Home Audiology 5 Steps to Get Started in Telepractice

5 Steps to Get Started in Telepractice

by Jessi Andricks
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mother and daughter using computer

Over the last few weeks, many schools and clinics nationwide—well, really worldwide—have been shutting down in response to COVID-19. While this is an uncertain time for all of us, fortunately many speech-language pathologists might be able to offer services for clients using telepractice.

Editor’s note: It is our hope to be inclusive of both professions, but we’re aware of the difficulty for many of our members, audiologists and SLPs alike, to convert their work to a telepractice model. According to ASHA guidelines, use of telepractice must be equivalent to the quality of services provided in person and consistent with adherence to the Code of Ethics, audiology scope of practice, speech-language pathology scope of practice, state and federal laws, and ASHA policy.

Even before this pandemic, more of us started using telepractice to provide services. Even if you have never held a telepractice session before, making the switch may be easier than you expect. For me, engaging students or clients through a video screen doesn’t feel much different than sitting across a table from them.

Here are a few things to consider as you get started:

Choosing a video conference platform

Per ASHA guidelines, your sessions need to be held over a video conference. As a general rule, free online meeting platforms do not have the encryption or security measures required to maintain student privacy. Some HIPAA-friendly platforms include: GoToMeeting, WebEx and the HIPAA-compliant version of Zoom. Facetime, Skype and Facebook Messenger are not HIPAA-compliant. Choose a meeting platform with password protection for each session.

Editor’s note: President Trump recently indicated that HIPAA restrictions on the use of platforms such as FaceTime and Skype for telepractice have been lifted. ASHA staff are reviewing that document.

Look for these basic features when choosing a platform:

  • Webcam sharing. This allows you to see your clients or students, and they can see you. Webcam sharing makes a session feel like you’re practically right there in the same room with each other.
  • Screen sharing. This lets you share your screen or digital materials with clients, so the client can see materials right there in front of them.
  • Interactive features. Most video conferencing platforms include options for onscreen drawing and sharing control of the keyboard and mouse with the student, allowing the student to interact directly with the activities you present on the screen.
Following HIPAA guidelines

Just like in your in-person practice, you’ll need to maintain client privacy. When sending emails about your client, avoid using the client’s full name. Instead, use the client’s or student’s initials to maintain privacy. When you send documents or show documents on your screen during sessions, make sure any private information is removed or blacked out, or passwords are used to secure the information.

Finding virtual activities

One great thing about telepractice is the numerous activities to use. As long as you can share it on your screen or display it from your webcam, you can use it in your session. It can be helpful for an adult to attend sessions, especially for younger children. Young clients might need help logging into their sessions and/or staying at the computer. Older children might not need help, but benefit from an adult being nearby. If working with an adult, who might not be familiar with technology, having a family member available can help too. In addition, the person helping or listening to sessions can work with the client on practice activities between sessions.

For younger students working on articulation and language skills, sites like PBS Kids, ABCya, and Starfall are useful resources. Older students working on language and reading comprehension often enjoy the reading passages and games on sites like Readworks.org and Quia. If you are working on pragmatic and social language, sites like Everyday Speech offer easy-to-use videos and worksheets.

Many SLPs also create digital resources available on sites like TeacherspayTeachers (TpT) or Boom Cards. These often focus on targeting a variety of speech-language goals. For adults, you can work toward goals using some of their favorite websites, books, or stories, or even by searching for their interests online and finding new ways to talk about them.

Making virtual sessions engaging

Whether working with adults or children, keeping them engaged is key. This might seem intimidating at first with telepractice, but isn’t too different from in-person sessions.

Adults might feel nervous about using technology. Try a test connection before the first session and walk them through how things will work. This  test can help build the rapport you need and put them at ease.

