What is Teletherapy? (The Definitive Guide)

What is Teletherapy?

Teletherapy is the online delivery of speech, occupational, and mental health therapy services via high-resolution, live video conferencing. Teletherapy sessions are very similar to traditional speech, occupational therapy, or mental health sessions with one major exception. Instead of sitting in the same room, students and therapists interact via live video conferencing.

During therapy sessions, the student and therapist can see, hear, and interact with one another in real time, using webcams, headsets, and a live, synchronous online learning environment.

If you’ve ever used Skype on your computer or FaceTime on your iPhone, you’ve used a similar type of technology.

The actual therapy is the same as the therapist would deliver face-to-face, only teletherapy is done with a computer! Licensed therapists use traditional therapy techniques and activities and enhance those techniques through innovative software and tools and have the technology literally at their fingertips to plan and deliver high-quality services.

Which Therapies Can Teletherapy Provide?

Teletherapy can deliver speech-language, occupational, and mental health therapies. Regarding speech-language therapy, it is most common to find language and articulation delivered via teletherapy. However, this is not due to the effectiveness of the therapy, but rather to reimbursement limitations.

Why is Teletherapy Necessary?

therapist shortageApproximately 5% of America’s school-age population - 3.5 million children - require speech, occupational, or mental health therapy. While the need is growing annually, there is an increasing shortage of therapists to meet that demand.

As reported by the United States Bureau of Labor Statistics: "there is a considerable national shortage of SLPs projected over the next five years. An additional 28,800 SLPs will be needed to fill the demand between 2010 and 2020–a 23% increase in job openings."

Further exacerbating the problem, the geographical distribution of these therapists is unequal, which means that there is a worsening shortage, particularly in rural areas. This makes it difficult for schools to provide adequate services for many of their children who desperately need services.

What is the Impact of the Therapist Shortage?

The growing SLP shortage means higher caseloads for district therapists which results in inferior therapy sessions for the children, leads to SLP burnout on an unprecedented scale, causes unexpected recruiting and turnover expenses, and students making slower—or no—progress against their IEP goals.

Recruiting and retaining staff serving students with disabilities is particularly difficult in rural areas. Salaries are not competitive, and rural areas are far from urban cultural centers and universities, which restrict teachers from participating in training and development programs that would enhance them professionally.

Attrition of speech therapists in rural districts can be two to three times the national average. Turnover is especially acute among professionals who travel long distances from site to site, on an itinerant basis, to serve students with disabilities. Many teachers reportedly resigned because of the isolation of their social and cultural lives.

Also, finding replacement therapists is no picnic for school administrators. The higher recruitment fees charged by staffing agencies to find “distant and elusive” SLPs, and the tragic reality is this: there is less money available to provide the children with the services they need.

The shortage has inflated the cost of therapy and put a heavy burden on already overstretched school budgets and personnel who must spend inordinate amounts of time and energy searching for and managing scarce therapists. Often, rural school districts cannot afford to have their therapists.

Why is Teletherapy the Optimal Solution?

Teletherapy is an innovative, cost-effective solution that offers maximum flexibility by overcoming barriers of distance, unavailability of specialists, and impaired mobility.

While onsite contractors control the timing and may lock schools into rigid schedules, the network of therapists and the online delivery model allows for therapy to be provided when it’s convenient for the school and the students; even if that’s before or after school hours.

By extending top-quality clinical services to remote, rural, and underserved populations, teletherapy holds the key to significantly reducing therapist shortages, guaranteeing children needed services, and alleviating severely strained school budgets. As a result, school administrators and SpEd directors can be free to focus on other critical educational priorities.

teletherapy for allWho is Benefiting From Teletherapy?

Schools:

  • Flexibility: Teletherapy affords schools previously unprecedented flexibility and access to top-notch therapists, as they are no longer limited to locally-based clinicians, but can draw from an extensive nationwide network of highly qualified, certified therapists.
  • Cuts Costs: Teletherapy has exceptional value and is affordable. While some say that teletherapy is more expensive than traditional onsite therapy due to the added costs incurred by equipment, paraprofessionals, and technology, the truth is quite the opposite. Except for the cost of the computer; teletherapy saves money because:
    • The price of a therapist is generally the same whether the therapy is delivered onsite or via teletherapy.
    • Traveling expenses are eliminated.
    • Traditional staffing agencies charge a premium fee to find a therapist who will travel, which does not apply to teletherapy.
  • Effectiveness: Schools have better access to specialists as well as culturally and linguistically diverse therapists as well as therapists with specialties, allowing for more targeted and effective outcomes.
  • Freedom: School districts no longer have to recruit, screen, and manage therapists, pay transportation expenses, or worry about interruptions in therapy when clinicians are absent, leave, or no longer with the district. Services remain uninterrupted, freeing up staff time for other educational priorities.
  • Peace of Mind: Teletherapy relieves schools of other administrative headaches and expenses as well by streamlining scheduling, easing tracking and reporting, simplifying, auditing, and organizing accurate and instantly retrievable records through the digital services provided. This ability to access critical information instantly - all in real time - increases parent satisfaction and minimizes the risk of compliance issues.

