We here at Abington Speech Pathology and RemoteSpeech are looking ahead with determination to meet the ever-changing and evolving landscape of the world of speech-language pathology. For over 20 years, we have worked to stay abreast of the latest trends of all things related to speech therapy, to adapt our services to the dictates of market demand with unique consideration for those that need us.
The launch of the Covid 19 pandemic in 2020 provided us with the unique opportunity to lend our consult to school districts nationwide, helping them to effectively adapt to an online learning environment using operational procedures, tactics, techniques, and technology that we had mastered over one decade earlier with the launch of RemoteSpeech.com. While we have come a long way in the last two years, we recognize that the challenges caused by Covid 19 are still present, with long-term implications that are still widely unknown.
To stay current on the latest developments of Covid 19 and its effects on speech-language pathology, we have highlighted some of the latest developments of our covid-reality below. This list includes applications for SLP in treating the effects of Covid 19, market trends and projections, federal announcements, bi-partisan legislation, policy, and more for the diverse audience that we serve (including patients, educators, school administrators, parents, therapists, and beyond)!
With an estimated 10-to-30 percent of COVID-19 survivors experiencing “long-haul” symptoms, such as brain fog and swallowing difficulties, University of Southern Mississippi (USM) speech-language pathologist, Dr. Steven Cloud, emphasizes the need to seek care from qualified experts who can help sufferers regain their quality of life. He shares this message in recognition of May as national “Better Hearing and Speech Month (BHSM).”
“The pandemic has posed so many challenges to all of us as a society, but one of the most persistent and vexing difficulties is that many people are having symptoms for months after contracting COVID-19,” said Dr. Cloud. “Some of these symptoms include brain fog, difficulty eating and drinking, and speech and language problems. These issues can affect the ability to return to work, to take care of one’s family, and to fully recover. Speech-language pathologists (SLPs) are professionals trained in these areas who can make a huge difference in recovery from COVID-19.”
How They Help
Speech-language pathologists can help people with, or who are recovering from, COVID-19 experiencing short- and longer-term difficulties in the following areas:
Cognition
Many COVID-19 “long-haulers” are reporting persistent brain fog as a debilitating symptom following their bouts with the virus. This can prevent a return to work and impact their ability to tend to family responsibilities. SLPs can work with individuals to improve their memory, attention, organization and planning, problem-solving, learning, and social communication skills — such as re-learning conversational rules or understanding the intent behind a message or behind nonverbal cues. The focus is on the individual’s specific challenges and regaining the skills that are most important to his/her daily life experiences and priorities.
Swallowing
People diagnosed with COVID-19 may experience swallowing problems that can place them at risk for choking or aspiration, which occurs when food goes into the lungs instead of the stomach. This may be the result of time spent on a ventilator, or it may be another side effect of the virus. SLPs use different tests to determine what happens when a person swallows and how the related muscles are working — helping a patient’s medical team, including the SLP, decide on the best course of treatment with the patient and the family. SLPs may recommend modified textures of food and drink for patients, treatment exercises to strengthen the tongue, lips, and muscles in the mouth and throat, and strategies to make eating and drinking safer, such as modifying the pace of chewing/eating, size of food bites, and more.
Communication
People diagnosed with COVID-19 are also experiencing speech and language difficulties. Some, such as those who spent a significant amount of time on a ventilator or who experienced low oxygen levels to the brain, may have muscle weakness or reduced coordination in the muscles of the face, lips, tongue, and throat — making it difficult to talk. Others, particularly those who experienced a COVID-related stroke, may experience a language disorder called aphasia —which makes it hard for someone to understand, speak, read, or write. SLPs work with patients through targeted treatment sessions to improve their communication and understanding skills.
Individuals with severe speech and/or language difficulties may need to find other ways to answer questions or to tell people what they want, through gestures with their hands, pointing to letters or pictures on a paper or a communication board, or by using a computer. These are all forms of augmentative and alternative communication. SLPs can help find the appropriate method to meet an individual’s treatment needs.
Amid concern about how a lack of social interaction tied to the COVID-19 pandemic could affect young children and their communication development, experts say a key tool already has helped blunt any widespread regression: teletherapy.
