Examining the perspectives of augmentative and alternative communication specialists on conducting evaluations with people with Amyotrophic Lateral Sclerosis via telehealth

Abstract

Purpose: To examine the perspectives of speech language pathologists (SLPs), who are augmentative and alternative communication (AAC) specialists working with people with ALS (pALS), on conducting SGD evaluations via tele-AAC vs in-person. Methods: Fifteen AAC specialists were assigned to watch videos of SGD assessments for eight pALS. The SLPs were provided with a checklist based on the AAC Clinical Assessment Project (AAC CAP) protocol that contained 17 different elements of an AAC assessment. The reviewers rated how comparable remote assessment was of each of the 17 elements to in-person evaluation and described any advantages or challenges with the tele-AAC assessment. Results: Across all 17 elements, most reviewers rated tele-AAC assessment as “same/comparable” to in-person sessions. From qualitative comments, the most common advantages that reviewers mentioned of tele-AAC assessment included that it was more functional, increased caregiver availability, and increased pALS’ comfort at home. The most common challenges identified by reviewers were technical difficulties and a limited comprehensive assessment due to the remote modality. In a follow-up survey inquiring about possible changes in attitudes towards tele-AAC following the COVID-19 pandemic, most of the same reviewers indicated that they had transitioned to remote service provision during the pandemic and would likely continue with a mix of in-person and telehealth services depending largely on patient preference and the SLPs own comfort and preference in providing telehealth. Conclusions: AAC specialists have found that conducting SGD assessments via tele-AAC is same or comparable to in-person evaluations with notable advantages and challenges. Tele-AAC should continue to be considered as a service modality for pALS.