Seminar updated for delivery on 2nd April 2020. Presenter Dr Lucy Bryant (Lecturer in Speech Pathology, UTS Speech Pathology SPROUTS Clinic Manager). This is the second running of the free webinar. 300 registrations from Australia and overseas, across disciplines of allied health professionals and others.

1. UTS CRICOS 00099F
Speech Pathology Reaching Out at UTS
Dr Lucy Bryant
SPROUTS Clinic Manager
Lucy.Bryant@uts.edu.au
“Rapid Transition to Telepractice”
Experiences and Lessons from the UTS SPROUTS Clinic
(A response to the COVID-19 Pandemic) Updated 2nd April 2020

2. We would like to acknowledge the Gadigal People
of the Eora Nation upon whose ancestral lands our
campus and clinic now stand. We would also like to
pay respect to the Elders both past and present,
acknowledging them as the traditional custodians of
knowledge for this land.
Acknowledgement
of Country

3. Acknowledgements, Declaration, and Sharing
• This presentation was developed and delivered by Dr Lucy Bryant, Lecturer in speech
pathology at UTS, March/April 2020
• Dr Bryant and UTS do not have any financial interest in COVIU and do not receive any
financial benefit from COVIU or any other product mentioned in this presentation
• Proper attribution and acknowledgement of resources developed by staff and students at
UTS (as on resources) should be preserved if materials from this presentation are shared
• This presentation was delivered for free in response to the COVID-19 pandemic impacting
on health sites and the provision of allied health services
• Please consider sharing any resources you develop for use during telepractice sessions,
so that other people can benefit at this extraordinarily difficult time
SPROUTS and Telepractice

4. Outline
Using Telepractice – The Evidence
COVIU and other Software
Help and Support
Assessment and Therapy Resources
Facilities and Hardware
SPROUTS and Telepractice

5. UTS CRICOS 00099F
Using Telepractice:
Some Evidence
SPROUTS and Telepractice

6. Telepractice in Allied Health
• Position statement and guidance from relevant national bodies
• Collated by the Centre for Research Excellence in Telehealth
https://cretelehealth.centre.uq.edu.au/policy-digest/position-papers
• Speech Pathology Australia
• Australian Physiotherapy Association
• Occupational Therapy Australia
• Services for Rural and Remote Allied Health
• Radiology, Pharmacy, Psychiatry, Pathology, Medicine, Surgery…
• Substantial and growing evidence that telehealth/tele-practice services are not inferior to
face-to-face sessions
SPROUTS and Telepractice

7. Telepractice in Speech Pathology
• Some evidence that some clients are more satisfied
• Australian Stuttering Research Centre at UTS – Current NHMRC research investigating
telehealth interventions
• Loads of research – voice, dysphagia, speech, language, AAC … it's time for speech
pathologists to implement!
• Let's stop talking about it, and just do it.
SPROUTS and Telepractice

8. Telepractice: stimulated by the COVID-19 Pandemic
• Useful during social distancing during the present pandemic
• removing the necessity of seeing the client in person;
• enabling services to continue when clinics close;
• reducing the number of people present in the clinic.
• Provision of services and its relationship to income and employment
• Your clients can receive a continuous service
• Access to new clients and new models of service delivery now and in the future
• Rural and remote
• Unable to travel
SPROUTS and Telepractice

9. Telepractice in Clinical Education: The SPROUTS
Experience
• It's easy to do – the clinical educator starts the call, and the student and client log in to
the same call.
• The client (teacher/parent), speech pathology student, and clinical educator in the call
can mute the audio and the camera.
• This means that the clinical educator on mute can observe while not being seen or
heard.
• Allows remote observation of the student's session, and growing autonomy.
• Allows collaborative service delivery, so the clinical educator can join the student in the
'online room'.
• The educator can jump into the session as needed to offer assistance and supervision.
SPROUTS and Telepractice

10. UTS CRICOS 00099F
Facilities and Hardware
SPROUTS and Telepractice

11. Physical Space for Telepractice
• Use the space you already have
• A clinic room
• An office
• At home - anywhere that is quiet, private and has a computer
• Consider a screen or blank backdrop without distractions
• Space demand is smaller – just you sitting (or standing) at a computer
• All your resources are online
• Where they can’t be online, use a document camera to show them
SPROUTS and Telepractice

12. The SPROUTS Clinic Space at UTS GSH – 100 Broadway
SPROUTS and Telepractice
Large Clinic Room Small Clinic Room Reception Area

13. Hardware for Telepractice
• A computer with a webcam and a microphone
• We use a standard HP laptop
• Clients use similar laptops
• Could also access using a tablet computer if needed
• We sometimes use a second monitor and split screen configuration
• Connect second screen with a VGA or HDMI cable
• In “display settings” – change to split screen
• Allows us to use a shared screen and see it and the client at the same time
(typically when sharing a screen in a video call, you can only see one or the other)
SPROUTS and Telepractice

