An Insight Into Perceptions of Speech-language Pathologists About the Barriers to Providing Online Speech-language Therapy in Iran

Objective The advancements in communication and information technology have brought about significant changes in the provision of healthcare services, including speech-language therapy. In this regard, telehealth has recently emerged as an accessible and effective method. The present study aims to identify the challenges of providing online speech-language therapy services in Iran from the perspective of speech-language pathologists. Materials & Methods This qualitative study was conducted from 2021 to 2022. Snowball sampling was used to select 14 speech-language pathologists (10 females and 4 males) with a mean age of 29 years and at least one year of experience in providing online services during the COVID-19 pandemic. Data were collected using semi-structured interviews, conducted individually by audio and video calling on messaging apps (WhatsApp and Skype). Data analysis was done using the thematic data analysis method. Results Six themes emerged: Lack of educational/professional guidelines (lack of academic training related to the provision of online speech therapy services, and absence of clear guidelines for conducting online speech therapy), socio-cultural issues (interference of work with personal life, and informality of online sessions), communicational/interactional challenges (lack of face-to-face interaction with patients, slow internet speed for communication and data transmission, poor video quality in Iranian apps, distraction and increased inclination of children to play with phones, filtering of foreign messaging apps, inadequate internet coverage in some rural and urban areas, and lack of specialized and official apps for online service delivery), financial barriers (inability of some families to afford internet packages and suitable phones, unwillingness of some families to pay high fees for online speech therapy, and unclear pricing for online speech therapy services), decreased quality of patient assessment/treatment (inability to correctly implement certain therapeutic techniques, inaccurate assessment of children, incorrect diagnosis of speech-language disorders, lack of accurate recognition of the child’s abilities, failure to hold group therapy sessions, the use of diagnostic and therapeutic tools, and increased fatigue and burnout for therapists and families), and lack of supervision over therapy sessions (involvement of non-professionals in online therapy, and neglect of patient rights). Conclusion Various structural, professional, cultural, and ethical barriers can hinder the delivery of online speech-language therapy services in Iran. Providing educational programs in medical universities, developing essential guidelines to protect the rights of therapists and patients, designing specialized and efficient apps, and establishing proper communication infrastructure can facilitate the online provision of these services in Iran.