Telepractice: The Australian Experience in an International Context
McCarthy, Melissa, Duncan, Jill, Leigh, Greg, The Volta Review
Telepractice is emerging as a viable alternative to traditional "face-to-face" service as practitioners seek to meet the diverse needs of children who are deaf or hard of hearing and their families. Telepractice provides the opportunity for many countries to expand their reach and viability within their own borders as well as the possibility of delivering some services internationally. The potential benefits of moving to telepractice models of service delivery are significant, but successful implementation requires that consideration be given to potential barriers. As one of the international "early adopters" of telepractice, the experiences of service providers in Australia offer insight into the factors that influence the development of telepractice services as well as some of the potential barriers to implementation.
Telepractice is gaining global acceptance as evidence emerges of its benefits as a service delivery model (Doarn, Protilla, & Sayre, 2010; Gournaris & Leigh, 2004; Mashima & Holtel, 2005; Polovoy, 2008; Szeftel et al., 2011). In Australia, the use of telepractice with children who are deaf and hard of hearing and their families occurred in response to a unique combination of factors that required practitioners to look beyond traditional methods of service delivery. The vast distances in Australia, the low incidence of hearing loss, and the lack of qualified practitioners in the field have led some organizations, such as the Royal Institute for Deaf and Blind Children (RIDBC), to pursue the use of telepractice in supporting families of children who are deaf or hard of hearing.
The Australian Context
More than 10 years ago, two Australian nongovernment centers for children who are deaf and hard of hearing reported on their growing use of telepractice. Projects at those two centers - Taralye in Victoria (Rett, 2001) and Cora Barclay Centre in South Australia (Payne & Duncan, 2001) - variously relied on the use of Internet protocols, or Integrated Services Digital Network (ISDN) technology, to connect children and families in rural Australian locations to services provided in more populous areas. Flett (2001) described the trial placement of computers capable of videoconferencing in two locations to allow early intervention staff to interact with caregivers and the local kindergartens in which the children were enrolled. Payne and Duncan (2001) described the placement of integrated videoconferencing units in schools in remote locations to enable specially trained practitioners to work directly with students with hearing loss and also to communicate with local school personnel about programming and progress. These early applications of videoconferencing technology served as a partial proof of concept for telepractice as a method of service delivery in Australia.
Following these early applications of telepractice technologies, RIDBC developed a larger scale program in the state of New South Wales, initially using ISDN technologies and later using emerging technologies, such as Internet protocols over Symmetric Digital Subscriber Lines (SDSL). More recently, with the benefit of federal government funding support, the RIDBC Teleschool(TM) program has focused on installing dedicated videoconferencing equipment in family homes for the purposes of facilitating interaction between practitioners and families of children who are deaf and hard of hearing (McCarthy, 2011). RIDBC Teleschool has continued to explore the use of a variety of technologies, including cellular networks for vidéoconférence facilitation, iPods and iPads to deliver session-support resources, and the use of Australia's developing National Broadband Network for higher speed and more reliable Internet connections with families in remote locations. A second article in this issue (McCarthy, 2012) provides more detailed information regarding the RIDBC Teleschool program and its model of service delivery.
As one of the international "early adopters" of telecommunications technologies and telepractice to serve the needs of children who are deaf or hard of hearing, Australia is able to act as an example to other countries that are beginning to explore and implement these approaches. …