Technology learning

eHealth learning journey

The eHealth learning journey has been designed to help SLTs learn about eHealth.

It’s on the subject of ehealth and aims to give therapists an understanding of the range of technologies available to support practice (apps, telehealth and social media); to help you to plan how to implement these in a way which is safe and evidence-based; and to help you to use those technologies in line with rules around information governance and data security

Practice-based scenarios

Use practice-based scenarios to explore potential situations involving the use of communications technology.

They can be used to:

• Aid reflection
• Guide your thoughts
• Prompt discussion with your colleagues
• Form part of your CPD.

The following scenarios are relevant to the use of communications technology; the full list of scenarios can be found at Practice-based Scenarios:

• Apps with no evidence base (Download). During a session a parent proudly shows you an app they have downloaded and been using with their child. You do not think there is any clinical evidence to support the claims the app’s creators say it achieves. Also relates to: Evidence-based practice
• Confidentiality and tablet use (Download). Your trust has bought iPads but does not yet allow therapists to use them with clients. This is due to concerns about them possibly accessing patient confidential information. Also relates to: Duty of care; Information governance; Confidentiality
• Email attachments (Download). A parent has been emailing you video clips of their child in different situations, such as interacting with child peers, family members and out in public. What professional practice issues do you need to consider?
• Facebook. You learn that a local group of mums are talking about their SLT experiences on a Facebook group, sharing ideas and therapy experiences, you and other colleagues have been named. Some have been praised and others criticised. One of your colleagues wants to write a response.
• Facebook friends (Download). A teenage service-user who has high functioning autism contacts you through Facebook, asking to be your friend. You know that they suffer with anxiety and depression.
• Facebook privacy issues (Download). You are a member of a Facebook group for carers of people with selective mutism. You open the group pages to see there is a post from a parent about their child, a young boy, accompanied by his photo and where he is being treated. What do you do?
• Funding for iPad or other tablet. You have recommended an AAC app for the iPad for a child. An iPad with the AAC app has been loaned to the child on a trial basis. The trial has been successful. However, the app is only available for the iPad. The child’s parents have said they cannot afford a new iPad, but may be able to purchase a cheaper tablet. Also relates to: Technology for SLTs
• Incorrect advertising of services (Download). You come across a new website promoting a local independent speech and language therapy practice. The concern you have is that the two NQP therapists are advertising themselves as specialists in SLI, autism, dysphagia, cerebral palsy and stroke. What do you do?
• Skype request (Download).
• Recommended AAC app (Download). A family member would like you to recommend an AAC app they could use to communicate but you feel that this may be inappropriate given the severity of the patient’s communication difficulties and their cognitive deficits. Also relates to: Inclusive communication
• Review of AAC app use (Download). You visit a patient in their home to review their use of an AAC app. You discover that they have not been using the AAC app but that they have been enjoying using other functions on the iPad, e.g. listening to music, browsing the internet. The iPad had been loaned to the patient by the speech and language therapy department. Also relates to: Duty of care
• Screen time for children (Download). You are using an app with a child in a speech therapy session. The parent says that they do not wish for you to use the app, as they are concerned about the amount of time their child is spending in front of the screen. Also relates to: Evidence-based practice
• Twitter (Download). You’re using Twitter to share general links and information with SLTs from around the world. A parent/carer of one of your service-users asks you to re-tweet a petition against service cuts in your area.
• YouTube. There’s a highly vocal individual who purports that all social skills work for people with autism is insulting to the autistic community (it’s society that needs to be more accepting). They record regular blogs on YouTube and have named you as an example of the problem.

Frequently asked questions

• How can I set up a social media account for my service?
• Should I have separate professional and personal social media accounts?
• What privacy settings should we have on our social media accounts?
• How often should you update and monitor communications technology?
• Will the use of communications technology lead to therapists being contacted out of working hours?
• When is it appropriate to use social media to communicate with clients?
• How should text messages, phone calls, emails and other correspondence be recorded in clinical notes?
• Should you share personal mobile phone details with colleagues and service users?
• How should I respond to complaints or inappropriate posts on social media/via email?

How can I set up a social media account for my service?

• Read the RCSLT advice in Communications technology: establishing use, and take a look at the RCSLT Techipes.
• Speak to the communications team within your organisation for social media policies, advice and support.
• Speak to colleagues and other services that are currently active on social media to learn from their experiences.

