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.
COVID-19, coronavirus, pandemic, speech and language therapy, communication and swallowing disorders, service delivery, post-extubation dysphagia, telepractice, alternative and augmentative communication systems
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).
DKTD-Dil ve Konuşma Terapistleri Derneği (2020a). Dil ve Konuşma Terapistleri için COVID-19 Pandemi Kılavuzu. https://www.dktd.org/tr/files/download/p1e6m6ogp1142oouinq9175s12oh4.pdf (Erişim Tarihi: 23.04.2020).
DKTD-Dil ve Konuşma Terapistleri Derneği (2020b). COVID-19 ADİS Kartı. Hazırlayan: Daşdöğen, Ü. https://www.dktd.org/tr/files/download/p1e4e8vmkl9em1igs18nuad810to4.pdf (Erişim Tarihi: 13.04.2020).
DKTD-Dil ve Konuşma Terapistleri Derneği (2020c). Dil ve Konuşma Terapisinde Tele-Terapi Uygulama Kılavuzu. Nisan 2020. https://www.dktd.org/tr/dktd-tele-terapi-kilavuzu-a (Erişim tarihi: 13.04.2020).
Doarn, C. R., Zacharias, S., Keck, C. S., Tabangin, M., DeAlarcon, A., & Kelchner, L. (2019). Design and implementation of an interactive website for pediatric voice therapy—the concept of in-between care: a telehealth model. Telemedicine and e-Health, 25(5), 415-422.
Douglas, S. N., Nordquist, E., Kammes, R., & Gerde, H. (2017). Online parent training to support children with complex communication needs. Infants & Young Children, 30(4), 288-303.
El Solh, A., Okada, M., Bhat, A., Pietrantoni, C. (2003). Swallowing disorders post orotracheal intubation in the elderly. Intensive Care Medicine, 29(9), 1451–1455.
Fu, S., Theodoros, D. G., & Ward, E. C. (2015). Delivery of intensive voice therapy for vocal fold nodules via telepractice: a pilot feasibility and efficacy study. Journal of Voice, 29(6), 696-706.
Goldsmith, T. (2000). Evaluation and treatment of swallowing disorders following endotracheal intubation and tracheostomy. International Anesthesiology Clinics, 38(3), 219–242.
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.
Guan WJ., Ni Z., Hu Y., Liang W., Ou C., …, Zhong N. ark. (2020) Clinical Characteristics of Coronavirus Disease 2019 in China. New England Journal of Medicine. 382, 1708-1720.
Hafner, G., Neuhuber, A., Hirtenfelder, S., Schmedler, B., & Eckel, H. E. (2008). Fiberoptic endoscopic evaluation of swallowing in intensive care unit patients. European archives of otorhinolaryngology: Official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): Affiliated with the German Society for Oto-Rhino-Laryngology – Head and Neck Surgery, 265(4), 441–446.
Karlsson, V., Bergbom, I., & Forsberg, A. (2012). The lived experiences of adult intensive care patients who were conscious during mechanical ventilation: A phenomenological-hermeneutic study. Intensive and Critical Care Nursing, 28 (1), 6-15.
Lauer SA., Grantz KH., Bi Q., Jones FK., Zheng Q., …, Lessler J. ve et al . (2020) The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application. Annals of Internal Medicine.
Lavoie, M., Macoir, J., & Bier, N. (2017). Effectiveness of technologies in the treatment of post-stroke anomia: a systematic review. Journal of Communication Disorders, 65, 43-53.
Leder, S. B., Warner, H. L., Suiter, D. M., Young, N. O., Bhattacharya, B., Siner, J. M., et al. (2019). Evaluation of swallow function post-extubation: is it necessary to wait 24 hours? Annals of Otology, Rhinology & Laryngology, 128(7), 619–624.
Lee, S. A. S. (2018). The treatment efficacy of multiple opposition phonological approach via telepractice for two children with severe phonological disorders in rural areas of West Texas in the USA. Child Language Teaching and Therapy, 34(1), 63-78.
Liu Y, Gayle AA, Wilder-Smith A & Rocklov J. (2020) The reproductive number of COVID-19 is higher compared to SARS coronavirus. Journal of Travel Medicine, 2ci7(2).
