Telepractice in speech-language pathology is an exciting and effective option for serving the growing number of speech students. Telepractice is the use of telecommunications to deliver services, such as speech therapy, at a distance. The Lincoln Intermediate Unit #12 has successfully conducted live web videoconferencing telepractice for speech therapy sessions for many years. 

Telepractice is defined as “the application of telecommunications technology to deliver professional services at a distance by linking clinician to client, or clinician to clinician for assessment, intervention, and/or consultation.”  It is the position of the American Speech-Language-Hearing Association (ASHA) that telepractice is an appropriate model of service delivery for the profession of speech language pathology (ASHA, 2005).  Telepractice may be used to overcome barriers of access to services caused by distance, unavailability of specialists or subspecialists, and/or the client’s impaired mobility. Telepractice offers the potential to extend clinical services to remote, rural, and underserved populations, and to culturally and linguistically diverse populations. 

Looking at “TELE” through Lincoln Intermediate Unit #12 speech programming:

T = Therapy? Yes, it’s another form of service delivery. It is still ‘face-to-face’ and it is still live. LIU telepractice uses a standard computer with securely encrypted video web conferencing to connect student to therapist. Follow this link for systems requirements: https://support.zoom.us/hc/en-us/articles/201362023-System-Requirements-for-PC-and-Mac

These are interactive sessions between student(s) and a Pennsylvania licensed, American Speech-Language-Hearing Association (ASHA) certified, and Pennsylvania Department of Education (PDE) certified Lincoln Intermediate Unit #12 speech-language pathologist (SLP). The SLP uses evidence-based therapeutic techniques, as in more traditional service sessions, to meet the student’s individualized IEP goals in articulation, language, fluency, or voice. 

E = Effective?  Yes, studies have shown that telepractice in speech therapy produce the same outcomes as in-person therapy.  In some cases, greater results were obtained, such as when parents are involved. In others the student would not have had access to any therapy. Curriculum connections and communication with the teachers, and participation in IEP meetings are all possible via email or telecommunications with the LIU SLP. Follow this link to read more about Telepractice studieshttp://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934956§ion=References

L = Legal?  Yes, the use of telepractice does not remove any existing responsibilities in delivering services, including adherence to the Code of Ethics, Scope or Practice, state and federal laws (e.g., licensure, HIPAA, FERPA, and ASHA policy documents on professional practices. Therefore, the quality of services delivered via telepractice must be consistent with the quality of services delivered in-person, must ensure student progress toward IEP goals, and must comply with all state, federal, and local mandates (ASHA, 2005).  

Licensure is the biggest hurdle to telepractice: the practitioner must be licensed in the state in which s/he resides AND in the state the client resides. The therapist delivering the service must be Pennsylvania Certified, as well as observe any corresponding requirements ancillary to their professional license/certification. Currently, there is no federal  law which prohibits the use of this method of service delivery. The student’s IEP team makes a determination on a case-by-case basis if the student is a good candidate for this type of service delivery model. Follow this link for additional information on laws and regulations: http://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934956§ion=Key_Issues#State_and_Federal_Laws_and_Regulations

E = Everyone?  Almost everyone! But it is not suitable for all clients/students. An example:  Articulation – it is often difficult to see and hear the subtle changes in articulatory precision, and if physical manipulation of the articulators is required to achieve optimal positioning for sound production, this cannot be done via telepractice. Some students with significant attention, behavior, or physical issues that prevent them from using a computer may be better served by traditional methods of therapy. Follow this link for information on client selection: 

http://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934956§ion=Key_Issues#Client/Patient_Selection 

Telepractice Testimonials

"I think that when I was doing speech on the computer, it was more interesting than in person. If was fun because I have never had to do speech on the computer before. I also like it because when we do speech, we play games on the white board. We also can share our screen with each other so we can see what the other person is doing. Then again, I have never web chatted with anyone before. That is why I like doing speech over the computer."                                                                                                                                  Student, 8th grade

" Telepractice is an interactive, engaging, alternative to traditional speech methods. Over the past four years we have transitioned from traditional "in-person" methods to Telepractice and I have noticed greater interest and excitement from the students to participate since we have made the switch. My students have been improving as expected per their individual goals with Telepractice. The applications and tools used to complete speech sessions over the computer are effective and appealing for our current generation of students. They are excited to participate and look forward to their sessions every week, which is behavior that I had not observed from the students when we observed traditional speech and language practices. "                                                                                                                                                            Special Education Teacher 

How to get started?

1. Cost?  If your district already purchases speech services from the Lincoln Intermediate Unit #12, there is no additional cost for telepractice, other than the actual service time!  If your district does not contract for speech services, there are fees associated. 
   
   
2. Review the following information regarding requirements for PC or Mac computers:  https://support.zoom.us/hc/en-us/articles/201362023-System-Requirements-for-PC-and-Mac
   
   
3. Contact Jamie R. Tome, SLP, Supervisor of Speech Language Support Services at (717) 624-6468 or    jrtome@iu12.org