Therapists:

  • Independence: Teletherapy is a dream come true for therapists. It allows therapists to be their boss, enjoy flexible hours, and eliminates travel.
  • Comfort: Teletherapists can serve children nationwide, work either part-time or full-time, and grow their career within the comfort of their own homes.
  • Productivity: Teletherapy promotes productivity by managing caseloads and workloads more efficiently and spending more time working with kids and less time in the car.
  • Materials: Teletherapists have access to the ever-expanding array of creative, engaging, and motivating material available both on websites and apps. The possibilities seem to be genuinely endless! There is no way for any clinician to stay abreast of the accelerating rate of invention.

Families

  • Engagement: By utilizing fun and engaging digital technology, teletherapy is exceptionally kid-friendly. Today’s children are comfortable with computers and love game-based activities such as video interactions and digital learning. In this rapidly developing technological world of ours, the digital dimensions of online therapy have become very natural and almost expected.
  • Consistency: Students benefit as well; since the attrition rate of therapists is often directly related to distance and travel time, eliminating travel results in a marked rise in that therapist’s consistency.
  • Relaxed: For shy and more reserved children, teletherapy is less intimidating the traditional face-to-face therapy.
  • Parental Monitoring: Teletherapy provides the capacity to remotely log in and observe the session in real time allowing parents or members of the child’s “team” to see his or her progress.
  • No More Babysitter: Online sessions conducted at home or in school eliminate the need to ever travel to another session and worry about babysitting for the other children.

onsite therapy sessions

Is Teletherapy as Effective as Onsite Therapy?

There is a myth circulating in therapy circles that teletherapy is of inferior quality to traditional face-to-face therapy. This is patently false.

Since therapists are ASHA (American Speech-Language-Hearing Association) certifed, there is no compromise in the quality of the therapist.

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Regarding the online mode of delivery, teletherapy has been used successfully since the late 1990s for hundreds of thousands of therapy sessions across the United States. It is and has been considered an effective and appropriate therapeutic delivery mode based on 20 years of research by over 40 academic published studies.

The first was the landmark paper by the Mayo Clinic in 1997 which stated, "Telemedicine (teletherapy) evaluations can be reliable, beneficial, and acceptable to patients with a variety of acquired speech and language disorders, both in rural settings and within large multidisciplinary medical settings."

Also, ASHA gave its endorsement in 2005: “Based on the strong body of peer-reviewed research supporting telepractice ... ASHA recognizes telepractice (teletherapy) as a valid means of service delivery for audiologists and speech-language pathologists.”

Worth noting, the effectiveness of telepractice (teletherapy) was corroborated by a 2011 study by Kent State University researchers comparing students receiving traditional in-person therapy and those receiving telepractice in public school settings. They found that the outcomes for the telepractice group were equal or better than the in-person group.

Why is Global Teletherapy Your Best Option?

Global Teletherapy has formed an extensive team of highly qualified speech and language pathologists, occupational therapists, and mental health clinicians who deliver top-quality teletherapy in 27 states.

Over the past few years, Global Teletherapy has played a pivotal role in helping children, regardless of geographic location, who otherwise would have no access to SLPs, OTs, or counselors get the therapy they need to be successful.

Global Teletherapy Offers Many Benefits:

Schools:

  1. Global Teletherapy therapists are professionally certified (e.g., ASHA for SLPs) and are seasoned with a minimum of two years of professional experience. Also, they have been trained in teletherapy techniques before providing services.
  2. Global Teletherapy handles recruitment and management of clinicians and ensures that they are appropriately licensed and credentialed in the school district’s state.
  3. Global Teletherapy assures that therapists are available when needed and handles session scheduling. The school district provides an onsite paraprofessional to facilitate logistics during therapy sessions.
  4. Global Teletherapy ensures that sessions are extremely secure and in compliance with HIPAA, FERPA, and COPPA guidelines. Sessions are conducted using a trusted technology used by millions of users worldwide with 24/7 support to ensure the success of every therapy session.
  5. Global Teletherapy can practically guarantee school administrators fewer headaches from dealing with therapist attrition and the consequential need to fill vacancies. They also streamline scheduling, ease tracking and reporting, and simplify auditing and compliance.