Should I have separate professional and personal social media accounts?

Many therapists prefer to have a personal social media account and an additional professional or business account. This is one way of maintaining a boundary between work and personal life. It enables you to manage any inappropriate contact on a personal account, such as a service-user requesting to be your ‘friend’ on Facebook by, possibly, redirecting them onto the professional or service account.

If private therapists on Twitter use their accounts for multiple purposes, a disclosure could be useful, e.g. stating that any views or opinions expressed are their own and not their services.

What privacy settings should we have on our social media accounts?

Depending on the exact social media in use, there are various options for privacy settings. For example, on Facebook you can select who can join a particular group, or send messages to the whole group. Consider carefully the purpose of using of the communications technology before you set up the social media account, including the level of privacy needed.

Take into account:

• Who will be using the account within the service, and who the target audience and who other likely audiences might be.
• How often a moderator will need to check it.
• Who may use the social media to contact you, and what kind of messages they might want to communicate.
• What kind of information you might need to respond with.

How often should you update and monitor communications technology?

Due to the easy accessibility of communications technology, it is often expected that responses to communication will also occur quickly.

Many now assume emails are checked every work day. If this is not the case, it may be useful to have a disclaimer on your email signature stating your working pattern and possibly when a response may be expected. If you are out-of-the-office or on annual leave, an out-of-office message and details of who to contact in an emergency can be set up on your email account.

Some advise that, in order to appear active, Twitter accounts should be monitored at least daily and tweets sent around daily. Facebook pages should also be monitored daily, with posts at least weekly. Refer to, and if necessary set, your own service standards regarding checking and updating social media.

Comments and messages sent via social media may be viewed by potential service-users. Messages are easily forwarded on, or screenshots can be taken and shared. Consider responding to messages in date order, and be mindful about the content you include in your posts.

Will the use of communications technology lead to therapists being contacted out of working hours?

Communications technology often allows patients to contact services at a time that is convenient to them, therefore expectations about response times need to be consistently managed. Ensure that you/your organisation have clear guidelines about when messages are checked and responded to. Don’t initiate a conversation out of these hours, as this will suggest you are accessible at times when you are not.

When is it appropriate to use social media to communicate with clients?

Social media is a valuable method of communicating with a wide audience about relevant topics or issues. It can be used to share general information, such as tips and strategies, but should not be used for any matters that are confidential, including any patient-specific information.

How should text messages, phone calls, emails and other correspondence be recorded in clinical notes?

See Information Governance: record keeping.

Should you share personal mobile phone details with colleagues and service users?

Along with the HCPC and RCSLT guidelines and standards, consider the issues raised in the Professionalism section. Consider the most appropriate means of communication with service-users. If they ask for your personal mobile phone details, be prepared with other options for communication that you can offer.

Independent practitioners may wish to consider having separate phone numbers for professional and personal use. For professional discussions, colleagues should use secure technology, i.e. work telephones, email accounts, tablets etc. that meets information governance standards.

How should I respond to complaints or inappropriate posts on social media/via e-mail?

Complaints should be managed in the same way as a complaint in person or on the telephone, i.e. according to your organisation’s policy, and HCPC and RCSLT guidelines. This will normally include acknowledging the complaint quickly and giving a timescale within which the person will receive a fuller response.

If a complaint can be viewed by the public on social media, a brief response stating that you will contact the person privately with a fuller response should be posted. This will make other viewers aware that the post has been acknowledged and addressed by the organisation. Any discussions about specific incidents or cases should be carried out following the confidentiality and professionalism guidelines, and not on social media.

Inappropriate or abusive posts should be removed, if possible as soon as they are identified, with an explanation, if required, to the poster as to why it was inappropriate. If you cannot remove posts, e.g. in a forum, a message clearly stating the guidelines for posting should be repeated to all users to ensure appropriate use of the communications technology and continued engagement from other users.

Further learning

The internet has a wide range of resources to support growth of your knowledge and skills in technology. Information from websites and online forums, you tube tutorials and e-learning courses.

Speech and language therapists must be aware of the source of this content and how it is regulated to make an informed decision about using it to support their knowledge and skill base.

RCSLT technology basecamp is a forum for meeting other speech and language therapist interested in technology, sharing ideas and asking questions.

Contact Hubs@rcslt.org to get your login details.

