The challenges of applying pragmatic language assessment via telehealth in Saudi Arabia

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Background: During the COVID-19 pandemic, many speech and language therapists (SLTs) adopted telehealth instead of face-to-face sessions to provide assessment and intervention to children with speech and language difficulties. However, there is limited information regarding the application of telehealth assessment to children with pragmatic difficulties, particularly in Saudi Arabia. Aims: This research explores the challenges of implementing pragmatic language assessment via telehealth for children in Saudi Arabia. It seeks to understand the assessment tools used in telehealth pragmatic language skills compared with face-to-face sessions, the advantages and disadvantages of implementing telehealth assessment and the future applicability of telehealth assessment of pragmatic language skills. Methods: A mixed methodology was used; this consisted of 25 surveys with closed and open- ended questions and semi-structured interviews with 7 SLTs. Results: Almost half of the SLTs (12 SLTs, 48%) conducted telehealth assessments during the COVID-19 lockdown. Most SLTs adjusted the assessment tools for telehealth, relying predominantly on informal assessment, including family questionnaires and child observation. Advantages were easy access to assessment service and observing the children in their natural environment setting. However, major difficulties included limited assessment tools as well as technical issues. Overall, telehealth assessment is a potential alternative method for assessing children’s pragmatic language skills. However, some recommendations were reported by SLTs to overcome the challenges in the future. Conclusion: Telehealth assessment is a growing area; hence, further research is needed to address the challenges and recommendations for its effective implementation for children with pragmatic language difficulties.