Getting Started with Teletherapy

Several of you have been asking about teletherapy! I was fortunate enough to be able to interview Tracy Sippl from S&L Teletherapy Consulting. She did a fabulous job addressing several common questions about teletherapy!

Check out the video interview or scroll down for a transcript of our conversation. I also included time stamps, in case you’d like to jump to a specific question in the video.

[2:00] What do you like most about teletherapy?

Well, living in Wisconsin, I like being able to work from home, especially in the winter. I can sit behind my computer and snicker as I see those neighbors drive into work in the blizzards. I also like the idea that with teletherapy, I find that I’m able to…my time is devoted to therapy, rather than to these extra-curricular activities and routines that are required when you work on-site. There’s no bus duty, there’s no proctoring for state testing, those types of things that would normally pull you away from therapy. It’s basically just the meat and potatoes – it’s therapy, and that’s the part I’ve always enjoyed.

[3:00] What are some of the challenges associated with teletherapy?

That’s a great question, because I think there are a lot of companies out there looking to hire SLPs, and they paint a very rosy picture. But, as an independent person, I want to be sure that everybody understands that there are drawbacks, as there are to everything, and I think it’s only fair to mention those, as well, so you can make an educated decision. One of the things, if you’re a hands-on person, you obviously don’t have that physical touch, you know where you would put your hand on the student’s shoulder to get their attention or things like that, hand over hand manipulation. There are certain things you can have your tele-helper provide in an appropriate manner, depending on the therapy situation, because obviously they’re not SLPs – they’re not usually an SLP aide. They’re usually like a teacher’s aide or a paraprofessional. Another drawback is being an independent contractor, you do not get benefits. You do not get sick days, and you end up – which was kind of a shocker to me in the beginning was – paying additional income taxes, because you have to pay a self-employment tax, which is another like 15.75% on top of what you normally pay. So, when you are being paid a certain amount per hour, you have to be sure to take that into account when you agree on your hourly pay. There’s more foot work in terms of – I guess I should say ‘finger work,’ because instead of being in the hallway or in your speech therapy room and going down the hall and talking to the teacher, everything is email or phone calls. So that instantaneous answer or finding out how Johnny’s doing in the 1st grade with reading, that takes a lot more work to be able to make that connection. Not that it can’t happen, but it is more time-consuming. I think those are the main ones that I think people should be aware of.

[5:30] Have you found any tools that help you overcome some of those challenges? Or are there any tools in general that you really like to use in the teletherapy setting?

Well, I find the more interactive the platform is that, whether you’re contracting with the company and they have their own platform, or if they use some video conferencing platforms that are already in existence, the more interactive they are, I feel like they keep the child – or the student – more engaged. And, basically, I’ve seen progress increase probably more so than compared to platforms where the child just sits there and watches you interact with the screen. So, you know, if you’re able to incorporate – there are a multitude of websites that a person can use. For example, one platform that I’m familiar with that I really do like using is Zoom, not that there aren’t other ones out there I’m sure. Zoom is what I’ve come across with my experience that I’ve found to be really interactive. So, showing videos, interactive games – and that platform allows me to use the sound, so the student can hear the sound. On some of the other platforms, you have to take your microphones off and hold the microphone next to the earpiece, which is doable, but when you’re trying to talk to the student and have them play it again and listen to the video, it’s inconvenient. The platform is a huge factor. Researching online resources – I like to use a lot of videos for working on social skills. There are some great Pixar short films out there that don’t have any talking, so it’s all up to interpretation, body cues, body language, you name it – it’s fun. And, honestly, for some of the older students, using certain research sites, like Smithsonian or Discovery Channel, those types of things, too. One of the benefits that I should’ve mentioned earlier was that kids are so savvy – tech-savvy…

[9:40] When do you typically treat students? During the day or after school?

Ah, good question! That’s another positive about the teletherapy. It’s more or less your decision. If you’re working with students that attend a virtual school or a cyber school, you could do after school hours – the families are pretty flexible. Now, if you’re working with a brick-and-mortar school, usually they want you to do it within the school day, because they’re using the computer at the school, the tele-helper’s at the school, that type of thing. But, that would be a good question to ask if you’re looking at working with a teletherapy company or contracting with them, is if they have that flexibility – part-time, full-time, depending on the size of the caseload – how much you want to work. There’s that availability, as well.

[10:50] What ages do you work with?

Okay, good. I’ve worked with – I would say I’ve worked with 3-year-olds through 8th grade. That’s been the majority of my experience. I take that back – I’ve actually worked with middle school I guess up to 9th grade. Each age group has its challenges. Again, you have the little 3-year-olds, which are very active. I have not personally worked with an early childhood program. I think it’s doable, but I think there’s a lot of creativity involved, and then you’re using the people that are on-site as support personnel, or even team-teaching with the early childhood teacher, those types of things. A 3-year-old sitting in front of a computer for any more than five minutes at a time is difficult. So, one example of a student – and this is not a young child – but this young adult was autistic, hearing … visually-impaired, there’s no one else available as an SLP, you do what you need to do.

[12:55] Do you work with students with behavioral needs?

One of the nice things with teletherapy, too, is because students are so drawn to technology…I feel badly at times, because I feel like I’m taking advantage of their area. They’re so drawn into it that we can actually use it to our advantage. Behavioral modifications and behavior issues are a lot less. I can’t say that they go away, but you have your program set up where you’re going to figure out what you’re going to do, talk to the teacher, and if this is a child who has difficulties in general – what you would normally do within the school. You just adapt it to work with them virtually.

[15:15] What advice would you give to someone just starting in teletherapy?

Training is important, besides having the experience of working in the schools, but I tell a lot of people, if they’re not sure – because that’s the way I started out – I was working in the schools part-time and then provided teletherapy part-time, so I wanted to get a feel of if I actually liked it enough to jump ship. If you have the flexibility, I recommend trying it over a summer. Obviously, this summer’s pretty much gone already. But, working with ESY or extended school year students would be a good chance to get a feel for whether you like it or not, because it’s different. It is different. You don’t have that collegial contact where you’re actually, you know, next door to somebody in another office, where you can chat and say, ‘Good morning.’ It can be isolating. Training, whether it be online training – there are courses online that you can take. ASHA has some great continuing education classes you can take to get you familiar with teletherapy. I have one out there that gives you the basics of what to look for, what to ask companies, those types of things, too, through Purdue University. People can always Facebook message you or something – or myself – if they’re interested in learning more about that.

[16:45] Do you have any other resources you’d like to share?

There is a video – if you type in, if you search ASHA and go in there and type ‘telepractice video.’ They have an introductory video that talks about all the research that’s been done. It gives you a good basis as to what teletherapy actually is.

Otherwise, I also have a website with some information on there. I also provide pretty inexpensive consulting services just to help people get started.

Join the Special Interest Group 18 Telepractice – that’s a huge resource.

There are some great Facebook groups out there – Telepractice SLP or Teletherapy SLP. Just type ‘teletherapy’ in the search bar, and you’ll be surprised with what you’ll come up with – people with materials and information, you name it, they’ll be able to provide information. I just caution you, if you’re looking into some of these things, a lot of people want to push to have you join the company they’re working with. Research first. Just keep in mind that a lot of people get a bonus, you know, as a referral bonus for having people coming to work with their company. Not that there’s anything wrong with any of them necessarily; it’s just do your research so you know what you’re looking at, because some pay more, some pay less, some are easy to work with, some are not. Like with anything, I guess!

That’s all for now! Stay tuned for more teletherapy ideas!