Impact of COVID-19 on the speech and language therapy profession and their patients.

Introduction: The UK's response to the COVID-19 pandemic presented multiple challenges to healthcare services including the suspension of non-urgent care. The impact on neurorehabilitation professions, including speech and language therapy (SLT), has been substantial. Objectives: To review the changes to SLT services triggered by the COVID-19 pandemic with respect to referral rates, service delivery and outcomes, as well as examining the contribution of SLTs to the neurorehabilitation of COVID-19 patients. Methods: Two surveys were distributed to Royal College of Speech and Language Therapists (RCSLT) members exploring experiences of service provision at 6 weeks and 22 weeks after the pandemic was declared in the UK. Responses to closed-ended questions, including questions regarding referral numbers were analyzed descriptively and compared at the two time-points. A database comprising routine clinical data from SLT services across the UK was used to compare information on patients receiving services prior to and during the pandemic. Data on COVID-19 patients was extracted, and findings are provided descriptively. Results: Referrals to SLT services during the acute COVID-19 period in the UK were substantially less than in the same period in 2019. A number of service changes were common including adopting more flexible approaches to provision (such as tele-therapy) and being unable to provide services to some patients. Database analysis suggests fewer patients have accessed SLT since the pandemic began, including a reduction in neurorehabilitation patients. For those who received SLT, the outcomes did not change. SLTs supported a range of needs of COVID-19 patients. Treatment outcomes for COVID-19 patients with dysphagia were positive. Discussion: The pandemic has affected neurorehabilitation and SLT services broadly: referral patterns are different, usual care has been disrupted and interventions have been modified affecting the impact on patient outcomes both positively and negatively. Some patients with COVID-19 require and benefit from SLT intervention

Improving efficiency through innovation in the ‘real-world’: feasibility of a co-designed telehealth solution for individuals with aphasia

BACKGROUND: Research indicates that speech and language therapy for individuals with aphasia delivered via telehealth is acceptable and facilitates good outcomes. Although adoption of telehealth has increased following COVID-19, it has not been implemented broadly. Telehealth could assist services to meet the recommended intensity of therapy for individuals with aphasia. OBJECTIVE: The study aimed to investigate the barriers and facilitators to adopting telehealth for individuals with aphasia at two local NHS trusts; and to co-design a telehealth solution responding to these challenges. The feasibility of this solution was also investigated. A secondary objective is to highlight the value of real-world data (RWD) collection in evaluating clinical practice. METHODS: An experience-based co-design study was conducted, which developed and piloted a bespoke telehealth solution across service pathways at two NHS sites. Feasibility was evaluated qualitatively through interviews and quantitatively from RWD collected through the telehealth software. RESULTS: The telehealth solution incorporated outsourcing of the service to a specialist company, provision of hardware and software and regular support for individuals with aphasia and their carers. Take up was associated with a positive impact and the RWD revealed a substantial increase in the hours of therapy the individuals with aphasia received. CONCLUSION: Personalised telehealth solutions which respond to local and personal needs are feasible and an acceptable way to increase the intensity of speech and language therapy for some individuals with aphasia, bringing services more in line with evidence-based recommendations and optimising patient outcomes. Embedded RWD collection systems are valuable for evaluation

Amplifying the voices of underrepresented speech-language pathologists: A scoping review using the transformative research paradigm.

Purpose: To investigate the characteristics of studies that included underrepresented speech-language pathologists (SLPs) as research participants. Method: A scoping review was conducted using the principles of the transformative research paradigm, which promotes the meaningful involvement and empowerment of marginalised groups. Co-production with minority SLPs was facilitated. The search strategy was run in six databases, and the transformative checklist used for analysis. Result: Twenty studies were included. Bilingual and male SLPs were among the most commonly included underrepresented SLPs. Most studies were conducted in the USA (n = 16), and used survey methods. The studies provided valuable insights into the experiences and practices of underrepresented SLPs, and yielded practical solutions to foster inclusion and diversity in the profession. Most studies demonstrated a transformative potential, but the active engagement of underrepresented SLP participants in the research cycle was rarely demonstrated. Conclusion: This review calls for a shift in how and why research is conducted when including underrepresented SLP participants. Through the lens of the transformative research paradigm, we can rethink the broader aim of research and the role of researchers and participants. Using research as a platform to give visibility, voice, and agency to minority groups can stimulate change and equity in the profession

Editorial Perspective: Speaking up for developmental language disorder - the top 10 priorities for research

Developmental language disorder (DLD) is one of the most common neurodevelopmental conditions, yet is chronically underserved, with far fewer children receiving clinical services than expected from prevalence estimates, and very little research attention relative to other neurodevelopmental conditions of similar prevalence and severity. This editorial describes a research priority-setting exercise undertaken by the Royal College of Speech and Language Therapists, which aims to redress this imbalance. From consultations with researchers, practitioners and individuals with lived experience, 10 research priorities emerge. Our goal is to share these priorities with the wider research community, to raise awareness and encourage research collaboration to improve outcomes for young people with DLD

An evaluation of speech and language therapy services for people with long COVID in the UK: a call for integrated care

