Using Virtual Clinics for Speech and Language Therapy
By Jayne Ramirez Inscoe, Advanced Specialist in Communication, Nottingham Auditory Implant Programme
H was 15 years old when he was re-referred to the Nottingham Auditory Implant Programme (NAIP). His hearing loss had deteriorated to the point where the best acoustic hearing aids could not provide him with adequate hearing for speech.
Living with his family in Hereford, he understood that he would have to miss school and study time and travel to and from Nottingham in order to receive cochlear implants, during the year running up to his GCSE preparation. As a teenager, we knew that H himself would need to be motivated in order to achieve his potential with the new cochlear implant technology.
Whilst waiting for the operation, H proudly showed me his new smartphone, which he could not use to make conventional phone calls as he could not hear effectively, however we discussed some of the innovative ways that NAIP and the implant manufacturers were trialling internet applications for patients to check and control what they were hearing, and how virtual clinics were being used as an alternative to face-to-face appointments for some patients. H was highly motivated and interested in using these applications himself.
Over the first 6 months, clinicians offered rehab support at school and in the clinic. H needed to learn to trust the increased access to speech afforded by his cochlear implant technology. He continued to mishear and misperceive words, particularly in challenging listening conditions and needed to remember to clarify what had been said. H was interested in trying a virtual clinic at home out of school hours for subsequent rehab appointments, avoiding the need for him to miss lessons.
The impact of implementing Virtual Clinic
Virtual Clinic allowed the clinician to have a dialogue with H about how things were going, meaning his parents could observe how he was able to speak for himself, ask and answer questions and to cope with communication breakdown and repair. By using Virtual Clinic, H was able to use his excellent lip-reading to support his listening, and he gained the confidence to make more video calls with family and friends as an alternative to conventional phone calls.
The clinician has been able to monitor H’s progress with his cochlear implants and offer advice as effectively as face-to-face visits, saving travel time and costs for both the clinician and the family. But the biggest gains have been in H’s increased independence, use of effective communication strategies and ability to make video calls with family and friends. H hopes to study Drama in the future, and the skills he has developed using Virtual Clinic will be essential for a successful career.