Go to https://rcslt.basecamphq.com/login to log in.

RCSLT Research Centre develops SLTs’ skills to be able to access the evidence base related to using and measuring the efficacy of technology within their organisation.

RCSLT Study Day about using technology in practice, includes inspiring lightning talks from SLTs on how technology like apps and video conferencing are transforming the way they work.

SLT Learn an annual online event hosted by Pearson, featuring webinars and videos from professionals about a wide range of topics relevant to speech and language therapy. Access the SLT Learn 2016 recordings and the SLT Learn 2015 recordings which also featured a webinar from Speechbloguk entitled ‘Social Media: How can it help you as an SLT’.

Further reading

Communications Technology

Allen, Carolyn. (2011). The use of email as a component of adult stammering therapy: a preliminary report. Strathclyde University – discussion paper into her work using emails therapeutically.

Bowen, Caroline. (2014).Information & Communication Technology (ICT) Social Media and Speech & Language Therapy. ‘Mind the Gap’. Royal college of Speech and Language Therapists conference – provides an overview of the use of ICT and social media, as well as a focus on how Twitter is used by SLTs for professional purposes.

Chitwood, Luke. (2014). How to get more Twitter followers in 9 different ways (ethically).

Telehealth

ASHA: American Speech and Hearing Association.Telepractice overview. Overview of the American standards of practice in the field of telehealth.

National Centre for Hearing Assessment and Management, Utah State University. What is telehealth? Considerations when working with deaf and hearing impaired children in the early years.

Nuffield Trust. The impact of telehealth on use of hospital care and mortality. Evaluates the impact of telehealth on hospital use and mortality from the Department of Health’s Whole System Demonstrator pilots, believed to be the largest ever trial of telehealth.

Poole, H. et al. (2017). Keeping in touch (KIT):face to face with speech therapist via the internet – project evaluation. Liverpool Community Health NHS Trust.

RCSLT (2015) Journal review to investigate how S/LT feature in telehealth.

Speech Pathology Australia. Position statement: Telepractice in speech pathology. Overview of the Australian standards of practice in the field of telehealth.

General

Aphasiology. (2016). Issue 30. Entire issue devoted to digital technology and aphasia.

Fox, Martha Lane. (2015). Digital recommendations for the NHS. Discusses how to increase the take-up of internet-enabled services and tools in health and social care.

Lowenthal, Dominique. Team Scotland: stronger through technology. PowerPoint presentation which provides initial advice and encouragement for SLTs new to communications technology and examples of how these technologies are being used in NHS Dumfries & Galloway Scotland.

Online resources

Apps:

Aphasia-friendly resources, free resource library that contains an aphasia friendly guide to setting-up iTunes accounts, Apple IDs, downloading apps etc.

Aphasia software finder, includes information on apps that may be of benefit to people with aphasia.

Geek SLP, provides information on educational apps and technology.

Jane Farrell Consulting, information about AAC apps, including those with switch access.

NHS beta apps library. All apps submitted for review must pass a Digital Assessment Questionnaire to ensure quality.

The Knowledge Network for Scotland has a list of apps and mobile-enabled websites.

Child Development, 0-6 years (Jan 2014). The Northern Ireland Social Care Council issued information on a free new app for social workers, early years workers and parents. Find more on the Apple and Android versions of this app.

My Therapy: Provides reviews of apps, with the help of NHS specialists.

Speaking of apps, provides reviews of speech therapy apps for adults and children.

Swallowing Disorder Foundation, provides information on dysphagia apps for patients and clinicians.

Tactus Therapy, resources for apps for neurological rehabilitation and a blog with app tips and information.

Yapp Guru: provides a large number of reviews of therapy apps and educational resources.

Communications Technology/Telehealth:

RCSLT Techipes ‘how-to’ and information guides:

• Facebook
• GoToMeeting
• How to join a webinar
• Linkedin
• Skype
• Teleconference
• Twitter
• Videoconference – setting up and joining
• WhatsApp

General

CITCEN Toolkit, an online resource created by Speech and Language Therapists, contains advice, solutions to common problems and a range of resources.

Liverpool Community Health Device allocation.

ICO. (2014). Bring your own device (BYOD).

ICO. (2016). A practical guide to IT security.

ICO. (2016). Encryption.

ICO. (2012). Guidance on the use of cloud-based computing by organisation version 1.1.

