Good morning, reader!
Several months ago, I had the privilege to present for two classes at my alma mater (via our online platform!). The professor's focus of the class was having practicing therapists of differing backgrounds present on different aspects of our field, including CFY, specific settings, and a typical day at a setting.
While I'm not the most well-versed or the first tele-practicing therapist out there, I love to share my triumphs and troubles with anyone seeking advice. I enjoy staying active on the tele-therapy front because it is a new part of our field, and I want to encourage more therapists to give it a try!
For my presentation, I made a short handout, but I don't stick to a plan almost ever. Isn't that the life of an SLP? Make a beautiful, thorough lesson plan and watch it sail away in the wind because your client either hates it or tackles all 20 activities in 5 minutes.
Generally, though, I stuck to my talking points. We had a time for answering questions at the end, but the students weren't familiar enough with the field yet to know what specific teletherapy-related questions to ask. Needless to say, I talked for 50 minutes....in each class.
Because you're reading and not listening (I apologize for not recording the presentation), I'll do my best to translate the points into paragraphs, so bear with me! And without further ado, Tackling Tele-therapy:
There's a lot of points you may not consider when first beginning teletherapy. First, are you going to find and service clients on your own, or are you going to seek a company to hire you? If you go through a company, like I did, you may be told up-front that you need to purchase licenses for (several) other states to support the amount of hours you want to work. At the time, I had both an Ohio and a Florida SLP license, but there weren't any clients who contracted through my company in either state. I had to additionally purchase a Michigan, Oklahoma, and West Virginia license because I was looking for the maximum possible hours. And still, I was only given 31 hours a week, because that was all the students there was a need for last year. Keep in mind that you need a license for both your state of residence and your client's. If you're traveling a lot, you'll need licenses for each place where you provide therapy (for example, if I go home to visit my parents for the holidays and school is still in session, I could bring my computer and do therapy as long as I have an active license in Pennsylvania.). Consider also whether you need a teacher's certification, too, or if an SLP license will suffice. If you're working through a company, they should tell you this information. You can check out ASHA's information about state telepractice requirements here.
You also need to think about liability insurance and FBI clearances. Both are relatively inexpensive, but are still costs you have to consider. Plus, you need to make sure your liability insurance covers "self-employed." As an independent contractor, you are considered self-employed. Which means you don't get benefits or PTO, either.
Thirdly, consider your technology. I had to upgrade to the fastest internet money could buy so that my video streaming software (Go to Meeting) would run efficiently. I also had to buy a brand-new computer. And about computers- I use a Mac (I'm a loyal consumer of Apple), but PCs work well, too. I can't speak to their quality, but I have colleagues who tell me they work fine. Additionally, I use a document camera and Articulation Station through my iPad so I take the guesswork out of articulation therapy. Again, though, those were not cheap items. Luckily, I had an iPad, but I spent the $60-some to purchase Articulation Station Pro so I wouldn't need to scramble for materials. I also purchased a subscription to Education.com so that I could have access to endless language games and worksheets. Not to mention my Teachers pay Teachers purchases. I'm also extremely fortunate to have a mom who is an SLP, too. She's shared so many digital files with me that I had to buy a terrabyte of memory for my computer. Also, as an independent contractor, if I wanted to administer evaluations, I would have to purchase these myself. I don't know about you, but the cost of one test is a lot- factor in if you need an articuation, language, and fluency test. That's a giant cost you bear yourself.
You will have technology issues. Your computer will lose audio randomly. Your internet will cut out. You computer may restart mid-session. It happens! The most important thing, I've found, is to keep an open line of communication with your families. I always save my family's phone numbers in my phone so this is not a huge issue. One time, we had so much trouble, the student and I kept the video and screen-sharing features on the computer, and talked through the phone. You just do whatever you need to to make it work.
You can read my post about client internet connection here, but I will say this- if your student/client has a bad or slow internet connection, you're not having good therapy.
Most of the time, restarting your computer fixes a lot of the issues. If not, I've called the Geniuses at Apple I don't know how many times. They're extremely helpful and they have always followed up with my more complicated issues. I make a point to explain that I'm a speech language pathologist who does online therapy through a video streaming program, and I work from home. Knowing it's my livelihood has helped them better understand what I need and how quickly I need it to be completed. :)
If all else fails, I've rescheduled students who I simply couldn't get my computer working for. As long as the family is okay with it, it was never a problem.
The biggest factor to consider is time zones. A funny little scenario which was not so funny at the time:
I had a kindergarten student - who we'll call Marianne - in Oklahoma (which is in Central Standard Time). I live in Eastern Standard Time, so if our session started at 9:00 AM for me, they would be at 8:00 AM for her. Marianne's mom was always great at telling me if they needed to reschedule therapy for the following week if she had a doctor's appointment or if there was a tornado warning. One busy week, Marianne's mom forgot to call, so we rescheduled our therapy time to 10:00 AM for that Friday. When Friday came, I waited during our session and gave her a call when she didn't log in. I had forgotten the time zone difference! I asked if she was still attending therapy that day, and they said they would be there in an hour. Because my schedule was so loaded, I had another student from 11:00-11:30. Panicking, I tried to decide what to do, while keeping up with my other students that morning. When 11:00 came, Marianne and I had our session while I silently brooded over my mistake. A few minutes after we logged off, I got a phone call from the other student. He apologized that he had slept through his session that day.
Luckily, this worked out in my favor, but I've since began writing the student's therapy time (in his/her time zone) next to their therapy time. That way, I have that extra visual, and I don't have to remember who is in a different time zone and who isn't.
What does therapy look like?
If you're reading this blog, you've probably seen a few of my teletherapy posts already, but in case you haven't, I'll give a brief overview:
Your best bet is to find common-core linked websites (like ABCYa), because you don't get the opportunity to reach out to teachers about their classroom lessons. In addition to using my iPad, I really like Mommy Speech Therapy and Heather Speech Therapy for articulation pages of target words, and Home Speech Home for various materials. As always, Teachers Pay Teachers, too! And I love Education.com. For pragmatics (and language, too) I like YouTube. Here's a great channel to help with language concepts.
And that's a wrap! I also gave demonstrations about an articulation and a language therapy session, but I don't have a recording for you to post here. I hope this was helpful!
What other start-up questions do you have about teletherapy?
The Cyber Speechie