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  • Writer's pictureAndrea Lau, SLP

Home-Based Speech Therapy and the COVID-19 pandemic

Myself, and I'm sure many of you as well, have been wondering about what home-based speech therapy may look like in this current situation. As with many other service providers during this current situation, lots of new remote and virtual care services are being set up with great success! However, with talks of SLP services resuming by the middle of May here in BC, I would like to share some thoughts on what this might look like in the context of a clinician resuming in-home private therapy services and to highlight a few special considerations for this form of service.

Based on the WorkSafe BC Safety Plan, they have shared this useful infographic for planning resumption of services. As shown in the figure below, it is recommended that the primary level of protection is by limiting ("elimination") the risks of person-to-person transmission. What might this look like? I certainly don't have all the answers, however I welcome the chance to learn more and to research the safest plan for all. Suggestions and further discussion are definitely welcomed!

Food for Thought:

1) Elimination: Does this mean that we should prioritize the continuation of virtual/teletherapy services despite the government's allowance to resume in-person service delivery? Also, how does the clinician and the client ensure that 2m of physical distancing is maintained? Is this idea feasible for speech & language therapy?

2) Engineering controls: Is it practical and functional to be providing speech therapy sessions in the clients' homes with the requirement of a clear physical barrier separating the client and clinician? I find this to be quite unlikely, and also not a feasible request to make as there is little control over the client's home environment.

3) Administrative controls: With this idea of setting rules and guidelines for infection control and cleaning hands, and for limiting the number of individuals in a room, as well as limiting the length of time for being in close proximity - how can this be implemented in each clients' own homes? In addition to maintaining the typical standards of disinfecting, can I, as the clinician, ensure I have enough single-use/disposable items, and make sure that I and the client have enough materials that do not require sharing?

4) PPE: With so much of speech and language requiring focus on speaking, and providing visual cuing and responses from watching the movement of our lips and tongue, are we able to replicate this form of therapy while wearing a mask? A workaround for this may be to allow the client to remain unmasked, and the clinician could possibly wear a clear face-shield. Would this provide sufficient safety?

This leaves much food for thought, and I look forward to further researching to ensure we may proceed in the safest manner. I thank everyone for your patience during this learning curve, and I hope you all remain safe and healthy!

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