Therapists:

  1. Global Teletherapy provides professional training on how to deliver services via teletherapy.
  2. Global Teletherapy supplies a trove of materials for their therapists. They have an extensive library of resources and activities to which therapists are given access. These resources and activities can be utilized as is or modified to meet specific student needs.
  3. Global Teletherapy shows the therapist how to gain access to great additional resources free of charge.
  4. Occupational Therapists are provided a complimentary OT Toolkit which has many items that can be used in the therapy session, such as play dough, theraputty, adaptive paper, etc.
  5. Global Teletherapy has created venues for therapists to communicate and interact with each other. These venues provide an invaluable opportunity to share problems, brainstorm solutions and grow professionally.
  6. Global Teletherapy has both part-time and full-time opportunities available and will guide therapists in obtaining licensure in other states.

Families:

  1. Global Teletherapy ensures that each child will work with a top-notch therapist. They meticulously screen every clinician with a comprehensive interview and an exhaustive review of clinical experience, licenses, and qualifications.
  2. Upon acceptance, the therapist is trained in teletherapy technology, and each therapist’s subsequent performance is closely monitored. Global Teletherapy ensures that every therapist is licensed and has all the necessary credentials for your state or region.
  3. Global Teletherapy promotes consistency.  Although teletherapy’s flexible nature makes it possible for a child to have more than one therapist every child is assigned to a particular clinician, who assumes responsibility for that child’s therapy.
  4. This arrangement promotes continuity and a trusting and consistent relationship between the online therapist, child, parents, and teacher. If the child needs a new therapist for any reason, Global Teletherapy will ease the transition with minimal disruption to the child’s therapy.
  5. Global Teletherapy provides supervision. An onsite paraprofessional (or a parent/learning coach for virtual school students) supervises and handles any hands-on requirements, especially for younger students. Some older students may not require supervision, depending on the policy of the school.
  6. Once the session has begun, the children are interacting with the therapist online, and the paraprofessional, while remaining on hand to assist if necessary, can do other work. A single paraprofessional can supervise several students participating in separate, simultaneous sessions or one session together.

what is telepractice

Common Questions We Get From Therapists

1 - What is the Technical Setup for Teletherapy?

Unfortunately, there is a myth that teletherapy is technically complicated. Nothing could be further from the truth. While the technology is quite powerful, setup and using that technology is quite simple and straightforward!

A Global Teletherapy, our representatives walk new therapists through the process, and a Global Teletherapy tech will always be there to provide any necessary support.

Technical requirements on the part of the therapist are only a computer with an Internet connection, a webcam, and an audio headset. If needed, Global Teletherapy can provide a specified amount of webcams and headsets at no extra charge.

2 - Since the Delivery is Online, is Privacy a Concern?

The confidentiality and privacy of all student data and secure information is protected as our system is secure and encrypted per HIPAA and FERPA regulations and COPPA compliant.

3 - How Much Experience Does a Therapist Need Beforehand?

As long as you have experiencing delivering therapy onsite for those diagnoses that you will be providing online, you should be fine. Your therapeutic experience is necessary because teletherapy doesn’t alter the techniques and treatment approaches that are appropriate but rather is their adaption to the online venue.

4 - What Settings Utilize Teletherapy?

Teletherapy could be delivered in practically any setting that onsite therapy is provided such as in the home, in a hospital, in a clinic, etc., However, at the moment the only environment in which teletherapy is widespread is in the schools.

5 - Does Insurance Cover Teletherapy?

Neither major insurances nor Medicare currently reimburses for teletherapy services. That being said, substantial efforts are being made at both the local and federal level to change this.

6 - Is Teletherapy for Everyone?

While study after study demonstrates the effectiveness of this excellent alternative, nevertheless some students will still benefit more from traditional on-site therapy. For example, online therapy is not the preferred option for students with minimal attention skills or alertness. In some instances, a “hybrid” option (combining on-site with online therapy) may be optimal.

7 - How Do Therapists Communicate With Teachers and Parents?

The therapist initially makes contact with parents and teachers at the beginning of the year and provides their contact information. They email the teacher monthly–at a minimum–to discuss targets, progress, and needs in the classroom/curriculum.

