JCPSLP Vol 23, Issue 1 2021

substitutes, they did not successfully navigate the challenges of identifying alternatives for hands-on tactile cues, suggesting further training in this area would support telehealth practice. Facilitators to successful telehealth included administrative support for clinicians and more explicit discussion with parents or direct training relating to their co-therapist role. Managers acknowledged increased clinician anxiety related to telehealth practice and the need for additional administrative support for clinicians, as well as the importance of preparing telehealth rooms. The COVID-19 pandemic has required many clinicians to rapidly expand telehealth practice with young children. This study underlines the value of exploring telehealth practice changes to identify how clinicians can better respond to telehealth practice. Acknowledgements BUSHkids provided the setting, clinicians and equipment for this research and proposed the telehealth models to be trialled. BUSHkids sponsored the first author’s PhD scholarship and provided funds for transcription. The authors have no conflict of interest to declare. They take complete responsibility for the integrity of the data and accuracy of data analysis. References Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology , 3 (2), 77–101. https://doi.org/10.1191/1478088706qp063oa Commonwealth of Australia. (2019). Australian Early Development Census National Report 2018: A snapshot of early childhood development in Australia . https://www. aedc.gov.au/resources/detail/2018-aedc-national-report Coufal, K., Parham, D., Jakubowitz, M., Howell, C., & Reyes, J. (2018). Comparing traditional service delivery and telepractice for speech sound production using a functional outcome measure. American Journal of Speech-Language Pathology , 27 (1), 82–90. https://doi.org/10.1044/2017_ AJSLP-16-0070 Creswell, J. W., Hanson, W. E., Clark Plano, V. L., & Morales, A. (2007). Qualitative Research Designs: Selection and Implementation. The Counseling Psychologist , 35 (2), 236-264. https://doi.org/10.1177/0011000006287390 Deveney, S. L., Hagaman, J. L., & Bjornsen, A. L. (2017). Parent-implemented versus clinician-directed interventions for late-talking toddlers: A systematic review of the literature. Communication Disorders Quarterly , 39 (1), 293–302. https://doi.org/10.1177/1525740117705116 Dew, A., Bulkeley, K., Veitch, C., Bundy, A., Gallego, G., Lincoln, M., Brentnell, J., Griffiths, S. (2013). Addressing the barriers to accessing therapy services in rural and remote areas. Disability and Rehabilitation , 35 (18), 1564–1570. https://doi.org/10.3109/09638288.2012.720346 Ekberg, S., Danby, S., Theobald, M., Fisher, B., & Wyeth, P. (2018). Using physical objects with young children in “face-to-face” and telehealth speech and language therapy. Disability and Rehabilitation , 41 (14), 1–12. https://doi.org/ 10.1080/09638288.2018.1448464 Emerson, R. M., Fretz, R. I., & Shaw, L. L. (2011). Writing ethnographic fieldnotes. University of Chicago Press. https://doi.org/10.7208/ chicago/9780226206851.001.0001 Fairweather, G. C., Lincoln, M., & 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 Gabel, R., Grogan-Johnson, S., Alvares, R., Bechstein, L., & Taylor, J. (2013). A field study of telepractice for school intervention using the ASHA NOMS K-12 database. Communication Disorders Quarterly , 35 (1), 44–53. https:// doi.org/10.1177/1525740113503035 Grogan-Johnson, S., Alvares, R., Rowan, L., & Creaghead, N. (2010). A pilot study comparing the effectiveness of speech language therapy provided by telemedicine with conventional on-site therapy. Journal of Telemedicine and Telecare , 16 (3), 134–139. https://doi. org/10.1258/jtt.2009.090608 Grogan-Johnson, S., Gabel, R. M., Taylor, J., Rowan, L. E., Alvares, R., & Schenker, J. (2011). A pilot exploration of speech sound disorder intervention delivered by telehealth to school-age children. International Journal of Telerehabilitation , 3 (1), 31–42. https://doi.org/10.5195/ ijt.2011.6064 Grogan-Johnson, S., Schmidt, A. M., Schenker, J., Alvares, R., Rowan, L. E., & Taylor, J. (2013). A comparison of speech sound intervention delivered by telepractice and side-by-side service delivery models. Communication Disorders Quarterly , 34 (4), 210–220. https://doi. org/10.1177/1525740113484965 Hines, M., Lincoln, M., Ramsden, R., Martinovich, J., & Fairweather, C. (2015). Speech pathologists’ perspectives on transitioning to telepractice: What factors promote acceptance?. Journal of Telemedicine and Telecare , 21 (8), 469–473. https://doi.org/10.1177/1357633x15604555 Ingersoll, B., & Berger, N. I. (2015). Parent engagement with a telehealth-based parent-mediated intervention program for children with autism spectrum disorders: Predictors of program use and parent outcomes. Journal of Medical Internet Research , 17 (10), e227. https://doi. org/10.2196/jmir.4913 Law, J., Garrett, Z., Nye, C., & Law, J. (2003). Speech and language therapy interventions for children with primary speech and language delay or disorder. Cochrane Database of Systematic Reviews , (3) https://doi. org/10.1002/14651858.cd004110 Lincoln, M., Hines, M., Fairweather, C., Ramsden, R., & Martinovich, J. (2014). Multiple stakeholder perspectives on teletherapy delivery of speech pathology services in rural schools: A preliminary, qualitative investigation. International Journal of Telerehabilitation , 6 (2), 65–74. https://doi. org/10.1177/1357633x15604555 Parnandi, A., Karappa, V., Lan, T., Shahin, M., McKechnie, J., Ballard, K., Ahmed, B., & Gutierrez- Osuna, R. (2015). Development of a remote therapy tool for childhood apraxia of speech. ACM Transactions on Accessible Computing (TACCESS) , 7 (3), 1–23. https://doi. org/10.1145/2776895 Parsons, D., Cordier, R., Vaz, S., & Lee, H. C. (2017). Parent-mediated intervention training delivered remotely for children with autism spectrum disorder living outside of urban areas: Systematic review. Journal of Medical Internet Research , 19 (8), e198–e198. https://doi.org/10.2196/ jmir.6651 Phoenix, M., Smart, E., & King, G. (2020). “I didn’t know what to expect”: Describing parents’ expectations in children’s rehabilitation services. Physical & Occupational Therapy In Pediatrics , 40 (3), 311–329. https://doi.org/10. 1080/01942638.2019.1665155

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JCPSLP Volume 23, Number 1 2021

Journal of Clinical Practice in Speech-Language Pathology