“It’s crazy to me that we’re only just now discovering it, but it has changed the way that we think about things and the way that we do things,” says Meg Morgan, a clinical assistant professor at the University of New Hampshire and a bilingual speech-language pathologist servicing schools in Maine and New Hampshire.
The prospect of a return to school closures and other safety measures in light of the rapid spread of the omicron variant is likely to raise worries among some parents and experts that children could fall behind in their speech and language skills.
Stephen Camarata, a professor of hearing and speech sciences at the Vanderbilt University School of Medicine in Nashville, Tennessee, explains that children learn language and social skills through a “transactional” process involving interactions with their parents and other children once they enter school. Their neural development, he says, comes through initiation and getting feedback from their environment.
Camarata fears social isolation measures to stem the spread of COVID-19, while necessary as a public health action, may have delayed many of those important early interactions children need to develop.
“Hundreds of thousands of learning opportunities that are these day-to-day, minute-by-minute kinds of interactions where the environment gives them feedback that shapes their social skills, gives them information on vocabulary and language input, (have) been attenuated dramatically,” Camarata says
Still, Camarata says he so far has not seen conclusive evidence showing the social isolation that occurred in 2020 due to school closures negatively impacted children’s speech, language or social skills development. And though some speech-language pathologists who work in schools say they have seen declines in children’s communication skills since a return to in-school learning, views are generally mixed as to whether school closures have delayed development and if any negative impact that did occur in this area will have long-term implications.
US Secretary of Education Miguel Cardona sent a “Dear Colleagues” letter addressing labor shortages in K-12 education. According to letter, “The U.S. Department of Education (USDE) is committed to supporting districts and schools across this country in addressing teacher and staff shortages, minimizing disruption to in-person learning, and meeting student needs. That is why we are urging you to use resources from the $122 billion made available through the American Rescue Plan Act of 2021 (ARP) (Pub. L. 117-2) Elementary and Secondary School Emergency Relief (ARP ESSER) Fund and a portion of the $350 billion made available through the ARP’s Coronavirus State and Local Fiscal Recovery Funds (SLFRF) to ensure that students have access to the teachers and other critical staff they need to support their success during this critical period. This includes moving quickly to implement short-term strategies while also considering longer-term investments.”
According to the letter, ARP provides vital resources to hire additional educators and school staff and to improve compensation to recruit and retain educators and school staff. School districts should act with urgency to keep schools open for in-person learning and ensure they do not waste this opportunity to make critical investments. The letter also describes (1) evidence-based and promising short- and long-term strategies for addressing teacher and staff shortages that can be funded through ARP ESSER and (2) examples of how ARP and previous relief funds are already being used to attract and retain teachers and staff. These strategies can help to fill currently open positions and add and fill new roles, such as providing one-time initial hiring incentives, or short-term investments in additional staff to support students and educators and increased needs.
Experts on speech-language disorders and dialects, SLPs Kyomi Gregory-Martin of Pace University and Janna Oetting of Louisiana State University join the podcast to discuss a framework they say can better serve children in the schools.
In their 2016 Perspectives article, “Changing How Speech-Language Pathologists Think and Talk About Dialect Variation,” Gregory-Martin and Oetting propose shifting from a dialect versus disorder framework to a disorder within dialect framework. The change may sound subtle at first, but the implications run deep. Since SLPs treat the disorder, and not the dialect, Gregory-Martin says the disorder within dialect framework centers the conversation on the role of the SLP.
“We really shouldn’t care about what dialect variation is being spoken because we all speak a specific dialect. It really shouldn’t matter,” Gregory-Martin says. “The focus should really be on: Is there truly a language disorder present?”
On the podcast, the duo discusses the importance of knowing the community one is working in, and Gregory-Martin shares how unconscious biases towards dialect variations can affect services.
“If you feel certain ways about various dialect variations, whether you think they’re prestigious or they have a stigma, these attitudes may carry into how you provide assessment and treatment without you even being conscious about it,” Gregory-Martin says.
On November 5, 2021, the Secretary of Health and Human Services issued an Interim Final Rule that amended the conditions of participation in Medicare and Medicaid to require certain providers and suppliers to ensure their covered staff are vaccinated against COVID-19 (“Rule”). Enforcement of this vaccine mandate was delayed due to pending legal challenges by several states. On January 13, 2022, the Supreme Court weighed in on these challenges, ultimately upholding the Rule. As such, the vaccine mandate for eligible staff at Medicare and Medicaid-certified facilities is in effect.
