- By Beata Klarowska, M.S. CCC-SLP
- Wednesday, March 22, 2017
What is telepractice (teletherapy)?
Telepractice is the newest addition to
the field of speech and language pathology and it has gained popularity over
the past three years. It is an exciting and innovating service delivery as it
helps to reach individuals in remote or rural areas where speech therapy is sometimes
not an option.
was approved by the American Speech-Language-Hearing Association (ASHA) as an
appropriate method of service delivery in 2005. ASHA's
position is that “telepractice is an appropriate model of service delivery for
the professions of speech-language pathology [and audiology]. Telepractice may
be used to overcome barriers of access to services caused by distance, unavailability
of specialists and, or subspecialists, and impaired mobility” (ASHA, Speech-Language Pathologists Providing Clinical Services via
Telepractice: Position Statement [Position Statement], 2005).
ASHA has also added telepractice to its
directory of special interest groups (SG-18) (2011) http://www.asha.org/SIG/18/About-SIG-18/
ASHA defines telepractice as “the application of telecommunications technology
to delivery of professional services at a distance by linking clinician to
client, or clinician to clinician, for assessment, intervention, and/or
consultation.” Telepractice typically occurs in real time and ‘face to face’
with a clinician via online videoconferencing.
Who provides telepractice or online speech therapy services?
Speech and language pathologists:
To provide speech
and language services to rural schools,
To provide voice,
aphasia or cognitive therapy to satellite clinics from hospitals or private practices
or to individuals in underserved or remote areas,
To provide speech,
language or cognitive services to remote home health agencies, and
To consult and
train individuals or families, for instance, communication coaching, augmentative
and alternative communication (AAC), early childhood parent training, etc.
To provide hearing
To provide infant
hearing screening, and
To provide hearing
aid training, etc.
Basic Equipment for Conducting Telepractice or Online Speech Therapy
Web camera with 15
FPS (frames per second) capture rate (built in or separate)
Headset with attached
microphone (analog or USB)
connection (150 kbps minimum)
Conferencing Software for Telepractice or Online Speech Therapy
In addition to the above basic equipment, teletherapists must choose
a video conferencing tool. Some teletherapists use Skype or other video
conferencing software used by the general public to provide online speech
therapy (telepractice). However, practitioners must be aware that Skype and other
free video conferencing software do not comply with HIPPA and their use puts
your clients at risk for privacy and confidentiality breaches.
Many video conferencing software solutions, for example, Skype, provide
basic video and audio functionality, chat and screen sharing, but the
teletherapist and the client are not able to manipulate the exchanged materials
simultaneously. This may create certain limitations for therapy.
Speech and language pathologists might consider the TheraPlatform
video conferencing platform, which was developed by a speech and language
pathologist with therapists in mind. The TheraPlatform platform is HIPPA
compliant and therapists using TheraPlatform are provided with a written
business associate agreement (BAA). TheraPlatform is the only telepractice
video conferencing platform on the market that has built-in apps ready to be
used for online speech therapy on both web and mobile devices. All apps included
in TheraPlatform are fully interactive on both the client and therapist sides
and they track data. In addition to the apps included with TheraPlatform,
teletherapists can use and share their own materials, such as flashcards,
worksheets and Powerpoint presentations.
Some clients may
present with physical or cognitive challenges that prevent them from benefiting
from telepractice (online speech therapy). Being able to sustain attention for
reasonable time, follow simple commands and manipulate a computer mouse are
some of the basic physical and cognitive requirements of participating in
teletherapy. Teletherapists should develop their own protocols to determine
candidacy for telepractice.
Environment of Telepractice Session
In order to
provide high-quality telepractice (online speech therapy), the therapist should
consider the environment, the location, of both the client and the clinician.
Light, distractions, noise level, comfort and safety should be evaluated and
modified as needed prior to beginning a session.
Use of Facilitators
Younger children working
from home may need the supervision of their parents, especially in the
beginning of the program. The parent may need to teach the child the basic
computer skills needed for speech telepractice and help the child get ready for
his or her sessions. Children who receive speech telepractice services from
their school will need supervision as well. Facilitators may include a
teacher’s aide or other type of support personnel on the site.
The aide may:
children to and from therapy sessions,
up equipment for sessions,
child’s behavior as needed, and
with on-staff teachers and staff about scheduling and changes.
advises that teletherapists should provide their clients with an informed
consent form prior to conducting speech therapy online. Clients should also be
between telepractice and traditional therapy,
confidentiality issues, and
of the equipment involved.
speech and language pathologists providing telepractice or online speech
therapy must be licensed in the state of their client’s residency.