With children, they probably know how everything works and might even show you some tips. To keep them engaged, try incorporating the websites, apps, or games they like. Or find a way to bring their favorite session activities to them virtually. You can let the students share their screen to share those favorite activities with you. Try using YouTube videos or digital books to work on language. For students who respond well to music, sing along with music videos.

Reaching out for help

Looking for some resources and guidance on telepractice? ASHA offers several tools, such as Special Interest Group (SIG) 18, Telepractice, an updated Evidence Map on telepractice, information on payment for telepractice, constantly updated resource page on COVID-19, and a new telepractice page put together for this challenging time. You can also reach out to other SLPs through online forums like the SIG 18 community page or the E-Therapy Hot Topics Forum. Take advantage of these online forums to ask questions, share your resources, and find new materials or activities.

It can be intimidating to jump into the telepractice world suddenly, but once you do, you’ll find it similar to in-person sessions. You’ll see your clients, work on goals, and maybe even find new ways to engage with them in a virtual setting.

Do you have favorite tips or advice for launching or expanding telepractice sessions? Please share those—or ask questions—in the comment section below.

Jessi Andricks, MS, CCC-SLP, is a contract SLP providing services via telepractice with E-Therapy. She also writes and presents on helping SLPs reduce burnout and stress.  jessi@jessiandricks.com

Sara Smith, MS, CCC-SLP, is a lead content manager with E-Therapy. She also developed several apps for speech-language intervention. sara@electronic-therapy.com

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8 comments

Essie Jennings, MS, CCC-SLP March 20, 2020 - 4:03 pm

Hello, My name is Essie Jennings. I am a CCC-SLP. I work in the medical setting and work part-time helping with telepractice including accent modification and transgender voice. I love dysphagia and my elders and my early intervention population. I love humans. How can we get services to all children and adults in need, but not have get our state license for all 50 states? This divides. Can we make a distinction? Can we service in person with state licenses but then for telepractice we serve the world? Internationally? Help kids talk after cleft-palate procedure and continue OP services? Help elders in Alaska but also serve kids in NYC? This is already emerging, but I cannot afford my license in every 50 states? I want to serve my country and not be divided. How do SLPs help people?

Reply
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Shelley D. Hutchins March 27, 2020 - 3:32 pm

Hi Essie,

ASHA is working on an interstate licensing compact for telepractice. It’s been approved by three states so far and more expected soon. See the recent blog post from March 13. https://blog.asha.org/2020/03/13/west-virginia-is-first-of-3-states-to-pass-interstate-compact-for-the-professions/

You can also read more about telepractice across state lines on ASHA’s telepractice page, which is being updated with ever-changing guidelines during the COVID-19 pandemic. See a link to that page in the beginning of this article.

Reply
Lizzy April 3, 2020 - 3:26 pm

That’s amazing! How would we be able to find out if our own state will approve this? I am from Michigan!

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Marian Peloquin March 22, 2020 - 2:49 pm

Great information for us newbies to this! Will definitely help my post retirement options, too. Would you address group treatment?

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Regina Hartley March 24, 2020 - 10:56 am

This is great information which needs to get out to schools which are still deciding about safety of boom cards and electronic services.

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Lizzy March 25, 2020 - 9:41 am

For those that are providing telepractice at this time, do you have your own PLLC/liability insurance? I was laid off due to Coronavirus and am looking into providing telepractice and getting my own clients. I never had liability insurance because the company I had worked for provided it for me. What is the process in obtaining this and does any one have a broad articles of organization format I could follow? Thanks in advance as any advice is appreciated!

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Cathy March 29, 2020 - 9:13 am

I’ve carried my own liability insurance for years, through ASHA. It’s pretty inexpensive and gives me peace of mind. I’m sure there is a link here somewhere, its proliability through Mercer.

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Lizzy April 3, 2020 - 3:43 pm

Would someone be willing to do a Zoom session with me or through the other platforms, I could send the invitation if there is cost. I’m trying to do some practice sessions/meetings prior to obtaining clients.

Reply

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