To What Providers and Suppliers Does the Rule Apply? The vaccination requirements apply to Medicare and Medicaid-certified provider and supplier types that are regulated under Medicare and Medicaid health and safety standards (collectively, the Facilities). These Facilities include: Ambulatory Surgery Centers, Community Mental Health Centers, Comprehensive Outpatient Rehabilitation Facilities, Critical Access Hospitals, End-Stage Renal Disease Facilities, Home Health Agencies, Home Infusion Therapy Suppliers, Hospices, Hospitals, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Clinics, Rehabilitation Agencies, and Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services, Psychiatric Residential Treatment Facilities (PRTFs), Programs for All-Inclusive Care for the Elderly (PACE) Organizations, Rural Health Clinics/ Federally Qualified Health Centers (Medicare only), and Long Term Care facilities.
The Rule applies to eligible staff at almost all of these Facilities regardless of patient contact or clinical responsibility. This includes current staff and any new staff who will provide care, treatment or other services to the Facilities and/or their patients. For example, employees, licensed practitioners, students, trainees and volunteers, and any individuals who provide care, treatment, or other services for Facilities and/or their patients under contract or other arrangements. The Rule does not apply to individuals who provide services 100% remotely and do not have any direct contact with patients and/or other staff members.
The vaccine requirements do not apply to independent physician or dental practices, as they are not subject to CMS health and safety regulations. Individual physicians working for practices that have admitting or staff privileges at any of the Facilities, however, will be subject to vaccine requirements in order for the Facilities to comply with the Rule. In practice, this means that while a physician group itself does not have to comply with the Rule, physicians practicing within the group may be required to comply as a condition of hospital staff or other privileges.
Early in the pandemic, researchers observed Trusted Source that people recovering from COVID-19 were not returning to their pre-illness state of health — this is now commonly known as “Long COVID.”
Among the myriad persistent symptoms, many people experience Trusted Source headaches, memory issues, and cognitive deterioration.
Researchers from Northwestern University in Chicago, IL, were the first to report that even non-hospitalized people with COVID-19 demonstrated significant cognitive dysfunction that persisted well beyond 6 weeks from the acute infection.
In the journal Science, Dr. Serena Spudich and Dr. Avindra Nath review our current understanding of the neurologic consequences of COVID-19.
Building on clinical observations, autopsy, and laboratory findings, the authors propose theories of causality about how COVID-19 may result in long-term neurologic symptoms.
Neurologic complications of COVID-19 include:
The bipartisan legislation would eliminate Medicare’s geographic and originating site restrictions and establish policies that ensure Medicare coverage for telehealth services.
U.S. Sens. Susan Collins (R-ME) and Angus King (I-ME) are co-sponsoring the Telehealth Modernization Act, which aims to solidify access to and coverage of telehealth services for Medicare beneficiaries.
At the start of the COVID-19 pandemic, Congress introduced temporary emergency waivers to ensure Medicare beneficiaries could access and receive coverage for virtual care services.
According to HHS, almost half (43.5 percent) of all Medicare fee-for-service (FFS) primary care visits were conducted via telehealth in April 2020. Usage remained high during the first year of the public health emergency. In fact, from January to December 2020, nearly 52.7 million Medicare FFS beneficiaries used telehealth, a 63-fold increase from the year prior.
“Telehealth services have been a lifeline to patients and providers during the pandemic, ensuring that individuals can continue to receive quality healthcare from the safety and convenience of their own homes,” Sens. Collins and King said in a joint statement. “This bipartisan bill would expand telehealth services for Medicare beneficiaries, ensuring that seniors in Maine and across the country retain access to remote home health services during the COVID-19 emergency and future public health emergencies.”
The Telehealth Modernization Act seeks to make certain temporary policies permanent.
The bill would permanently eliminate Medicare’s geographic and originating site restriction. This restriction limits patients’ access to telehealth by requiring that Medicare beneficiaries live in rural areas and be present at a doctor’s office or other specified clinics in order to receive virtual healthcare services that are covered by their insurance.