ICO. (2014). Taking photographs in school: version 4.1.

Making cognitive connections, technology training to help those with cognitive challenges.

Speech Blog UK, two paediatric speech therapists provide blog reviews and links to other websites and useful information.

Speech Techie: looking at technology through a language lens, a speech pathologist’s view on apps for use in therapy and other related information.

Speech Therapy Living, provides app reviews and blog posts on topics related to adult speech and language therapy.

South Carolina Assistive Technology Program, resources for assistive technology.

The ASHA Leader Blog: the official blog of the American Speech-Language-Hearing Association, features many posts about apps by a variety of authors.

Videos and webinars

YouTube contains numerous videos demonstrating the use of iPads and apps in therapy. Many developers web pages also contain video demos and some training resources are available online. None of these have been officially accredited and should be evaluated using professional skills.

The topic of telehealth during the pandemic was included in the Northern Ireland Hub forum 2021. Watch the recording on YouTube and download the slides (PDF).

References

Boman, I.L. et al, (2010). Support in everyday activities with a home-based electronic memory aid for persons with memory impairments. Disability and Rehabilitation: Assistive Technology, 5 (5), 339-350.

Brandenburg, C. et al, (2013). Mobile computing technology and aphasia: An integrated review of accessibility and potential uses.

Aphasiology, 27 (4), 444-461.

Cicerone, K. D. et al, (2011). Evidence-based cognitive rehabilitation: updated review of the literature from 2003 through 2008. Archives of Physical Medicine and Rehabilitation, 92(4), 519-530.

Culley, C. & Evans, J.J. (2010). SMS text messaging as a means of increasing recall of therapy goals in brain injury rehabilitation: a single-blind within-subjects trial. Neuropsychological Rehabilitation: an international journal, 20(1), 103-119.

Cherney, L. R. (2010). Oral reading for language in aphasia (ORLA): Evaluating the efficacy of computer-delivered therapy in chronic non-fluent aphasia. Topics in Stroke Rehabilitation, 17 (6), 423-431.

Cherney, L. R., & Halper, A. S. (2008). Novel technology for treating individuals with aphasia and concomitant cognitive deficits. Topics in Stroke Rehabilitation, 15 (6), 542-554.

Choi, Y. H. et al, (2015). A Telerehabilitation Approach for Chronic Aphasia Following Stroke. Telemedicine and e-Health.

De Joode, E. et al, (2010). Efficacy and usability of assistive technology for patients with cognitive deficits: a systematic review. Clinical Rehabilitation, 24 (8), 701-714.

Des Roches, C. A. et al, (2014). Effectiveness of an impairment-based individualized rehabilitation program using an iPad based software platform. Frontiers in Human Neuroscience, 8.

American Speech-Language Hearing Association. (2011b). What to ask when evaluating any treatment procedure, product or program.

Apps for speech therapy, American speech therapist evaluates SLT apps and offers suggestions for their use.

Aptus speech & language therapy, includes posts on app-related topics and recommended apps.

Brady, L. (2011). Apps for Autism: An Essential Guids to Over 200 Effective Apps for Improving Communication, Behavior, Social Skills and More. Arlington, TX: Future Horizons, Inc.

Cann, K. (2015). Communication in a digital world. RCSLT Bulletin, June 2015.

Closing the gap, an assistive technology blog highlighting products, tools and strategies for individuals with disabilities.

Curtis, N. & Sweeney, S. (2012). APP-titude: App-enabled telepractice. The ASHA Leader, October 2012: vol 17 (online only).

Coppens, S. et al, (2016). The uniform evaluation of apps in education and speech and language therapy. Manuscript in preparation. (App Evaluation Chart)

Crawford, Stephanie & Phyllis S. Watson. AAC apps feature comparison. Web. 15 Sept. 2011.

Dunham,G. (2011). The future at Hand: mobile devices and apps in clinical practice: The ASHA Leader, April 2011; vol 16 (online only).

Dowds, M.M. et al, (2011). Toddlers and technology: teaching the techniques. The ASHA Leader, September 2011; vol 16 (online only).

Fernandes, B. (2011a). Embracing the need for revolution in education through iTechnology. Retrieved from https://www.geekslp.com/2011/06/embracingrevolution-education-itechnology/

Fernandes, B. (2010). Creative ideas to use the basic function of the iPhone or iPod Touch for speech therapy.

