In recent years, speech therapy has evolved to include a variety of approaches, each offering distinct advantages and certain drawbacks. In-person therapy allows clinicians to offer hands-on demonstrations and guidance, which can be particularly beneficial for clients who respond well to visual and physical cues. However, with technological advances, telepractice has emerged as a highly accessible and effective method for delivering therapy. Many clinicians are turning to hybrid therapy models that combine the strengths of in-person and telepractice approaches, offering a more comprehensive and flexible solution to meet diverse client needs.
One of the main advantages of in-person therapy is the ability for clinicians to offer hands-on learning and demonstrations (Kotlarek et al., 2022). In this context, clinicians can directly model techniques and provide practical guidance, which is particularly beneficial for clients who need visual and physical cues. This type of in-person interaction and feedback can be more difficult to replicate in telepractice, and this is one of the main reasons why in-person therapy can be highly effective for clients who benefit from these types of cues. Additionally, the controlled clinical environment of in-person speech therapy offers an advantage as it allows for direct observation and interaction, enabling clinicians to assess a client’s communication skills more thoroughly and tailor interventions accordingly. In a controlled environment, clinicians can observe the client in a consistent and predictable setting, minimising distractions that may occur in other environments. For example, a study by Kotlarek (2022) noted that environmental distractions were common during telepractice sessions, including noises and family members entering and leaving the room (Kotlarek et al., 2022). In contrast, a clinic provides a space where the clinician can carefully manage the environment, ensuring the client focuses on therapeutic tasks and the clinician can monitor and minimise external variables that might affect the client’s performance or progress (Hacker et al., 2022). Furthermore, a controlled environment can provide a sense of professional focus that can be beneficial for certain clients and allows for the use of specialised equipment without clients needing to have the appropriate technology or training at home (Bayati & Ayatollahi, 2021). This level of environmental control allows clinicians to have the most accurate information to assess client needs and make the best treatment decisions.
Telepractice is an effective and high-performing method of delivering speech therapy services, offering increased accessibility, better family participation, and clinical outcomes comparable to traditional in-person therapy. By eliminating geographical barriers and reducing travel, telepractice enables people living in remote areas to receive high-quality care (Behl et al., 2017; Erickson et al., 2022). It also promotes a family-centred approach by allowing caregivers to actively participate in therapy, which has been associated with improved intervention outcomes (Martínez-Rico et al., 2023; Dunst & Trivette, 2009). Telepractice allows therapy to take place in the child’s natural environment, which promotes greater skill generalisation and enables therapists to adapt interventions to real-world contexts (Retamal et al., 2022; McCue et al., 2010). Research has consistently shown that telepractice yields results similar to in-person therapy for various speech disorders, including stuttering, voice disorders, and aphasia (Theodoros, 2010; Cangi & Toğram, 2020). Furthermore, concerns about maintaining a therapeutic relationship in a virtual setting have been largely dispelled, with studies indicating no significant differences in clinician-client relationships between telepractice and face-to-face sessions (Winters, 2004). By combining accessibility, evidence-based effectiveness, and a flexible, family-centred model, telepractice constitutes a valuable and sustainable approach to delivering speech therapy services. Despite its many advantages, telepractice is not without challenges. While it improves accessibility and promotes family involvement, the absence of physical presence can pose difficulties in certain therapeutic contexts, particularly when direct interaction is needed, especially for young children. This lack of physical presence can hinder certain therapeutic techniques, such as physical prompts. To address this, therapists modify activities by using identical objects at both ends, incorporating a mix of auditory and visual cues, and adapting resources to maintain engagement (Ekberg et al., 2020). These adaptations help bridge the gap created by distance and ensure that telepractice remains an effective and interactive therapy mode.
A hybrid approach to speech therapy leverages the strengths of both in-person and telepractice methods, offering a balanced and effective solution for many clients. By combining these methods, hybrid therapy eliminates the limitations of each while maximising their respective advantages (Hassan, 2023). In-person sessions allow for comprehensive assessments, direct interaction, and the establishment of a strong therapeutic rapport, and they reduce the risk of technical difficulties (Kotlarek et al., 2022). Clinicians can use tactile methods and observe non-verbal cues more effectively, allowing them to provide immediate feedback and adapt therapeutic techniques in real time. At the same time, telepractice sessions offer increased accessibility, flexibility, and convenience, making it easier for clients to integrate therapy into their busy schedules. Telepractice also allows for treatment in the client’s natural environment, promoting skill generalisation and increasing caregiver participation (Hacker et al., 2022). The hybrid approach allows these advantages to be combined: in-person sessions can be used for initial assessments, more intensive therapeutic work, and activities requiring physical interaction, while telepractice can be used for more frequent, shorter sessions that reinforce skills and provide ongoing support. This combination of methods can also help maintain a high level of treatment intensity while meeting the needs of clients and their families (Kotlarek et al., 2022). For example, in-person sessions can be used to accurately identify and target errors, while telepractice sessions can reinforce these skills in the client’s home environment.
In conclusion, the evolution of speech therapy through hybrid methods represents a significant advance in service delivery. By integrating in-person and remote practice methods, clinicians can overcome the limitations of individual approaches while maximising the strengths of each method.
References
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