It is through cooperation, rather than conflict, that your greatest successes will be derived.
~ Ralph Charell
Good things are happening to bring service providers to people in need. A news release this month reads: Saskatchewan Joins Provinces and Territories in Amending AIT (Agreement on Internal Trade)
"The changes to labour mobility ensure the qualifications of workers who have been certified in an occupation in one province or territory are recognized as equivalent by all other provinces and territories. As a result, workers will not face mobility barriers within Canada. The amendments affect all regulated occupations, including (but not limited to): health professionals, engineers, accountants and people working in the skilled trades." -http://www.gov.sk.ca/news?newsId=6a6dcb35-ac1c-4aac-8645-79538b82bfc3
With eliminating barriers in mind, on-line therapy services eliminate geographical barriers related to distance. Unfortunately, other barriers to service tend to arise. In my experience as an international service provider, there have been three common challenges to overcome when connecting speech-language pathologists with people in need of services.
Bandwidth is like a highway that enables high speed connections that are essential for real time, on-line interaction. A crowded highway is not favourable. Saskatchewan is a province that is taking steps towards bringing the world to its students.
In 2005, the Saskatchewan government announced that "... SRnet can support advanced network applications, such as high quality video conferencing, that the commercial Internet is too slow or congested to support." Consequently, students can access learning regardless of geographical location. "...kids in schools around the province will be able to participate in collaborative projects with schools in other countries so that they can share their similarities and come to appreciate their differences." -http://www.gov.sk.ca/news?newsId=22b43d7a-a2f2-490f-8f0b-5d73eeb2bc02
We frequently work with schools to help them access better bandwidth before starting on-line services.
2. Code of Ethics:
Even though telepractice is not new, the Code of Ethics from state and provincial regulatory bodies for speech-language pathologists do not provide consistent guidelines for improving access to services via telepractice. ASHA and CASLPA offer informative documentation for using telepractice; however, SLPs must adhere to their regional association's position. To date, one region has prevented on-line therapy despite 200 parents signing consent forms for their children to receive services. When injustice becomes law, resistance becomes duty - use your voice to stand-up for this generation of children.
Moving forward, this is a link to a position statement that supports telepractice when used in the best interest of the client:
In regards to supervision, another region defines direct supervision as a service that occurs when "The supervising SLP is physically present within the environment or virtually present via real-time videoconferencing. The SLP is able to observe the support person carry out the assigned/delegated activity and can provide immediate feedback, redirection, and modeling as necessary." - Page 13, ACSLPA PREFERRED PRACTICE GUIDELINES: Speech-Language Pathologists’ Use of Support Personnel to Augment Speech-Language Pathology Service Delivery,
These two guidelines are examples of how a regulatory body can serve to protect its region's residents, while enabling them to have access to excellent services.
More often than not, SLPs need to have membership in the association within the region where their clients are receiving the service. I have more than one membership because I serve children beyond where I live. Multiple memberships are expensive. For the most part, regions have been able to offer memberships to my team quite quickly, with the exception of one specific region. In this region, six months after initially applying, members of my team are having their applications returned to them because they had their fingerprints done on the wrong card - the card we were told to use! SLPs are waiting to help the kids, and the kids are waiting for help. Another challenge was that this organization would not accept an application from a wonderful SLP from out of country because she did not have a current social security number (she previously had one while a student in the region). When I explained that she would not be living in the country, but she was well prepared to serve the children via telepractice, it was explained to us that since there was a "line on the form" for a social insurance number, we had to provide one. She could not obtain one since she did not live in the country. Did you know that she earned her master's degree in that region? The SLP was waiting to help the kids - the kids were waiting for help. All this time, the school district has not received any applicants from SLPs who actually live there.
On a positive note, this is a link about an international agreement between SLP associations around the world: -http://www.asha.org/about/news/2004/QuadMRA.htm
Barriers or borderless? Preventing or providing? Apathetic or accessible? Conflict or cooperation? With all hands on deck, our collective contributions will yield a generation of engaged learners who would have the world within their reach - a world that could use their embrace.
Marnee Brick, MSc
Speech-Language Pathologist and Director of Speech Therapy
TinyEYE Therapy Services (Speech Therapy Telepractice)