14. Supporting others (colleagues, clients):
Tips to 'move to online' for sessions
• This presentation includes resources that will help you to teach your colleagues
• Use the resources as needed to show your clients (have a practice run)
• Clients need Internet and computer + reassurance: "we can troubleshoot to help you"
• Provide a handout to clients - picture + written guides "follow these steps to connect"
• Have a phone back-up connection to ring and help to "get back online"
• Teach tech 'operational competency' and 'strategic competency' + resilience
• Planning for steps to take if connection is lost
• Draw upon the motivation and benefit of (a) not travelling, and (b) being able to self-isolate.
SPROUTS and Telepractice

15. UTS CRICOS 00099F
Telehealth Software used
at SPROUTS
SPROUTS and Telepractice

16. Why ?
• Chosen for privacy, strong tech support, and ease of use
• Created within the CSIRO through research into telehealth
• Fully compliant with Australian privacy principles
• Encrypted software to ensure confidentiality and privacy
• All call content (video and audio) is encrypted
• AWL servers located in Sydney
• For more information https://help.coviu.com/en/articles/412368-privacy-security-of-data
SPROUTS and Telepractice

17. Internet Requirements for - Bandwidth
• Connectivity – requires a sustained internet connection – For you AND your client
• Scalable connection
Means the capacity of the call (available bandwidth) will vary depending on what is
available
• A minimum bandwidth of 700Kbps upload and download to establish connection
• COVIU will use a maximum bandwidth of 1Mbps if it is available
• Minimum bandwidth of 350Kbps to hold a quality video call**
** For a 2-party call. Add an extra 350Kbps upload & download per additional caller
SPROUTS and Telepractice

18. Internet Requirements for - Data Usage
• Based on a 3-person call (client, CE and student SP)
• At maximum bandwidth
30-minute session = 675 MB
60-minute session = 1.35 GB
• A minimum bandwidth
30-minute session = 237 MB
60-minute session = 473 MB
SPROUTS and Telepractice

19. How to Access for Sessions
• Clinics will need a license – See the COVIU website
(starting at $19.95 per user per month)
• Clients don’t need any special software – runs through the web browser
• An email is sent to clients with a customisable link
• Clients MUST use Google Chrome
• Device doesn’t matter (phone, tablet, laptop), as long as it is the Chrome browser
• Feedback from clients has been very positive
SPROUTS and Telepractice

20. How to Access for Clients
SPROUTS and Telepractice
• After accessing the room link
• Client will “join as guest”

21. How to Access for Clients
SPROUTS and Telepractice
Position the client’s face here.
Make sure the webcam is
working.
Click here to take the
photo. This is
compulsory to enter the
therapy room.
Enter the client’s
name here.
• Client takes a headshot
The client must take a photo.
This is a security feature so you
can see who is joining your call
It does not save
Some will block the camera
• Enters name
Additional layer of security so
you can see who is logging-in
• Then clicks “continue”

22. How to Access for Clients
SPROUTS and Telepractice
• Client directed to online waiting
room
• Customisable wait music (from
existing options only)
• Client waits here for the clinician
(as they would in a physical
clinic)
• The client can dial in at any time
(no restriction on how early)

23. How to Access for Clients
SPROUTS and Telepractice
• A newer feature of COVIU
• Client is asked to acknowledge
• That video is a bit different to
face-to-face
• That tech problems might
occur
• They can exit a call if they
need to
• Consent is not recorded and
is asked for every visit

24. How to Access for Clients
SPROUTS and Telepractice
• Client name and image will
appear here
• “Accept” or “Decline”
Additional security – only people
you accept to the room can
enter your session.
• Will also ring to alert clinician
that client is waiting
This can be muted

25. How to Access for Clients
SPROUTS and Telepractice
• Client will enter once accepted,
and have a clear view of their
clinician

26. Some features of
Some things to look at during the demonstration…
• Share your screen, a document or a file
• Use a whiteboard as a shared creative space
• eLr – interactive Extra Language Resources
• Book sessions
• Take payments
• Customise for your clinic - branding
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27. : Other Information to Note
• You will need to register each user / team member / clinician
• It comes at a price – currently (Mar 2020) starting at $19.95 / month
• Each clinician receives their own virtual room (where they are admin and control who
enters)
• Shared rooms – limited available (but this may change to one per clinician)
Any person listed on the account can accept and decline guests
• Number of people per room depends on the account level you pay for.
SPROUTS and Telepractice