Purpose Long COVID is a complex and highly heterogeneous condition with a variable symptom profile, and calls have been made for an integrated care approach to be taken for its management. To date, no studies have explored speech and language therapy services or needs associated with long COVID. This service evaluation aimed to gauge the level of demand on speech and language therapy services for individuals with long COVID in the UK; their clinical needs, the organisational arrangements of services and the barriers and facilitators of delivering quality care. Design/methodology/approach A service evaluation was undertaken via distribution of an online survey to speech and language therapists (SLTs) receiving referrals for individuals with long COVID. Analysis was completed using descriptive statistics, with thematic analysis to evaluate qualitative data. Findings One hundred and eleven SLTs responded. Eighty-six percent were seeing individuals with long COVID in their “everyday” service, in uni- or multi-disciplinary teams, without any “dedicated” resource. Dysphagia and dysphonia were the most reported symptoms. Most respondents (66.7%) indicated the individuals they were seeing were of working age, and that an individuals' speech and language therapy needs were impacting their wellbeing. Perceived barriers to quality care included fragmented and non-integrated care pathways. Multi-disciplinary and integrated working was a key enabler. Originality/value This study provides novel insights into the current speech and language therapy needs of and care pathways for individuals with long COVID in the UK SLTs have unique expertise and are integral to supporting individuals with long COVID and should be a part of integrated care teams

How is routinely collected data being used in allied health research? A scoping review protocol.

Abstract Background Many areas of allied health are impacted by a paucity of research that is translatable to clinical practice. Research utilising real-world data, such as routinely collected patient data, may be one option to efficiently create evidence to inform practice and service delivery. Such studies are also valuable for exploring (in)equity of services and outcomes, and benefit from using non-selected samples representing the diversity of the populations served in the ‘real world’. This scoping review aims to identify and map the published research which utilises routinely collected data. A secondary aim is to explore the extent to which this literature supports the pursuit of social justice in health, including health inequalities and diversity and inclusion. Method This review utilises Arksey and O’Malley’s methodological framework for scoping reviews (Arksey & O’Malley, 2005) and draws on the recommended enhancements of this framework to promote a team-based and mixed methods approach (Westphaln et al., 2021). This includes searching electronic databases and screening papers based on a pre-specified inclusion and exclusion criteria. Data relevant to the research aims will be extracted from included papers, including the clinical/professional area of the topic, the source of data that was used, and whether it addresses elements of social justice. All screening and reviewing will be collaborative and iterative, drawing on strengths of the research team and responsive changes to challenges will be made. Quantitative data will be analysed descriptively, and conceptual content analysis will be utilised to understand qualitative data. These will be collectively synthesised in alignment to the research aims. Discussion This project aims to systematically map the extent to which routinely collected patient data is used in research to answer clinical questions, and to scrutinise the capacity of such studies to address issues related to social justice that may be overlooked in traditional research methods. Our findings will highlight the extent to which such research is being conducted and published, including gaps and make recommendations for future endeavours for real-world data studies. The findings from this scoping review will be relevant for practitioners and researchers, as well as health service managers, commissioners, and research funders

Amplifying the voices of underrepresented speech-language pathologists: A scoping review using the transformative research paradigm

Purpose: To investigate the characteristics of studies that included underrepresented speech-language pathologists (SLPs) as research participants. Method: A scoping review was conducted using the principles of the transformative research paradigm, which promotes the meaningful involvement and empowerment of marginalised groups. Co-production with minority SLPs was facilitated. The search strategy was run in six databases, and the transformative checklist used for analysis. Result: 20 studies were included. Bilingual and male SLPs were among the most commonly included underrepresented SLPs. Most studies were conducted in the USA (n=16), and used survey methods. The studies provided valuable insights into the experiences and practices of underrepresented SLPs, and yielded practical solutions to foster inclusion and diversity in the profession. Most studies demonstrated a transformative potential, but the active engagement of underrepresented SLP participants in the research cycle was rarely demonstrated. Conclusion: This review calls for a shift in how and why research is conducted when including underrepresented SLP participants. Through the lens of the transformative research paradigm, we can rethink the broader aim of research and the role of researchers and participants. Using research as a platform to give visibility, voice and agency to minority groups can stimulate change and equity in the profession

Amplifying the voices of underrepresented speech-language pathologists through research: A transformative scoping review

Purpose: To investigate the characteristics of studies that included underrepresented speech-language pathologists (SLPs) as research participants, to better understand the knowledge that was generated, the research processes that were used, and the extent to which they could enable empowerment of participants. Method: A scoping review was conducted according to the principles of the transformative research paradigm, which promotes the involvement of marginalized groups in ways that amplify their voices, value their knowledge, and address power inequities. Consultation and co-production with minority SLPs were facilitated. The search strategy was run in six databases, and the transformative checklist was used to analyse the studies. Results: 20 studies were included. Bilingual and male SLPs were among the most commonly included underrepresented SLPs. Most studies were conducted in the USA (n=16), and used quantitative survey methods to investigate SLP service delivery with disaggregation of data by SLPs with different attributes. Findings of the included studies provided valuable insights into the unique experiences and practices of underrepresented SLPs, and yielded practical solutions to foster inclusion and diversity in the profession. Most studies demonstrated a transformative potential, but the authors’ plans to achieve change were often unclear, and the active engagement of underrepresented SLP participants in the research cycle was demonstrated in only five studies. Conclusion: This review calls for a shift in how and why research is conducted when including underrepresented SLP participants. Through the lens of the transformative research paradigm, we can rethink the broader aim of research and the role of researchers and participants. Using research as a platform to give visibility, voice and agency to the minority members of our community can shape the evidence-base and inform tomorrow’s SLP practices, hence becoming an empowering mechanism to stimulate change and equity in the profession