ARCHIEVE

Speech and Language Therapy Management during COVID-19 Pandemic: “What Should We Do Now?”

Seyhun Topbaş Namık Yücel Birol Hilal Berber Çiftci Beril Polat Berna Kırımtay Ayşegül Yılmaz
Abstract

All humanity is struggling with the COVID-19 pandemic, which appeared in Wuhan, China in December 2019 and spread all over the world. This virus is mainly transmitted through droplets produced by the infected individuals and the illness manifests with symptoms such as fever, cough, fatigue and dyspnea. Due to the highly contagious nature of the disease, strict isolation and hygiene measures must be taken. Healthcare professionals who are fighting against COVID-19 at the frontline face the highest level of virus transmission risk during this pandemic. Speech and language therapists, confronting the pandemic at the frontline along with their fellow healthcare providers as professionals, are forced to stop carrying out certain procedures that produce aerosols to protect both themselves and the patients, and use personal protective equipment when required by the clinical practice undertaken, as well as applying other modifications to service provision procedures. Because COVID-19 has a severe impact on some patients, they are admitted to intensive care units. When that is the case, the SLP’s play a critical role in ensuring the communication between the patients and the healthcare personnel. As an example, the use of alternative and augmentative communication systems can be sustained during intensive care. In addition, many patients in intensive care units develop acute respiratory distress syndrome. These patients need long-term mechanical ventilation. After the patients are extubated, they need to be evaluated for voice and swallowing disorders. In addition to the above-mentioned roles SLPs undertake at hospital settings, when it is not possible to carry out face to face evaluation and therapy, clinical adaptations and teletherapy may be recommended. This review aims to guide speech and language therapists in our country in many ways during the COVID-19 pandemic. Hence, the review will be surely updated, in the light of the new developments.

Keywords

COVID-19, coronavirus, pandemic, speech and language therapy, communication and swallowing disorders, service delivery, post-extubation dysphagia, telepractice, alternative and augmentative communication systems

References

Ajemian, M.S., Nirmul, G.B., Anderson, M.T., Zirlen, D.M. & Kwasnik, E.M. (2001). Routine fiberoptic endoscopic evaluation of swallowing following prolonged intubation: implications for management. The Archives of Surgery, 136(4), 434–437.

ASHA-American Speech-Language-Hearing Association (2020a). SLP Service Delivery Considerations in Health Care During Coronavirus/COVID-19. https://www.asha.org/SLP/healthcare/SLP-Service-Delivery-Considerations-in-Health-Care-During-Coronavirus/#endoscopic (Erişim tarihi: 19.04.2020).

ASHA-American Speech-Language-Hearing Association (2020b). Guidance to SLPs Regarding Aerosol Generating Procedures. https://www.asha.org/SLP/healthcare/ASHA-Guidance-to-SLPs-Regarding-Aerosol-Generating-Procedures (Erişim tarihi: 19.04.2020).

ASHA-American Speech-Language-Hearing Association (2020c). Infection Control Resources for Audiologists and Speech-Language Pathologists.  https://www.asha.org/Practice/infection-control/ (Erişim tarihi: 19.04.2020).

ASHA-American Speech-Language-Hearing Association (2020d). Telepractice. https://www.asha.org/prpprinttemplate.aspx?folderid=8589934956 (Erişim tarihi: 19.04.2020).

Ben-Aharon, A. (2019). A practical guide to establishing an online speech therapy private practice. Perspectives of the ASHA Special Interest Groups, 4(4), 712-718.

Bhatraju, P.K., Ghassemieh, B.J., Nichols, M., et al. (2020). Covid-19 in Critically Ill Patients in the Seattle Region - Case Series. New England Journal of Medicine. doi: 10.1056/NEJMoa2004500

Boisvert, M. & Hall, N. (2014). The use of telehealth in early autism training for parents: a scoping review. Smart Homecare Technology and TeleHealth, 2, 19-27.

Brodsky, M. B., González-Fernández, M., Mendez-Tellez, P. A., Shanholtz, C., Palmer, J. B., & Needham, D. M. (2014). Factors associated with swallowing assessment after oral endotracheal intubation and mechanical ventilation for acute lung injury. Annals of the American Thoracic Society, 11(10), 1545–1552.

Brodsky, M.B., Levy, M.J., Jedlanek, E., Pandian, V., Blackford, B., Price, C., et al. (2018). Laryngeal injury and upper airway symptoms after oral endotracheal intubation with mechanical ventilation during critical care: A systematic review. Critical Care Medicine, 46(12), 2010-2017.

Brodsky, M.B., Pandian, V., & Needham, D.M. (2020). Post-extubation dysphagia: a problem needing multidisciplinary efforts. Intensive Care Medicine, 46, 93–96.

Clark, R. R., Fischer, A. J., Lehman, E. L., & Bloomfield, B. S. (2019). Developing and implementing a telehealth enhanced interdisciplinary pediatric feeding disorders clinic: a program description and evaluation. Journal of Developmental and Physical Disabilities, 31(2), 171-188.

Clawson, B., Selden, M., Lacks, M., Deaton, A. V., Hall, B., & Bach, R. (2008). Complex pediatric feeding disorders: using teleconferencing technology to improve access to a treatment program. Pediatric Nursing, 34(3), 213-217.

Covert, L. T., Slevin, J. T., & Hatterman, J. (2018). The effect of telerehabilitation on missed appointment rates. International Journal of Telerehabilitation, 10(2), 65.

CPLOL-Standing Liaison Committee of E.U. Speech and Language Therapists and Logopedists (2020). Speech-Language Therapy Practice During COVID-19 Emergency Crisis. Üye Ülkelere Gönderilen Bildirge Mektubu. https://www.dktd.org/tr/files/download/p1e6k90k4e10ur1k9ajq287c1iuh4.pdf (Erişim Tarihi: 23.04.2020).