Telepractice is a service delivery model for speech-language therapy that enables children and families to access professional services at a distance by linking the speech-language pathologist (SLP) to the child for therapy via computer. This is especially important when a child has extensive medical needs or when distance to receiving services is a barrier therapy.
Some individuals may have already experienced “telemedicine” visits by accessing a physician via this newer medical model. The use of telepractice for speech -language therapy must ensure the same quality of services provided in person and adhere to the Code of Ethics (ASHA 2016a) and Scope of Practice in SLP (ASHA 2016b), as well as state and federal laws including confidentiality through HIPAA.
Services in Pennsylvania for telepractice include the rule that services may only be accessed when a speech language pathologist is licensed in the state where the individual is located. For example, an SLP who is licensed in PA may see a child for therapy who is accessing care anywhere within that state, but not across state lines. Insurance companies differ as to reimbursement for these services. Some schools, especially cyber-charter schools, often provide this method of service.
The method of intervention depends on the identified child’s age. Best practices in telepractice include having an adult on the call for children ages 8 and under. Telepractice may be accessed by a parent of a young child (ages birth to four) and include a parent participation model. This is defined as the parent being the identified person on the call, and the parent provides information about the child and the speech language pathologist (SLP) acts as a coach. This is a good model for parents of children that have newly diagnosed medical conditions that contribute to the speech problem. It is also used for parents/children that are homebound, or when there are no specialists within traveling distance. Best practices in telepractice include having an adult on the call for children ages 8 and under. Older children may be on the call without an adult sitting right next to them, but still in the room. This is to ensure that the caregiver is privy to the content of the session and available for help in keeping the child on-task and assist in technology needs.
If telepractice is a method of intervention that a family will be trying, then there are a few technology needs that should first be addressed. Make sure that there is reliable internet connection, high-speech internet connection is vital to the telepractice sessions. Upgrade your internet service frequently. Prior to the telepractice session, do a technology check of the audio and video feed. Good quality microphones, computer cameras and speakers will improve the overall experience. Make sure that there are no others in the household using a streaming service at the same time as the telepractice session, as this pulls down the bandwidth. Make sure that the lighting is adequate so that the clinician can see the child’s face.
Telepractice is a method of service delivery that is recognized by the American Speech-Language and Hearing Association (ASHA), the professional organization for speech-language pathologists and audiologists. This service delivery platform should afford the same progress toward speech and language goals as an in-office consult. When progress and delivery are not sufficient, the family should make plans to have the service in office. If you would like to learn more about telepractice services, please contact me.