The online therapist will communicate with parents in the same way an onsite therapist would. Homework, as well as notes, are “sent-home” through a virtual backpack. Clinicians deliver IEP progress reports and participate in IEP meetings via video conference.

8 - Can I Practice Teletherapy With My Regular Clinical Position?

Yes!  One of the many advantages of teletherapy is its flexibility. You can do teletherapy part-time if you like. And if you get hooked, full-time positions are available as well. Whenever it works for you, don’t forget that you will be working from the comfort of your home!

Time to Take the Next Step

School administrators, schedule your free demo.

Therapists, apply today to join our team.

Parents, contact us to find out more.

teletherapy parent

5 Tell-Tale Signs Your Client is Being Raised by a Narcissist

What is a Narcissistic Parent?

Before we can begin to discuss how to identify the child who is being raised by a narcissistic parent, we need to understand exactly what is a narcissistic parent.

A narcissistic parent is that parent who in any number of ways is attempting to control his child’s life. The parenting dynamic gets flipped on its head as the parent uses the child for his own needs instead of taking care of the child’s needs. Most of the time, the narcissistic parent sees his child’s independence as threatening.

When the parent feels threatened he will coerce the child to live within the parent’s shadow often demanding that unreasonable expectations be met for the child to “earn” the parent’s love. The truth is that often such a parent convinces himself that he loves his child when in reality he loves himself.

This is not to say that every parent who has high expectations for his child, may display firmness when appropriate, or desire for the child to make him proud is a narcissist. The hallmark of the narcissistic parent is that the child’s ultimate value is in serving the parent in some way.

5 Tell-Tale Signs Your Client Has a Narcissistic Parent

1. Attachment Issues

A child who is suffering the emotional absence, abuse or neglect from a parent subconsciously questions how safe any relationship can be. The reaction of the child can present either as an avoidant attachment or anxious attachment. Avoidant attachment is when the child shuts others- avoidance. Alternatively, an anxious attachment is when the child chases after others to love him.  

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2. Needs Explosion

Since the narcissistic parent has manipulated his child into sacrificing the child’s basic emotional needs to his needs, the child learns to ignore and bury his own needs continuously. The child becomes the spectacular caretaker at his own expense. Then one day something triggers the child, and the result is an instant explosion of needing someone to meet those sublimated needs. The child seemingly lacking needs becomes the neediest!

3. Chronic Self-Blame or Shame

Not every narcissistic parent openly emotionally abuses his child. Nonetheless, he doesn’t seem to hear their child’s pain either. And how could he? After all, such a parent is very busy, with himself!  Because these children are trapped in their own home, their only choice is to offer up their self-esteem as barter for their own care. The child tells himself that he is the problem in the hope that if he “behaves better” he can get his parent’s attention.

4. Becoming Fiercely Independent

A child who is more adventurous and extroverted may swing the other way entirely. The constant frustration borne of the narcissistic parent may convince the child that emotional intimacy is a complete farce. No one is reliable or trustworthy, so the only way to proceed is by becoming completely detached and independent.  Since this is impossible to sustain it may set the child up for a needs explosion.

5.  Codependency

On the other hand, those children possessing a more sensitive temperament may become the compulsive caretaker. The only way they can be emotionally nurtured is to take care of others. Their narcissistic parents never cultivated their child’s sense of self so now the only way for the child to remove his pervasive emptiness and loneliness is to derive it from others by taking care of them.

rural schools teletherapy

How Can Rural America Be More Inviting to Teachers and Therapists?

It seems like a mantra already. In droves, people are fleeing Rural America for the big cities. It was reported that in the first fifteen years of this century the rural population in the state of Illinois alone decreased by over 80,000 people. And that decline was even more for young people.

But such a population shift is more than just a “hollowing out” of rural communities. There are very unfortunate consequences to these people drain such as declining incomes, a lower tax base and lower levels of education for the children.  This often translates into fewer or less qualified teachers and therapists available to serve.

But the pain doesn’t stop there. Rural communities have become accustomed to the annual migration of those high school graduates who are the “best and the brightest”. The loss of such talented youth who could potentially help lift the community out of their doldrums is outright depressing.

So what are the dedicated leaders of these communities to do as they watch the cities that they love suffer this seemingly unstoppable decline? Considerable research was undertaken to answer this perplexing dilemma and their answer may come as a surprise.

A New Strategy to Bolster the Population in Rural America?

A team of researchers from the University of Montana and USDA’s Economic Research Service conducted hundreds of interviews at local high school reunions and came to a surprising conclusion. Arresting rural population loss, and consequently fostering economic development may depend less on retaining the youth after graduation and more on attracting former residents somewhere down the road, even years later.

