Speech-language Telepractice Services During the COVID-19 Lockdown: Perspectives from Parents in Malaysia
DOI:
https://doi.org/10.63144/ijt.2025.6650Keywords:
COVID-19, Pandemic, Parents, Speech-language services, TelepracticeAbstract
This study explores Malaysian parents’ perspectives on speech-language pathology (SLP) telepractice services during the COVID-19 lockdown. SLP services for families living in rural areas of Malaysia can be challenging, due to travel issues associated with distance, transportation costs, scheduling conflicts, and for patients with restricted physical mobility. To investigate the efficacy of SLP services in Malaysia during the COVID-19 lockdown, 70 parents’ preferences and perspectives were explored via a survey of demographics, service engagement, and views on telepractice. During lockdown, 48.6% of children received in-person speech-language services, while 38.6% received telepractice or combined services. Of those receiving services, 91.2% reported benefits, but 70.4% disagreed that telepractice could replace in-person sessions. Parents reported children’s attention span and rapport-building challenges with telepractice. Attitudes about telepractice varied: 14.3% positive, 60% negative, 25.7% neutral. Open-ended responses revealed that some held a preference for in-person services due to attention, communication, and technological barriers. The telepractice benefits noted were parental involvement and convenience. The findings suggest a shift toward remote therapy during the COVID-19 lockdown, with positive parental perceptions. However, doubts remain about the ability of telepractice to fully replace in-person sessions, warranting further research on therapy effectiveness and limitations.
References
Ahmad, K., Ibrahim, H., Othman, B. F., & Vong, E. (2013). Addressing education of speech-language pathologists in the World Report on Disability: Development of a speech-language pathology program in Malaysia. International Journal of Speech-Language Pathology, 15(1), 37-41. https://doi.org/10.3109/17549507.2012.757709
Al Awaji, N. N., Almudaiheem, A. A., & Mortada, E. M. (2021). Assessment of caregivers’ perspectives regarding speech-language services in Saudi Arabia during COVID-19. PLoS One, 16(6), e0253441. https://doi.org/10.1371/journal.pone.0253441
Al-Worafi, Y. M. (2023). Telehealth and Telemedicine in Developing Countries. In Handbook of Medical and Health Sciences in Developing Countries: Education, Practice, and Research (pp. 1-26). Springer. https://doi.org/10.1007/978-3-030-74786-2_309-1
Aljabri, N. Q., Bulkeley, K., & Cusick, A. (2023). Perspectives of Saudi occupational therapists regarding telerehabilitation: A qualitative study. International Journal of Telerehabilitation, 15(2). https://doi.org/10.5195/ijt.2023.6584
Amar, H. (2008). Meeting the needs of children with disability in Malaysia. Medical Journal of Malaysia, 63(1), 1-3. https://www.e-mjm.org/2008/v63n1/Children_with_Disability.pdf
Amaran, S., Kamaruzaman, A. Z. M., Esa, N. Y. M., & Sulaiman, Z. (2021). Malaysia healthcare early response in combatting COVID-19 pandemic in 2020. Korean Journal of Family Medicine, 42(6), 425. https://doi.org/10.4082/kjfm.20.0117
American Psychological Association. In. (2018b, April 19). Volunteer bias. In APA Dictionary of Psychology. https://dictionary.apa.org/volunteer-bias
Arunachalam, A. S., & Balambigai, N. (2022). Parents' perceptions, preferences, and satisfaction with teletherapy for speech-language pathology services during the COVID-19 pandemic. International Journal of Science and Healthcare Research, 7(2), 145-149. https://doi.org/10.52403/ijshr.20220421
Ashburner, J., Vickerstaff, S., Beetge, J., & Copley, J. (2016). Remote versus face-to-face delivery of early intervention programs for children with autism spectrum disorders: Perceptions of rural families and service providers. Research in Autism Spectrum Disorders, 23, 1-14. https://doi.org/10.1016/j.rasd.2015.11.011
American Speech-Language-Hearing Association. (2005). ASHA Speech-language Pathology Health Care Survey. Issue Briefs. https://www.asha.org/research/memberdata/healthcare-survey/
