Adapting Telepractice to School-Based Situations

Are you a school-based clinician adapting to telepractice? Do you feel overwhelmed during these uncertain times?

You’re definitely not alone. Many school districts are turning to telepractice to ensure continuity of services for their students with IEPs. As school closures extend through the current academic year—and possibly beyond, so does the demand for quality remote service delivery.

Navigating this kind of uncharted territory brings unique challenges, but we can get through this. It’s extremely important to stay on top of the latest state and federal updates relating to telepractice policies, licensure requirements, procedures, and regulations. Frequently visiting the websites for your professional organization (such as ASHA and AOTA) is a great way to stay informed on issues like these.

Implementing an Effective Telepractice Plan

There are a number of special considerations you’ll need to account for when implementing an effective telepractice plan for school districts. With so much uncertainty surrounding the timeline for a return to traditional in-person instruction, planning for potential longer-term remote services is imperative.

Here are just a few of the things that should be a part of the planning process.

1. Adequate training and professional development for SLPs, OTs, and support staff

The shift toward telepractice has happened so quickly that, for many, relying on one’s own resourcefulness or reaching out to other telepractitioners for guidance and support became one of the primary sources of information during the preliminary stages of this ongoing healthcare crisis. As the dust begins to settle, school districts need to ensure that the professional development and ongoing relevant training is available to therapists and their support staff.

These trainings should relate specifically to:

• The platform being used
• How to deliver an effective teletherapy session
• Case studies to demonstrate best practices for teletherapy
• How to successfully administer assessments via a teletherapy platform
• How to select a variety of appropriate materials to utilize with various deficits via teletherapy

These and similar trainings are vital to the success of a school-based teletherapy program. Keep in mind—there is a learning curve to delivering therapy services remotely; however, once clinicians gain the necessary skills and begin to feel more comfortable with telepractice, it truly is an effective service delivery model.

2. Proper equipment to ensure the delivery of comparable services

Ensuring that basic equipment is available to both the clinician and student is a prerequisite to quality service delivery. The minimum requirements are:

• A desktop/laptop
• Webcam (built-in or external)
• Headset or microphone (noise cancelling works best for maximum audio output)
• High-speed internet connection
• Ethernet cable to connect directly to the router (an ideal situation is direct connection for highest overall bandwidth, but if Wi-Fi use is necessary, instruct students to be as close to the router as possible)
• Teletherapy platform and a policy in place that adheres to HIPAA and FERPA guidelines

3. Educating the parent/caregiver to clearly communicate expectations for success

When providing services remotely from a student’s home, parent/caregiver involvement is critical to the student’s overall success. Developing and maintaining a strong line of communication between the clinician, the school, and the student’s family members needs to begin as early as possible.

Parents/caregivers need to be made aware of the vital role they play in ensuring that their child logs in as scheduled, is prepared with necessary equipment, is in a quiet room free of distractions, and completes all carryover assignments. It really is a team effort, and parents/caregivers need to be educated on the importance of their commitment.

When executed properly, parents/caregivers become highly effective collaborators in the therapy sessions of the youngest students and greatly aid in skill carryover.

4. Access to resources and materials to aid in a smooth transition to telepractice

Keeping students motivated and engaged via teletherapy definitely impacts their active participation during your sessions. If they are having fun while learning, measurable outcomes tend to be better.

It is important to familiarize yourself with the wide variety of teletherapy platform-friendly digital options, including:

• Boom Cards™
• Resources for Google Drive
• Interactive PowerPoints
• Interactive PDFs
• Static PDFs

You should also keep in mind that activities that were effective in your face-to-face therapy can easily be adapted to work well with remote teletherapy sessions as well.

5. A review of current caseload sizes to ensure a manageable workload¹

Caseload sizes have been a constant challenge for school-based SLPs and OTs. When developing a plan for telepractice, it is crucial to consider group size limitations and how this can greatly impact a manageable workload.

From a general standpoint, group sizes via teletherapy are, on average, 2:1 or 3:1. This is primarily due to concerns with bandwidth to ensure quality audio and video output for all parties involved in the session.

As the size of the group grows, so does the potential for a compromised connection, which has a huge negative impact on the overall integrity of the session.

6. A network of trained professionals to turn to for support

Feeling supported by and connected to a team of fellow professionals helps to ensure a positive work environment. Working remotely should not mean you are feeling isolated and alone. Effort on the part of the school district (or your employer) needs to be made in order to equip you with a virtual professional learning community.

This network will ideally allow you to partner with fellow clinicians who have experience with telepractice or who can provide you with the resources you need to further your professional development.

Telepractice is a growing service delivery model, now more than ever before. With the current huge surge in the demand for quality teletherapy, it is imperative that schools around the world develop a plan to serve their students in the least restrictive environment as possible while ensuring that services are comparable to the traditional brick-and-mortar setting.

In the short-term, telepractice is a great solution to continuing therapy services for students in need. The long-term picture could prove that telepractice is a viable addition to speech-language pathology and occupational therapy departments in school districts to help bridge the gap and reduce the strain in this critical shortage area.

The evidence shows that telepractice is effective,² and proper implementation of this new way of connecting with our students will continue to help children all over the world progress and grow toward their therapy goals.