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Why do Former Dwellers Return to Rural America?

In order to maximize the benefits of this strategy, it is important to understand why one-time rural dwellers return to their former homes. When asked, most said that it was their desire to reconnect with their own parents and raise their children in the same environment they, the parents, had been raised in.

Beyond support from family and old friends, many returnees were seeking easy-going environments where they felt uninhibited “to do their own thing”. Also high on the list was the perception that rural communities were more secure and safe for their children. And for others, there were more “natural” concerns such as breathing fresher air or just getting back to nature.

Whatever the particular reason, one thing is clear, rural communities must implement those strategies that will encourage their youth to return. Once this mechanism is in place, much can change including raising the quality of education and professional services for children, including therapy by attracting top quality therapists to relocate.

What are Some Strategies to Attract and Retain the Youth to Rural America?

  1. Enable online business opportunities and long-distance learning through quality high-speed internet. High-speed internet is a contemporary staple of life.
  2. Create microbreweries and internet cafes to encourage socialization. These “third spaces” other than the office and the home are a must.
  3. Foster an entrepreneurial culture where it becomes easier for young people to build or own their business.
  4. Engage the youth in the conversation focused upon change. Value their opinions and give them a place in the local governments and community boards.
  5. Make the youth a focus and priority in marketing campaigns.
  6. Mimic dense urban areas by assuring that the neighborhoods are walkable and create downtown spaces to afford the benefits of the density of urban areas without sacrificing the advantages of the rural landscape. Another strategy to consider revolves around density. Smaller towns can appeal to millennials by maintaining their walkable neighborhoods and traditional downtown spaces—which mimic the benefits of dense urban areas.
speech apraxia

Speech Apraxia: A Poorly Understood Ailment That Can Spell Serious Trouble

What is Apraxia?

Unfortunately, childhood apraxia is a neurological condition that is poorly understood. It is characterized by a child’s difficulty in making certain motor movements despite having normal muscles.

Regarding developmental speech apraxia, the child has trouble moving her mouth and tongue to articulate sound. This happens even though the child wants to speak and his mouth and tongue muscles which are perfectly capable of doing so.

Children who have apraxia have been saddled with this debilitating condition from birth and find it difficult if not impossible to form words or even sounds. But since this inability isn’t a cognitive defect per se, these same children can often understand speech no less than other children.

Are Speech Apraxia and Aphasia the Same Thing?

There is another communication disorder which is at times confused with Speech Apraxia. This other disorder is known as Aphasia. Aphasia is when a person has problems in understanding or using words. The core of the problem is the inability to express the thought, not the inability to make those physical movements necessary for speech.

These two disorders, Speech Apraxia and Aphasia are sometimes confused partially because two disorders can occur together. To the untrained eye, the speaker is unable to communicate. “Why” is a question that he probably doesn’t bother to ask.

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What are Some of the Symptoms of Speech Apraxia?

  • There is little babbling during infancy
  • The child makes repeated attempts to pronounce words
  • When speaking the child will distort vowel sounds
  • There is a painful struggle or groping to make words
  • Long or complex words just can’t be said
  • The child seems to prefer to communicate non-verbally too often
  • The stresses or inflections on certain words or sounds is inaccurate
  • The child is inconsistent in pronouncing certain sounds or words
  • Consonants are omitted at either the end or beginning of words
  • Unable to string together syllables appropriately to make words

Developmental Apraxia often occurs in conjunction with other cognitive or language deficits such as:

  • Being clumsy
  • Having problems with grammar
  • Fine motor skills and coordination problems
  • Experiencing difficulty swallowing or chewing
  • Age-inappropriate vocabulary limitations

What Do Treatments for Speech Apraxia Focus On?

Developmental Speech Apraxia generally is not resolved without treatment. The treatment approaches and their effectiveness can vary from one child to the next. It is often prescribed meet with an SLP up to five times weekly.  In addition, the child may need time to practice the skills they are learning with their parents. Exercises often include:

  • Practicing repeatedly forming and pronouncing words and sounds
  • Working with melodies and rhythms
  • Making sounds into a mirror to see what it looks like
  • Touching one’s face while talking to see what it feels like
  • Sign language- to practice the required movements with their mouths

While Speech Apraxia is a very serious condition, the good news is that with the correct treatment that is diligently followed, the majority of children will see tremendous improvement. Not only that but studies have shown that many will completely recover.