Baker, A. J., Konigsberg, M., Brown, E., & Adkins, K. L. (2023). Successes, challenges, and opportunities in providing evidence-based teletherapy to children who have experienced trauma as a response to Covid-19: A national survey of clinicians. Children and Youth Services Review, 146, 106819. https://doi.org/10.1016/j.childyouth.2023.106819
Baker, E., & McLeod, S. (2011). Evidence-based practice for children with speech sound disorders: Part 1 narrative review. Language, Speech, and Hearing Services in Schools, 42(2), 102-139. https://doi.org/10.1044/0161-1461(2010/09-0075)
Bani Hani, H. A., Aljazi, A. B., Alkhamra, R., & Alomari, H. M. (2023). Speech-Language pathologists’ perception of telepractice at the start of the COVID-19 pandemic in Jordan. Communication Disorders Quarterly, 46(1), 37-45. https://doi.org/10.1177/15257401231185306
Bayati, B., & Ayatollahi, H. (2023). Speech therapists' perspectives about using tele-speech therapy: A qualitative study. Disability and Rehabilitation: Assistive Technology, 18(5), 621-626. https://doi.org/10.1080/17483107.2021.1900933
Black, L. I., Vahratian, A., & Hoffman, H. J. (2015). Communication disorders and use of intervention services among children aged 3-17 Years: United States, 2012. NCHS Data Brief. Number 205. Centers for Disease Control and Prevention. https://files.eric.ed.gov/fulltext/ED563897.pdf
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa
Brehon, K., Carriere, J., Churchill, K., Loyola-Sanchez, A., Papathanassoglou, E., MacIsaac, R., Tavakoli, M., Ho, C., & Manhas, K. P. (2023). Evaluating efficiency of a provincial telerehabilitation service in improving access to care during the COVID-19 pandemic. International Journal of Telerehabilitation, 15(1). https://doi.org/10.5195/ijt.2023.6523
Brumbaugh, K. M., & Smit, A. B. (2013). Treating children ages 3–6 who have speech sound disorder: A survey. Language Speech & Hearing Services in Schools, 44(3), 306-319. https://doi.org/10.1044/0161-1461(2013/12-0029)
Caffery, L. J., Catapan, S. D. C., Taylor, M. L., Kelly, J. T., Haydon, H. M., Smith, A. C., & Snoswell, C. L. (2024). Telephone versus video consultations: A systematic review of comparative effectiveness studies and guidance for choosing the most appropriate modality. Journal of Telemedicine and Telecare, 1357633X241232464. https://doi.org/10.1177/1357633X241232464
Chan, M. Y., Chu, S. Y., Ahmad, K., & Ibrahim, N. M. (2021). Voice therapy for Parkinson's disease via smartphone videoconference in Malaysia: A preliminary study. Journal of Telemedicine and Telecare, 27(3), 174-182. https://doi.org/10.1177/1357633X19870913
Chen, H., Li, H. X., Li, L., Zhang, X. H., Gu, J. W., Wang, Q., Wu, C. M., & Wu, Y. Q. (2024). Factors associated with intention to use telerehabilitation for children with special needs: A cross-sectional study. Telemedicine and e-Health, 30(5), 1425-1435. https://doi.org/10.1089/tmj.2023.0325
Chu, S. Y., Khoong, E. S. Q., Ismail, F. N. M., Altaher, A. M., & Razak, R. A. (2019). Speech-language pathology in Malaysia: Perspectives and challenges. Perspectives of the ASHA Special Interest Groups, 4(5), 1162-1166. https://doi.org/10.1044/2019_PERS-SIG17-2019-0005
Chu, S. Y., Mohd Normal, S. N. S. A. B., McConnell, G. E., Tan, J. S., & Joginder Singh, S. K. D. (2020). Challenges faced by parents of children with autism spectrum disorder in Malaysia. Speech, Language and Hearing, 23(4), 221-231. https://doi.org/10.1080/2050571X.2018.1548678
Chu, S. Y., Tang, K. P., McConnell, G., Mohd Rasdi, H. F., & Yuen, M. C. (2019). Public perspectives on communication disorders and profession of speech-language pathology. Speech, Language and Hearing, 22(3), 172-182. https://doi.org/10.1080/2050571X.2019.1570705
Clemens, S.K., Karem, P., Shifflett, K., Vegi, L., Ravi, K., & Brooks, M. (2018). Evaluating barriers to adopting telemedicine worldwide: A systematic review. Journal of Telemedicine and Telecare, 24(1), 4-12. https://doi.org/10.1177/1357633X16674087
Cole, B., Stredler-Brown, A., Cohill, B., Blaiser, K., Behl, D., & Ringwalt, S. (2016). The development of statewide policies and procedures to implement telehealth for Part C service delivery. International Journal of Telerehabilitation, 8(2), 77. https://doi.org/10.5195/ijt.2016.6206