Liu, J., Zheng X., Tong Q., Li W., Wang B., … & Yang D. (2020). Overlapping and discrete aspects of the pathology and pathogenesis of the emerging human pathogenic coronaviruses SARS‐CoV, MERS‐CoV, and 2019‐nCoV. Journal of Medical Virology, 92(5), 491-494.
Macht, M., King, C. J., Wimbish, T., Clark, B. J., Benson, A. B., Burnham, E. L., Williams, A., & Moss, M. (2013a). Post-extubation dysphagia is associated with longer hospitalization in survivors of critical illness with neurologic impairment. Critical Care, 17(3), R119.
Macht, M., Wimbish, T., Bodine, C. & Moss, M. (2013b). ICU-Acquired Swallowing Disorders, Critical Care Medicine, 41(10), 2396-2405.
Macht, M., Wimbish, T., Clark, B. J., Benson, A. B., Burnham, E. L., Williams, A., & Moss, M. (2012). Diagnosis and treatment of post-extubation dysphagia: results from a national survey. Journal of Critical Care, 27(6), 578–586.
McCarthy, M., Leigh, G., & Arthur-Kelly, M. (2019). Telepractice delivery of family-centred early intervention for children who are deaf or hard of hearing: A scoping review. Journal of Telemedicine and Telecare, 25(4), 249–260.
Malandraki, G. A., & Kantarcigil, C. (2017). Telehealth for dysphagia rehabilitation: the present and the future. Perspectives of the ASHA Special Interest Groups, 2(18), 42-48.
Malandraki, G. A., Roth, M., & Sheppard, J. J. (2014). Telepractice for pediatric dysphagia: a case study. International Journal of Telerehabilitation, 6(1), 3.
Marinschek, S., Dunitz‐Scheer, M., Pahsini, K., Geher, B., & Scheer, P. (2014). Weaning children off enteral nutrition by netcoaching versus onsite treatment: a comparative study. Journal of Paediatrics and Child Health, 50(11), 902-907.
Marvin, S., Thibeault, S., & Ehlenbach, W.J. (2019). Post-extubation dysphagia: does timing of evaluation matter? Dysphagia, 34, 210–219.
McGill, M., Noureal, N., & Siegel, J. (2019). Telepractice treatment of stuttering: a systematic review. Telemedicine and e-Health, 25(5), 359-368.
Molini-Avejonas, D.R., Rondon-Melo, S., Albuquerque de La Higuera Amato, C. & Samelli, A. G. (2015). A systematic review of the use of telehealth in speech, language and hearing sciences. Journal of Telemedicine and Telecare, 0(0), 1-21.
Overby, M. S. (2017). Stakeholders’ qualitative perspectives of effective telepractice pedagogy in speech-language pathology. International Journal of Language & Communication Disorders. 00(0), 1-12.
Patel, D. A., Krishnaswami, S., Steger, E., Conover, E., Vaezi, M. F., Ciucci, M. R., & Francis, D. O. (2018). Economic and survival burden of dysphagia among inpatients in the United States. Diseases of the esophagus. Official Journal of the International Society for Diseases of the Esophagus, 31(1), 1–7.
Peter, B., Potter, N., Davis, J., Donenfeld-Peled, I., Finestack, L., Stoel-Gammon, C., ... & Yokoyama, H. (2020) Speech and language treatment: randomized pilot trial of the Babble Boot Camp in infants with classic galactosemia [version 3; peer review: 2 approved with reservations]. F1000Research, 2020, 8:271
Postma, G.N., McGuirt, W.F., Sr, Butler, S.G., Rees, C.J., Crandall, H.L. & Tansavatdi, K. (2007). Laryngopharyngeal abnormalities in hospitalized patients with dysphagia. The Laryngoscope, 117, 1720-1722.
Pullins, V., & Grogan-Johnson, S. (2017). A clinical decision making example: Implementing intensive speech sound intervention for school-age students through telepractice. Perspectives of the ASHA Special Interest Groups, 2(18), 15-26.
Rangarathnam, B., McCullough, G. H., Pickett, H., Zraick, R. I., Tulunay-Ugur, O., & McCullough, K. C. (2015). Telepractice versus in-person delivery of voice therapy for primary muscle tension dysphonia. American Journal of Speech-Language Pathology, 24(3), 386-399.
