of remote speech therapy, are there clinically restricted areas? For Kathleen Roy, it is certain that certain manipulations, such as the use of a tongue depressor, are not done in virtual mode. But she believes that one can imagine that the work of the school speech therapist could be done 70 % remotely and 30 % in person, which would ensure a quality and quantity of services to students much greater than what it is currently possible to do: "We are in a helping relationship, the young people need speech therapy, too many of them do not benefit from the services they need, we do not have time to take good care of them and that's dramatic. Digital is the solution to finally explode the services for them. »

An innovation to generalize

Kathleen Roy was able to adapt certain administrative processes to take account of remote intervention, whether it was session recording practices, parental consent forms or record-keeping tools. She tested videoconferencing platforms, online exercisers and learned to integrate such tools into her daily life. The leadership of the CSS (additional services, legal, technological, etc.) is crucial here to ensure the deployment of the required conditions. 

As Geneviève Lapointe, head of professional services at the CSS des Patriotes, points out, "Kathleen's initiative and the results achieved with telespeech therapy are major for our mission, it is essential for us to support such innovation and ensure its generalization on the scale of our territory. »

For Kathleen, the pandemic will have been a moment of significant professional growth, which provides a glimpse of solutions to the problem of the lack of speech therapy services in the public school system. Because as a speech therapy professional, one dream remains: that of eradicating as soon as possible the language problems that mortgage the adult lives of thousands of Quebecers.