Doraiswamy, S., Abraham, A., Mamtani, R., & Cheema, S. (2020). Use of telehealth during the COVID-19 pandemic: Scoping review. Journal of Medical Internet Research, 22(12), e24087. https://doi.org/10.2196/24087
Ebert, K. D., & Kohnert, K. (2011). Sustained attention in children with primary language impairment: A meta-analysis. https://doi.org/10.1044/1092-4388(2011/10-0231)
Ebrahimi, S., Marzaleh, M. A., Zakerabbasali, S., Ahmadi, A., & Sarpourian, F. (2024). Comparing the clinical effectiveness of telerehabilitation with traditional speech and language rehabilitation in children with hearing disabilities: A systematic review. Telemedicine and e-Health, 30(2), 307-320. https://doi.org/10.1089/tmj.2023.0258
El Sady, S. R., Nabeih, A. A. S., Mostafa, E. M. A., & Sadek, A. A. (2013). Language impairment in attention deficit hyperactivity disorder in preschool children. Egyptian Journal of Medical Human Genetics, 14(4), 383-390. https://doi.org/10.1016/j.ejmhg.2013.05.001
Fairweather, G. C., Lincoln, M. A., & Ramsden, R. (2016). Speech-language pathology teletherapy in rural and remote educational settings: Decreasing service inequities. International Journal of Speech-Language Pathology, 18(6), 592-602. https://doi.org/10.3109/17549507.2016.1143973
Harkey, L. C., Jung, S. M., Newton, E. R., & Patterson, A. (2020). Patient satisfaction with telehealth in rural settings: A systematic review. International Journal of Telerehabilitation, 12(2), 53. https://doi.org/10.5195/ijt.2020.6303
Joginder Singh, S., Chan, M. Y., & Ahmad Rusli, Y. (2016). Practise patterns of Malaysian speech-language pathologists in managing children with speech and language delay/disorder. International Journal of Speech-Language Pathology, 18(6), 560-570. https://doi.org/10.3109/17549507.2016.1139624
Joginder Singh, S., Iacono, T., & Gray, K. M. (2011). A comparison of Malaysian and Australian speech-language pathologists' practices with children with developmental disabilities who are pre-symbolic. International Journal of Speech-Language Pathology, 13(5), 389-398. https://doi.org/10.3109/17549507.2011.603429
Kasamba, S., McVeigh, K. H., Moraes, A., Huang, Y., Puffett, N., & Lednyak, L. (2023). Continuity of early intervention services in New York City during the COVID-19 pandemic. International Journal of Telerehabilitation, 15(1). https://doi.org/10.5195/ijt.2023.6553
Keck, C. S., & Doarn, C. R. (2014). Telehealth technology applications in speech-language pathology. Telemedicine and e-Health, 20(7), 653-659. https://doi.org/10.1089/tmj.2013.0295
Kocyigit, B. F., Assylbek, M. I., & Yessirkepov, M. (2024). Telerehabilitation: Lessons from the COVID-19 pandemic and future perspectives. Rheumatology International, 44(4), 577-582. https://doi.org/10.1007/s00296-024-05537-0
Kraljević, J. K., Matić, A., & Dokoza, K. P. (2020). Telepractice as a reaction to the COVID-19 crisis: Insights from Croatian SLP settings. International Journal of Telerehabilitation, 12(2), 93. https://doi.org/10.5195/ijt.2020.6325
Lam, J. H. Y., Lee, S. M. K., & Tong, X. (2021). Parents’ and students’ perceptions of telepractice services for speech-language therapy during the COVID-19 pandemic: Survey study. JMIR Pediatrics and Parenting, 4(1), e25675. https://doi.org/10.2196/25675
Law, J., Garrett, Z., & Nye, C. (2004). The efficacy of treatment for children with developmental speech and language delay/disorder. https://doi.org/10.1044/1092-4388(2004/069)
Lee, S. A. S., Ang, C. H. M., Chafcouloff, E., Choi, S. H., De Chua, K. W., Cuadro, C. K., Hassan, F. H., Kariyasu, M., Lertsukprasert, K., & Sasheendran, S. (2024). Speech-language pathology and audiology professions in Asia: past history and current status. Perspectives of the ASHA Special Interest Groups, 9(4), 1197-1216. https://doi.org/10.1044/2024_PERSP-24-00039
Macoir, J., Desmarais, C., Martel‐Sauvageau, V., & Monetta, L. (2021). Proactive changes in clinical practice as a result of the COVID‐19 pandemic: Survey on use of telepractice by Quebec speech‐language pathologists. International Journal of Language & Communication Disorders, 56(5), 1086-1096. https://doi.org/10.1111/1460-6984.12669