RCSLT-Royal College Speech Language Therapy (2020). Royal College Speech Language Therapy Guidance on Personal Protective Equipment (PPE) and COVID-19 (2020). https://www.rcslt.org/-/media/docs/Covid/RCSLT-PPE-guidance-27-March-2020.pdf?la=en&hash=22F876E1C13587A0904D34149D02D7ECFEC15FBC. (Erişim Tarihi: 13.04.2020).
Sayın, İ., Yazıcı, Z. M.; Öz, F. ve Akgül, A. (2020). COVID-19 Salgınında Kulak Burun Boğaz ve Baş Boyun Cerrahisi Perspektifi. Turkiye Klinikleri Journal of Medical Sciences, Available online: 14 Apr 2020, DOI: 10.5336/medsci.2020-75313 (Erişim Tarihi: 19.04.2020).
Scheel, R., Pisegna, J. M., McNally, E., Noordzij, J. P., & Langmore, S. E. (2016). Endoscopic assessment of swallowing after prolonged intubation in the ICU setting. Annals of Otology, Rhinology & Laryngology, 125(1), 43–52.
Skoretz, S. A., Flowers, H. L., & Martino, R. (2010). The incidence of dysphagia following endotracheal intubation: A systematic review. Chest, 137, 665–673.
Skoretz, S. A., Yau, T. M., Ivanov, J., Granton, J. T., & Martino, R. (2014). Dysphagia and associated risk factors following extubation in cardiovascular surgical patients. Dysphagia, 29, 647–654.
SPA-Speech Pathology Australia guidance for service delivery, clinical procedures and infection control during COVID-19 pandemic. https://www.speechpathologyaustralia.org.au/SPAweb/About_us/COVID-19_News_and_Information/COVID-19__Guidance_for_Service_Delivery/SPAweb/About_Us/COVID-19/Guidance_for_Service_Delivery.aspx?hkey=fc19a880-e7a8-4246-8631-a474fc43d4ae (Erişim tarihi: 18.03.2020).
Sputnik Türkiye. (2020). https://tr.sputniknews.com/koronavirus-salgini/202004111041805874-koronavirusun-bazi-farkli-belirtileri-ortaya-cikti-koordinasyon-ve-konusma-bozuklugu/ 11.04.2020. (Erişim Tarihi: 13.04.2020).
T.C. Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü. COVID-19 Rehberi. COVID-19 (SARS-CoV-2 Enfeksiyonu) Rehberi. Bilim Kurulu Çalışması. https://covid19bilgi.saglik.gov.tr/depo/rehberler/COVID-19_Rehberi.pdf (Erişim tarihi: 17.04.2020).
Taylor, O. D., Armfield, N. R., Dodrill, P., & Smith, A. C. (2014). A review of the efficacy and effectiveness of using telehealth for paediatric speech and language assessment. Journal of Telemedicine and Telecare, 20(7), 405-412.
Theodoros, D., Aldridge, D., Hill, A. J., & Russell, T. (2019). Technology‐enabled management of communication and swallowing disorders in Parkinson's disease: a systematic scoping review. International Journal of Language & Communication Disorders, 54(2), 170-188.
Topbaş, S. (2019). T.C. Cumhurbaşkanlığı Eğitim ve Öğretim Politikaları Kurulu’na sunulan 2019/19 sayılı 24.01. 2019 tarihli DKTD Raporu.
Wales, D., Skinner, L., & Hayman, M. (2017). The efficacy of telehealth-delivered speech and language intervention for primary school-age children: a systematic review. International Journal of Telerehabilitation, 9(1), 55.
Weidner, K., & Lowman, J. (2020). Telepractice for adult speech-language pathology services: a systematic review. Perspectives of the ASHA Special Interest Groups, 5(1), 326-338.
World Health Organization. Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected: interim guidance. https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected (Erişim tarihi: 19.04.2020).
World Health Organization. Coronavirus disease 2019 (COVID-19). Situation report-89 https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200418-sitrep-89-covid-19.pdf?sfvrsn=3643dd38_2 (Erişim tarihi: 19.04.2020).
World Health Organizasiton (2020). Naming the coronavirus disease (COVID-19) and the virus that causes it. https://www.who. int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virusthat-causes-it (Erişim tarihi: 19.04.2020).
Wu, Y., Xu, X., Chen, Z., Duan, J., Hashimoto, K., Yang, L., Liu, C., & Yang, C. (2020). Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain, Behavior, and Immunity, S0889-1591(20)30357-3.