a School of Psychology & Counselling , Queensland University of Technology , Brisbane , Australia.
b Institute of Health & Biomedical Innovation, Queensland University of Technology , Brisbane , Australia.
Disabil Rehabil. 2019 Jul;41(14):1664-1675. doi: 10.1080/09638288.2018.1448464. Epub 2018 Mar 23.
Speech language therapists increasingly are using telehealth to enhance the accessibility of their services. It is unclear, however, how play-based therapy for children can be delivered via telehealth. In particular, modalities such as videoconferencing do not enable physical engagement between therapists and clients. The aim of our reported study was to understand how physical objects such as toys are used in similar and different ways across videoconferenced and "face-to-face" (hereafter, "in-person") therapy.
We used conversation analytic methods to compare video-recorded therapy sessions for children delivered across in-person and telehealth settings. Utilising a broader corpus of materials, our analysis focused on four client-therapist dyads: two using videoconferencing, and two who met in-person.
Both videoconferencing and in-person sessions enabled routine affordances and challenges for delivering therapy. Within in-person therapy, therapists made access to objects contingent upon the client producing some target expression. This contingency usually was achieved by restricting physical access to these objects. Restricting access to a toy was not necessary in videoconferenced therapy; therapists instead used techniques to promote engagement.
When delivering play-based therapy via telehealth, our study demonstrates how practitioners adapt the intervention to suit the particular medium of its delivery. Implications for Rehabilitation Telehealth enhances equitable access for those who cannot physically access rehabilitation services. Telehealth modalities can create practical challenges, however, when delivering interventions such as play-based therapy. Practitioners should intentionally adapt telehealth interventions to suit the particular telehealth modality they are using.
言语治疗师越来越多地使用远程医疗来提高其服务的可及性。然而，目前尚不清楚如何通过远程医疗提供基于游戏的儿童治疗。特别是，视频会议等模式无法使治疗师和客户之间进行身体互动。我们报告的研究旨在了解物理对象（如玩具）如何在视频会议和“面对面”（以下简称“现场”）治疗中以相似和不同的方式使用。
我们使用会话分析方法比较了在现场和远程医疗环境中为儿童提供的视频记录治疗会话。利用更广泛的材料语料库，我们的分析集中在四个客户-治疗师二人组上：两个使用视频会议，两个在现场会面。
视频会议和现场会议都为提供治疗提供了常规的辅助和挑战。在现场治疗中，治疗师使客户产生某些目标表达，从而使他们能够获得对象。这种附带条件通常是通过限制对这些对象的物理访问来实现的。在视频会议治疗中，不需要限制对玩具的访问；治疗师可以使用技术来促进参与。
当通过远程医疗提供基于游戏的治疗时，我们的研究表明从业者如何根据治疗的特定媒介来调整干预措施。对康复的影响远程医疗增强了那些无法亲自获得康复服务的人的公平获取机会。然而，当提供基于游戏的治疗等干预措施时，远程医疗模式可能会带来实际挑战。从业者应根据他们正在使用的特定远程医疗模式有意地调整远程医疗干预措施。