Manley, N. R., & Wilder, A. (2024). Clinical accommodations for children with co-occurring developmental language disorder and attention-deficit/hyperactivity disorder. Perspectives of the ASHA Special Interest Groups, 1-11. https://doi.org/10.1044/2024_PERSP-24-0007
Mansuri, B., Tohidast, S. A., Mokhlesin, M., Choubineh, M., Zarei, M., Bagheri, R., & Callaway Scherer, R. (2022). Telepractice among speech and language pathologists: A KAP study during COVID-19 pandemic. Speech, Language and Hearing, 25(3), 388-395. https://doi.org/10.1080/2050571X.2021.1976550
Marinos, G., Lamprinos, D., Georgakopoulos, P., Kavoukidis, N., Oikonomou, E., Zoumpoulis, G., Siasos, G., Schizas, D., Nikolopoulos, A., & Botonis, P. G. (2022). Evaluation of the perceptions, attitudes and practices among Greek non-professional athletes visiting a public hospital during March 2022, towards COVID-19 vaccination and its consequences on sports training and sports activity. Vaccines, 10(11), 1821. https://doi.org/10.3390/vaccines10111821
Marziali, E., Damianakis, T., & Donahue, P. (2006). Internet-based clinical services: Virtual support groups for family caregivers. Journal of Technology in Human Services, 24(2-3), 39-54. https://doi.org/10.1300/J017v24n02_03
Mashima, P. A., & Doarn, C. R. (2008). Overview of telehealth activities in speech-language pathology. Telemedicine and e-Health, 14(10), 1101-1117. https://doi.org/10.1089/tmj.2008.0080
May, J., & Erickson, S. (2014). Telehealth: Why not. Journal of Clinical Practice in Speech-Language Pathology, 16(3), 147-151. https://www.researchgate.net/profile/Meredith-Prain-2/publication/268334039_Dysphagia_support_in_disability_services_stakeholder_perspectives/links/5517d2fd0cf29ab36bc2bc69/Dysphagia-support-in-disability-services-stakeholder-perspectives.pdf#page=41
McLeod, S., & Harrison, L. J. (2009). Epidemiology of speech and language impairment in a nationally representative sample of 4-to 5-year-old children. https://doi.org/10.1044/1092-4388(2009/08-0085)
Ogourtsova, T., Boychuck, Z., O’Donnell, M., Ahmed, S., Osman, G., & Majnemer, A. (2023). Telerehabilitation for children and youth with developmental disabilities and their families: A systematic review. Physical & Occupational Therapy in Pediatrics, 43(2), 129-175. https://doi.org/10.1080/01942638.2022.2106468
Paul, L., Thomson, K., Asibey, S. O., Brady, M., van Wijck, F., Antwi, D., Opoku, E. N., & Sarfo, F. S. (2024). Views of service users, their family or carers, and health care professionals on telerehabilitation for people with neurological conditions in Ghana: Qualitative study. JMIR mHealth and uHealth, 12(1), e49501. https://doi.org/10.2196/49501
Pettinari, C. J., & Jessopp, L. (2001). ‘Your ears become your eyes’: Managing the absence of visibility in NHS Direct. Journal of Advanced Nursing, 36(5), 668-675. https://doi.org/10.1046/j.1365-2648.2001.02031.x
Quar, T. K., Rashid, M. F. N., Rosdi, M. Y. M., Ishak, W. S., & Chong, F. Y. (2023). Impact of the COVID-19 pandemic on individuals with hearing loss and audiology practice in a developing country. American Journal of Audiology, 32(1), 59-69. https://doi.org/10.1044/2022_AJA-22-00033
Quinn, E. D., Kaiser, A. P., & Ledford, J. (2021). Hybrid telepractice delivery of enhanced milieu teaching: Effects on caregiver implementation and child communication. Journal of Speech, Language, and Hearing Research, 64(8), 3074-3099. https://doi.org/10.1044/2021_JSLHR-20-00430
Sahoo, S., Sahoo, J., Kumar, S., Lim, W. M., & Ameen, N. (2023). Distance is no longer a barrier to healthcare services: current state and future trends of telehealth research. Internet Research, 33(3), 890-944. https://doi.org/10.1108/INTR-10-2021-0774
Seebacher, B., Bergmann, E., Geimer, C., Kahraman, T., Reindl, M., & Diermayr, G. (2024). Factors influencing the willingness to adopt telerehabilitation among rehabilitation professionals in Austria and Germany: A survey comparing data before and during COVID-19. Disability and Rehabilitation, 46(6), 1149-1157. https://doi.org/10.1080/09638288.2023.2193428
Shahouzaie, N., & Gholamiyan Arefi, M. (2024). Telehealth in speech and language therapy during the COVID-19 pandemic: A systematic review. Disability and Rehabilitation: Assistive Technology, 19(3), 761-768. https://doi.org/10.1080/17483107.2022.2122605