The legislation would also ensure that individuals living in rural areas continue to have access to virtual care by requiring Medicare to provide coverage for telehealth services provided at federally qualified health centers and rural health clinics.
Additionally, the bipartisan bill would give the HHS secretary the power to solidify Medicare coverage for virtual physical therapy, speech-language pathology, and additional specialty healthcare services. The HHS secretary would also have the authority to ensure continuity of virtual care and Medicare coverage for hospice and home dialysis patients.
The Telehealth Modernization Act was first introduced by former Sen. Lamar Alexander (R-TN) in July 2020 but did not receive a vote from Congress. In February 2021, Sens. Tim Scott (R-SC), Brian Schatz (D-HI), and Jeanne Shaheen (D-NH) re-introduced the bill.
Notable supporters of the legislation include the Alliance for Connected Care, American Medical Association, Connected Health Initiative, eHealth Initiative, and American Telemedicine Association.
Since the COVID-19 pandemic hit, lawmakers have introduced a handful of bills to help preserve access to telehealth for individuals across the country.
The Cures 2.0 Bill and the Telehealth Extension Act both include policies that aim to expand telehealth access for Medicare beneficiaries by lifting geographic and originating site restrictions. In addition, the Cures 2.0 legislation proposed policies that would help integrate telehealth into Medicaid programs and the Children’s Health Insurance Program (CHIP).
As the COVID-19 pandemic continues across the United States, states, payers, and providers are looking for ways to expand access to telehealth services. Telehealth is an essential tool in ensuring patients are able to access the healthcare services they need in as safe a manner as possible. In order to provide our clients with quick and actionable guidance on the evolving telehealth landscape, Manatt Health has developed a federal and comprehensive 50-state tracker for policy, regulatory and legal changes related to telehealth during the COVID-19 pandemic. Below is the executive summary, which outlines federal developments from the past two weeks, new state-level developments, and older federal developments. The full tracker with details for each state is available through Manatt on Health, Manatt Health’s premium subscription service.
The response to the COVID-19 virus is unprecedented. Because of our unique role in children’s K-12 education, we feel a responsibility to do what we can to assist schools, therapists, and students with this transition to online learning and seclusion. To ensure that our clients remain engaged and supported, our therapists will be providing complimentary “Support Sessions” to the country’s youth. We will also be assisting schools by training therapists for remote therapy.
Click here to schedule a complimentary consultation with an Executive Member of our Team.
Abington Speech Pathology and RemoteSpeech.com are uniquely prepared to provide assistance for parents of children with Speech-Language Pathology.
About Abington Speech Pathology
Abington Speech Pathology is managed and owned by a licensed speech-langauge pathologist. All of the company’s directors are licensed and remain clinical to better direct and support both the company’s clients and the clinical staff.
Through the years the company’s client base continues to grow and remains loyal. ASPS, INC has expanded its services to include Physical therapy, Occupational therapy, Teachers of the visually and hearing impaired, and School psychologists. ASPS, INC. now operates two offices. The corporate office is in eastern PA and services all 5 major counties surrounding the metro Philadelphia area. The Southern CA office services the Los Angeles and Orange County metro areas and at this point only offers speech pathology services to all settings.
The company offers the professional staff a lending library of materials. In PA, there are 2-3 continuing educational seminars to assist on clinical growth and state and national mandated continuing education requirements.
About RemoteSpeech.com
RemoteSpeech is a subsidiary of Abington Speech Pathology Services, a multi-faceted Rehab company that has provided Speech Staffing and support throughout the country for more than 20 years. RemoteSpeech combines crystal clear voice with the sharpest video to provide next-generation video calling and high-definition video delivery.
Prior to the Covid 19 pandemic, Orna Kempler-Azulay, President of RemoteSpeech, says the demand for speech-language therapists was outpacing the supply in some cities. RemoteSpeech is here to meet the demand. With its live, face-to-face interaction, RemoteSpeech is not the next best thing to being there in person — it’s just as good, and, in some cases, even better. With advanced state-of-the-art games, activities, and interactive screen sharing, students and adults will actually look forward to their therapy sessions.
Click Here to Learn More About Our Telepractice – Remote Speech-Language Therapy!
To provide high-quality speech and language therapy, occupational therapy, evaluations, accent modification, and educational psychology services to clients of all ages.
