Speech pathology can be provided effectively online through Telehealth (the use of telecommunications, such as video and phone calls). There is a growing body of research showing that Telehealth can be a successful and alternative way to provide speech pathology management, including for feeding assessment and therapy.
Babble & Munch Speech Pathology has expanded its services to include Telehealth for assessment, therapy and professional mentoring across Australia. Telehealth is also an important service in an ongoing health crisis like the COVID-19 pandemic, so as to continue to provide therapy to meet your child’s feeding and communication goals. It is important for children with feeding and communication difficulties that their services continue so as not to interrupt progress towards improvement.
Please Note: Babble & Munch Speech Pathology is only providing Telehealth services (no face-to-face services) for the near future due to COVID-19.
COVID-19 Telehealth Update: May 2020
Looking at our professional guidelines from Speech Pathology Australia and other professional bodies, almost all of the work we do at Babble & Munch with babies and children could be considered ‘high risk’ for exposure to ‘droplets’ that can transmit potential virus particles. We usually work up close with babies and children in and around their mouths, with eating food together, and with children who regularly sneeze and cough as part of their feeding and medical difficulties. This work would be difficult to do with full social distancing precautions to best prevent the risk of coronavirus spread. While we already work with a high level of infection control precautions in the clinic, many of our therapies would be impractical to carry out face-to-face with the degree of personal protective equipment (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 will continue to monitor the community restrictions, government and professional health advice, and community cases as we plan and adjust the path forward in our practice. This may look different to some other practices and to schools, as we consider our own practice circumstances and adjust as necessary. We want to thank you all for your patience and support through all these changes and wish you and your family a safe and healthy time.
Questions & Answers
How do we carry out feeding and communication assessment and therapy by Telehealth?
Telehealth can be used for initial assessment and therapy sessions for all ages (babies and children), and for feeding, swallowing and communication concerns. The main thing we cannot do as part of Telehealth is carry out a full oral examination (although we can do part of this remotely).
Telehealth can be carried out by phone, video sessions and email. For video sessions, a link to the online session will be emailed to you prior to your appointment.
Telehealth sessions can involve one of the below, or a combination:
- Video-call or phone session between parent/caregiver and speech pathologist to discuss progress and current difficulties, provide parent coaching and to develop a new plan (child does not need to be present at time of consultation for this type of session).
- Parent records photos/video of child or parent-child tasks (e.g. video of mealtime, video of therapy strategies at home, photo/video of assessment tasks provided by clinician) and sends this video to the speech pathologist. The speech pathologist then watches the video prior to the Telehealth session or watches with the parent during a video-call, before providing feedback, advice and a further plan as appropriate (child does not need to be present at time of consultation for this type of session).
- Video-call to both parent and child to carry out assessment and/or therapy, with the parent helping the child to participate in the session. This may involve setting up your tablet, laptop or phone to capture a child’s mealtime or therapy session implemented at home, under the direction of the speech pathologist. The speech pathologist may suggest some preparation you may need to do prior to the session (e.g. providing certain foods, toys or equipment). The speech pathologist may model certain therapy techniques, show you equipment from our clinic and it’s use, or interact directly with your child. Unless arranged otherwise, this is the usual Telehealth option that will be booked (child needs to be present).
- Email between the speech pathologist and parent to support the above sessions by providing session preparation or updates, handouts, therapy plans etc.
- A brief session summary emailed to the family after the session which includes the plan to continue at home between sessions.
What are the potential benefits and risks of Telehealth?
Many families have found Telehealth sessions to be very convenient, particularly during this COVID-19 crisis. As we have families who travel from all over Melbourne, Victoria and beyond, Telehealth has helped to increase access to our service and reduce travel times to zero! It also means that families from anywhere in Australia with internet may be able to access our services. Our speech pathologists who usually work in the clinic setting have found how beneficial it has been to participate in home mealtime and play environments, and some children and families have also been more comfortable with this method of ‘remote’ therapy.
There can be occasional issues with technology – usually these are able to be solved or worked-around within the session. Telehealth sessions also make it more difficult to carry out a complete oral examination and may make some treatment strategies a little more difficult to carry out (although you might be surprised by what we can do and achieve by Telehealth!).
Please see further details on the potential benefits and risks of Telehealth in our Telehealth Consent Form here.
How much does Telehealth cost?
Telehealth sessions are billed at the same hourly rate as our usual sessions (please contact our clinic for a Fee Schedule). Where shorter sessions are required (e.g. half hour phone review) we will bill in 10 minute increments for the time used.
The time we bill needs to include watching videos/reading email preparation prior to the session, time for the phone/video consults, and 5-10 minutes writing notes at end of session (this is part of our usual face-to-face session fee as our sessions are planned to finish at 50-55 minutes to allow time for writing notes).
We need to continue to charge for our time to provide Telehealth sessions in order to continue to provide our Babble & Munch services.
How is payment made for a Telehealth session?
You will be able to pay for your Telehealth session via credit card within the session (via a secure credit card facility) or via bank deposit. Payment is required on the day of service as per our usual terms. We will email you a copy of the paid invoice once payment is received. For any payment queries, you can talk to our reception team.
What rebates are available?
- NDIS self-managed funding – Telehealth is covered under NDIS and can be claimed back as per usual self-managed NDIS processes. We are not able to accept NDIS agency-managed or plan-managed funding.
- Medicare rebates – Telehealth for speech pathologists is temporarily covered under Medicare rebates for eligible children with a Chronic Disease Management (CDM) referral from the GP (please speak to our clinic and your GP for more information). Medicare CDM rebates are $53.80 per session (up to a maximum of 5 allied health rebates per year). Full payment for the session is required on the day of service and then the Medicare rebate can be processed back into your account.
- Private health fund rebates – Individual funds differ. Each family will need to confirm with their own health fund whether these services are covered under Telehealth. We are not able to process private health fund rebates through HICAPS for Telehealth and families will need to claim back directly with their health funds.
Is additional consent required?
What Telehealth program is used for client sessions?
We are currently using Coviu, a secure, Australian Telehealth program designed for the health system. We chose Coviu because of its security and privacy (e.g. end-to-end encryption), its additional features for therapy, and because it doesn’t require any additional app installation by families. A session link is emailed to the family on the morning of the appointment which they can access via their tablet, smart phone or laptop at the time of their appointment.