Singh, S. J., Kamarudin, K., & Sharma, S. (2022). The implementation of telepractice by Malaysian speech-language pathologists during the COVID-19 pandemic. Communication Sciences & Disorders, 27(1), 239-250. https://doi.org/10.12963/csd.21848
Sugden, E., Baker, E., Munro, N., & Williams, A. L. (2016). Involvement of parents in intervention for childhood speech sound disorders: A review of the evidence. International Journal of Language & Communication Disorders, 51(6), 597-625. https://doi.org/10.1111/1460-6984.12247
Swain, N. R., Eadie, P. A., & Snow, P. C. (2020). Speech and language therapy for adolescents in youth justice: A series of empirical single‐case studies. International Journal of Language & Communication Disorders, 55(4), 458-479. https://doi.org/10.1111/1460-6984.12529
Tang, C. Y., Bastani, A., Sidhu, B., Saberi, G., & Baker, E. (2024). Access, readiness and willingness to engage in allied health telerehabilitation services for adults: Does cultural and linguistic diversity make a difference? Healthcare, 12(11), 114. https://doi.org/10.3390/healthcare12111141
Tang, K. P., & Chu, S. Y. (2023). Public awareness of communication disorders and speech-language therapy in Malaysia. International Journal of Disability, Development and Education, 70(6), 1173-1188. https://doi.org/10.1080/1034912X.2021.1937956
Theodoros, D. (2011). Telepractice in speech-language pathology: The evidence, the challenges, and the future. Perspectives on Telepractice, 1(1), 10-21. https://doi.org/10.1044/tele1.1.10
Thong, H. K., Wong, D. K. C., Gendeh, H. S., Saim, L., Athar, P. P. B. S. H., & Saim, A. (2021). Perception of telemedicine among medical practitioners in Malaysia during COVID-19. Journal of Medicine and Life, 14(4), 468. https://doi.org/10.25122/jml-2020-0119
Tipre, M., Scarinci, I. C., Pandya, V. N., Kim, Y. I., Bae, S., Peral, S., Hardy, C., & Baskin, M. L. (2024). Attitudes toward telemedicine among urban and rural residents. Journal of Telemedicine and Telecare, 30(4), 722-730. https://doi.org/10.1177/1357633X221094215
US Department of Health and Human Services. (2017). Speech and language developmental milestones. Bethesda, MD: NIDCD Information Clearinghouse. https://www.nidcd.nih.gov/health/speech-and-language
Wainer, A. L., & Ingersoll, B. R. (2015). Increasing access to an ASD imitation intervention via a telehealth parent training program. Journal of Autism and Developmental Disorders, 45, 3877-3890. https://doi.org/10.1007/s10803-014-2186-7
Wallisch, A., Little, L., Pope, E., & Dunn, W. (2019). Parent perspectives of an occupational therapy telehealth intervention. International Journal of Telerehabilitation, 11(1), 15. https://doi.org/10.5195/ijt.2019.6274
Watson, L. R., Crais, E. R., Baranek, G. T., Dykstra, J. R., & Wilson, K. P. (2013). Communicative gesture use in infants with and without autism: A retrospective home video study. American Journal of Speech-Language Pathology, 22(1), 25-39. https://doi.org/10.1044/1058-0360(2012/11-0145)
Weerathunge, H. R., Segina, R. K., Tracy, L., & Stepp, C. E. (2021). Accuracy of acoustic measures of voice via telepractice videoconferencing platforms. Journal of Speech, Language, and Hearing Research, 64(7), 2586-2599. https://doi.org/10.1044/2021_JSLHR-20-00625
Wentink, M., Prieto, E., De Kloet, A., Vliet Vlieland, T., & Meesters, J. (2018). The patient perspective on the use of information and communication technologies and e-health in rehabilitation. Disability and Rehabilitation: Assistive Technology, 13(7), 620-625. https://doi.org/10.1080/17483107.2017.1358302
White, M., & Dorman, S. M. (2001). Receiving social support online: implications for health education. Health Education Research, 16(6), 693-707. https://doi.org/10.1093/her/16.6.693
Yoo, J., Yoon, M. S., Lee, C. K., Hong, G. H., & Choi, S. J. (2021). An exploratory survey of priorities in establishing telepractice system for SLPs and caregivers in Korea. Communication Disorders Quarterly, 42(4), 230-237. https://doi.org/10.1177/1525740120916414
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