Fernandes, Barbara (2011). iTherapy: the revolution of mobile devices within the field of speech therapy. Perspectives. School-based issues.

Fernandes, B. (2011b). iTherapy: The revolution of mobile devices within the field of speech therapy. Perspectives on School-Based Issues, 12 (2), 35-40.

Finch, E. et al, (2013). Using computer-based therapy as an adjunct to standard anomia therapy. Journal of Clinical Practice in Speech Language Pathology, 15 (1), 2-6.

Geek, S.L.P. (2013). Assessing speech and language skills using the iPad.

Gentry, T. (2014). Mobile Technologies as Cognitive-Behavioral Aids. Perspectives on Augmentative and Alternative Communication, 23 (3), 148-156.

Golstein, R. et al, (2011). Electronic reminding technology following traumatic brain injury: effects on timely task completion. Journal of Head Trauma Rehabilitation, 26 (5), 339-347.

Gosnell, J. (2011). Apps: An Emerging Tools for SLPs: A plethora of apps can be used to develop expressive, receptive, and other language skills. The ASHA Leader. October 2011, vol 16 (online only), 10-13.

Gosnell, J. et al, (2011). Using a clinical approach to answer, “What communication apps should we use?” Augmentative and Alternative Communication, 20, 87–96.

Holland, A. L. et al, (2012). How to use apps clinically in the treatment of aphasia. Seminars in Speech and Language, 33 (3), 223-233.

Hoover. E.L. & Carney.A. (2014). Integrating the iPad into an Intensive Comprehensive Aphasia Program Seminars in Speech and Language, 35 (1), 25-37.

Howell et al, (2014). Disinfecting the iPad: evaluating effective methods. J Hosp Infect. 2014, Jun; 87 (2):77-83.

Joan Ganz Cooney Center (2014). Family time with apps a guide to using apps with your kids.

Kuster, J. M. (2012, April 03). Internet: in search of the perfect speech-language app? The ASHA Leader.

Kelly, H. et al, (2016). Narrowing the “digital divide”—facilitating access to computer technology to enhance the lives of those with aphasia: a feasibility study. Aphasiology, 30 (2-3), 133-163.

Kurland, J. et al, (2014). iPractice: piloting the effectiveness of a tablet-based home practice program in aphasia treatment. Seminars in Speech and Language, 35 (1), 51-63.

Mahendra, N. et al, (2005). Evidence-based practice recommendations for working with individuals with dementia: Computer-assisted cognitive interventions (CACIs). Journal of Medical Speech Language Pathology, 13 (4), 35-44.

Menger, F. et al, (2016). Aphasia in an Internet age: wider perspectives on digital inclusion. Aphasiology, 30 (2-3), 112-132.

Mill, C. (2012). iPads for communication, access, literacy and learning (iCALL). CALL Scotland: The University of Edinburgh.

Palmer, R., Enderby, P., et al, (2013). Using Computers to Enable Self-Management of Aphasia Therapy Exercises for Word Finding: The Patient and Carer Perspective.

International Journal of Language & Communication Disorders, 48 (5), 508-521.

Palmer, R. et al, (2012). Computer Therapy compared with usual care for people with long-standing aphasia poststroke: a pilot randomized controlled trial. Stroke, 43 (7), 1904-1911.

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Seminars in Speech and Language (2014), Issue 35, entire issue devoted to Apps.

Sidock, J.(2011). Critical review: Is the integration of mobile device apps into speech and language therapy effective clinical practice. Retrieved from https://www.uwo.ca/

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Sutton, M. (2012). App-titude: Apps to Aid Aphasia. The ASHA Leader, June 2012, 17, 32.

Sutton, M. (2012, July 03). APP-titude: Apps for Brain Injury Rehab. The ASHA Leader, July 2012, 17, 21.

Sutton, M. (2012). Apps for an Adult Speech and Language Therapy Toolbox. RCSLT Bulletin. February 2012.

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Sweeney, S. (2012). APP-titude: Apps That Crack Curriculum Content. The ASHA Leader, August 2012, 17, 44.

Szabo, G., & Dittelman, J. (2014). Using mobile technology with individuals with aphasia: native iPad features and everyday apps. Seminars in speech and language, 35:(1), 5-16.

Schaber, T. & Wakefield, L. (2011). The PICO template for reviewing speech language apps: a decision-making tool for SLPs.

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