In conversations about telepractice, I often hear the concern that teletherapy is not as effective as in-person therapy. Apprehensions include: physical barrier that limits therapist’s control of the environment, poor child engagement, and not having a therapist “on-site”.
“Control of the environment”. In teletherapy, there is a new environment. True, it does take a session or two for the therapist to get used to this service delivery model, but you still do have complete control over the environment.
Case study (true story): 3 yr old female, cleft palate post surgery. The child comes into our brick and mortar clinic for one-on-one therapy. Her personality and learning style lends itself to strong independence and self-learning. Only 6 trials imitated on target sound in 30 minutes. Clinician and parent suggest home environment for added comfort. Clinician physically travels to child’s home. Only 5-8 trials imitated of target sound over 2 sessions. This child is engaged in pretend play with clinician and a trial is attempted. Child imitates the sound, but when second attempt with same strategy to elicit the target is approached, child deflects to other toys. Teletherapy is attempted as child is accessing webcam at home. 35 successful imitations of the same sound in 30 minutes! How can this be? She is completely engaged in the tasks presented! Using her favorite characters with games as motivators, she is easily willing to imitate the clinician and does so while feeling “in control” of the session.
“Poor child engagement”. Children are extremely familiar with technology. It is second nature to them, while still very exciting! If used properly and guided through with the therapist, this technology can be used to truly engage a child. Clinician feedback shows that teletherapy feels more like “a high concentration of goals targeted at one time”. The amount of time it takes to elicit targets in-person, is generally significantly less in a teletherapy session, due to positive child engagement. Greater progress is made in less time!
Not “on-site'“. The Speech Pathologist and paraeducator work closely to follow through on having the child at the computer for his/her therapy time. The paraeducator can physically move the camera angle to accommodate one child or a group, or a child having a challenging behavior. The SLP can still attend IEP meetings via the laptop and webcam, just as they would if they were on-site. Evaluations can either be done by the district evaluation team, or the virtual speech therapist can use the online assessments.
In general, speech therapy can be certainly be provided online. It is our first choice of service delivery. Is it a fit for every single student at the school? Maybe not. But for almost every student and districts, it is an excellent choice to keep kids engaged, learning, and making significant progress towards their goals.
Check out this most recent Review of Telehealth: