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Abstract

Background and aim
Telehealth is increasingly used within healthcare, including by Speech and Language Therapists working with people who have aphasia. Aphasia is a communication disability common post stroke that presents challenges for telehealth, (e.g. people with aphasia are more dependent on multimodal communication techniques), which can be difficult to interpret through videoconferencing platforms. Assessments are a core part of the SLT role, and can pose particular challenges for telehealth, (e.g. testing receptive language skills). This study explored how people with aphasia and clinicians experience telehealth in the context of completing assessments, including their priorities for future directions.

Methods and procedures
This study integrated four different research activities from the “Improving access to healthcare: Face-to-face And Telehealth Equivalence of assessments in Aphasia (FATE-A)” study. The four data sources used were: qualitative responses to a survey (n = 124 Speech and Language Therapists), a focus group study (n = 14 Speech and Language Therapists), usability testing sessions (n = 4 Speech and Language Therapists, n = 6 advisers with aphasia) and Patient and Public Involvement and Engagement (PPIE) workshops (n = 7 advisers with aphasia). Findings from the four sources were inductively analysed to develop descriptive themes taking a meta-synthesis approach. Divergence and convergence of themes between sources was explored.

Outcomes and Results
There were three main themes: barriers, facilitators, and current and future preferences. Barriers and facilitators included severity of aphasia and other impairments; presence or absence of helpers; competence with technology (both clinician and person with aphasia); challenges around hardware and video-conferencing platforms; poor versus reliable internet connectivity; factors specific to assessments (e.g. lack of standardized assessment for online use); challenges setting up online assessments; and the emotional impact. Additional facilitators included preparation and support with set-up, and support with emotional wellbeing. Clinicians wanted more resources to facilitate online assessment, better hardware and platforms. While clinicians and people with aphasia perceived benefits to telehealth, both stakeholder groups wanted a flexible personalized hybrid service. Although there was broad congruence of themes, different data sources contributed uniquely, for example, the challenges of negotiating multiple steps to get online (usability testing), and preferred terminology (PPIE).

Conclusions
It is likely that telehealth will continue to be a component of Speech and Language Therapy services. Both people with aphasia and clinicians considered telehealth a valid model of service delivery, so long as it is tailored to the needs of the individual, and is part of a person-centred model of care.

Publication Type:	Article
Additional Information:	© The Authors, 2026. Published by Taylor and Francis. This is an open-access article distributed under the terms of Creative Commons: Attribution Non-commercial No Derivatives Public License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Publisher Keywords:	Telehealth assessment; aphasia; meta-synthesis; hybrid service; usability testing
Subjects:	H Social Sciences > HN Social history and conditions. Social problems. Social reform P Language and Literature > P Philology. Linguistics R Medicine > RC Internal medicine
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Allied Health
SWORD Depositor:	Symplectic Administrator

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