28. UTS CRICOS 00099F
Assessment & Therapy
Resources
SPROUTS and Telepractice

29. Requirements for our Sessions
• Presence of an adult / support person to set-up, supervise and assist
• No restrictions on who can access services via telepractice
We must adapt the purpose, function and strategy to suit their needs
• Using a document camera
• Client can use pencil function or arrow function to point where needed
• Scanning stimulus items is generally a breach of copyright
SPROUTS and Telepractice

30. Assessments
• Online versions of some tests through Pearson Q-Global
• Limited tests available
• Language - CELF-5, PPVT 4 & 5, EVT 3
• Cognitive assessments
• Using a document camera
• Client can use pencil function or arrow function to point where needed
• Scanning stimulus items is generally a breach of copyright
SPROUTS and Telepractice

31. Assessments – For Younger Children
• Need for creativity in terms if the assessment types used
• Observational assessment – have the parent set up the computer to view a play space
• Language Sampling Analysis / Speech sample analysis
• Utilising the parent or a supportive adult during the assessment process
• You may need to meet briefly beforehand to instruct the supporting adult as to the role
they will play
SPROUTS and Telepractice

32. Adapting for COVIU
• Flashcards and games
• Create in PowerPoint
• 1 card per slide
• Save as a PDF
• Allows easy progression through items
• Allows client to draw on pages to interact
• Select, draw, add, erase, type
• Some interactive element is key to engaging the client
SPROUTS and Telepractice

33. Creativity and Design for Therapy
• Come student favourites
• Flash cards
• Board games – race to the finish, snakes and ladders
• Noughts and Crosses
• Complete the picture (Mr Squiggle-style)
• Active games and movement – to “wake up the brain”
• Simon says
• Dancing or stretching
SPROUTS and Telepractice

34. Creativity and Design for Therapy
• Some examples
• Flash cards
• Board games – race to the finish, snakes and ladders
• Noughts and Crosses
• Reading and listening comprehension activities
• Speech sounds and minimal pairs
• Assembling S-V-O sentences
• Visual schedules to help the client through the session
SPROUTS and Telepractice

35. Sharing a Screen
• Note that the client can VIEW your shared screen, but cannot interact with it
• Any web apps or games are generally not interactive
• Using an iPad as a second screen allows you to draw / use the touchscreen to annotate
• Apps like Duet Display, Apple SideCar, Slapshot Wired XDisplay
• Use something like the Microsoft Edge web browser to annotate a PDF
• Zoom allows you to share an iPad screen and iPad apps
• Select the iPhone/iPad option under Share Screen
• You will need to enable screen mirroring on your i-device – Instructions here
SPROUTS and Telepractice

36. For Adult Clients
• Sharing documents – that provide explanation
• Using the whiteboard for orthographic cuing
• Screenshare for video examples
• Similar strategies for picture cards, written information, stimuli as with children
SPROUTS and Telepractice

37. UTS CRICOS 00099F
Help & Support
SPROUTS and Telepractice

38. Some Interesting Blog Posts from COVIU
• Allied health telehealth reimbursements
https://blog.coviu.com/2020/03/09/what-telehealth-rebates-exist-for-allied-health-
practitioners/
• Telehealth usage in speech pathology
https://blog.coviu.com/2020/01/08/is-your-speech-practice-ready-for-2020/
• 5 step guide to marketing your digital practice
https://blog.coviu.com/2019/03/19/how-to-market-your-digital-practice-in-5-easy-steps/
• Coronavirus and telehealth
https://blog.coviu.com/2020/03/03/telehealth-keeping-healthy-people-safe-during-
coronavirus-outbreak/
SPROUTS and Telepractice

39. Where to go for Help from COVIU
• COVIU support
Website online chat
https://help.coviu.com/en/
• COVIU Frequently asked questions
https://help.coviu.com/en/collections/88269-faqs
• COVIU provides a course:
https://coviuacademy.thinkific.com/courses/speech-pathologists-a-complete-guide-to-
embracing-telehealth
SPROUTS and Telepractice

40. Some Evidence for Telepractice
• Evidence resources for telepractice from The Informed SLP
https://www.theinformedslpmembers.com/free-telepractice-research-reviews
• Position Statements on Telepractice
https://cretelehealth.centre.uq.edu.au/policy-digest/position-papers
• Try Google – Telepractice in Speech Pathology (or your discipline)
SPROUTS and Telepractice

41. Resources from UTS
• Some examples available to you from the SPROUTS Clinic students
• Email Bronwyn.Hemsley@uts.edu.au for a link to the Cloudstor for additional download
materials
SPROUTS and Telepractice

42. UTS CRICOS 00099F
Dr Lucy Bryant – SPROUTS clinic manager
Lucy.Bryant@uts.edu.au
SPROUTS and Telepractice