Working in schools for 23 years was very rewarding for me, but in 2012, I found myself looking for a different avenue for delivering speech-language pathology services. Simply, I was ready for a change.
Therapy sessions seemed to have become more condensed, requiring me to work with groups rather than specific students, which was not always beneficial for them. Incorporating technology into therapy sessions seemed to help my students maintain focus, motivating them to work. Whether I used technology to help students practice articulation drills, writing organization or social skills, they enjoyed it.
Could I find a job opportunity that would allow me to bring together my interests in working from home and using technology to provide speech-language services? The answer seemed to be “telepractice,” also known as “teletherapy.”
I knew leaving my position in the schools would be a bit intimidating. Questions began swirling through my mind: What were the “pros” and the “cons” of leaving my current position? Would it be worth leaving the schools to work from home? Did I want to provide treatment as an employee of a company or as a private provider?
I’ve always wanted to work from home; being able to transport my children to and from school and spending time with them afterward was a major motivator. I’ve also longed for scheduling flexibility that working from home would allow (the ability to throw in a load of laundry between sessions or plan in the evening without needing to drive back to work). But would I miss the staff camaraderie? What about students’ hugs? Would I feel isolated? Since I began providing telepractice treatment, the answer to each of these potential drawbacks has been “no.” To me, the “pros” have far outweighed the “cons.”
I researched telepractice some more on the ASHA website, which reviews studies pointing to teletherapy’s efficacy, and joined ASHA Special Interest Group 18, Telepractice. I later attended a teletherapy training in Maine that tasks that would ordinarily take 60 minutes to complete when providing “onsite” speech/language therapy could be accomplished during approximately 35 minutes of teletherapy!
Next, I considered providing teletherapy as a private practitioner, but I balked at the additional marketing and operational work that would require, even though I knew it would mean being my own boss and making my own schedule.
After careful consideration, I decided to accept an offer to become a teletherapist with a company I knew delivered quality training and treatment. At my company’s direction, I attended American Telemedicine Association-accredited training provided by Michael Towey.
Regarding equipment, I recommend using:
• A laptop with at least a 15” screen and built-in webcam (or you can use an external webcam).
• A headset with attached microphone or external speakers with an external microphone (I prefer a headset because the microphone is always close to the students’ mouths).
• A document camera for use during therapy. You can find most of this equipment on Amazon.
The software I use is a HIPPA-compliant, video-conferencing platform provided by my employer. It is important to consider security and compliance when selecting a Web-conferencing platform (Skype, for instance, is not compliant). Some telepractice companies require that you purchase your own equipment as well as their telepractice software. Be sure to consider that in your research.
For materials, I have found different online resources to draw from: SLP blogs (such as ChapelHillSnippets.com), eNewsletters, and ASHAsphere. I often use my own materials via a document camera. Once I received the necessary equipment and became comfortable with it, I worked on reviewing each student’s IEP, listing goals/objectives for each, and documenting IEP/re-evaluation due dates. Training a paraprofessional was the next step because I needed someone to: chaperone students coming to and leaving from therapy, be a behavior manager as needed, serve as a technology problem-solver, help as a student-response “confirmer,” and be a “skill-carryover” assistant when possible.
Connecting with students via teletherapy has a different “feel” when compared to onsite therapy. While working in the schools, students would draw pictures for me, hug me, and stop in my speech room to see how my day was going. Obviously hugs aren’t available over the Internet, but I have found that there are other ways to connect with students.
Frequently, when students first join the session, their faces light up, and I’ll hear, “Good morning, Mrs. Sippl! What are we doing today?” If my students earn a few minutes of free-choice time at the end of a therapy session, frequently they will ask to draw or color online. Once they’re done, they’ll explain that the drawing is for me and that I need to print it out to hang on my wall. As you can see, the “connection” with students is not lost. It is just different.
Based on my own telepractice experiences, my sense is that students are able to accomplish more in less time compared with face-to-face therapy. Teletherapy has its own rewards, and students find ways to show you how important you are to them. Once, as I was working with a Kindergarten student, she looked at me and exclaimed, “Hi, Mrs. Sippl! I’m so excited to see you today! I love you!”
Tracy Sippl, MS, CCC-SLP, is a Seymour, Wis.-based speech-language pathologist and tele-therapist with Cumberland Therapy Services. She is an affiliate of ASHA Special Interest Group 18, Telepractice.