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Engaging with Students through Live Videoconferencing!

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DotCom Therapy just released its latest advocacy video showcasing the testimonials of multiple stakeholders (found here for reference: https://vimeo.com/198222131). We would like to continue the momentum surrounding innovation in service delivery through DotCom Therapy services by providing evidence-based reference points regarding teletherapy. As a company founded and run by therapists, we are charged with championing the efficacy of this model through presentation of supportive data. Who doesn’t love data? We also account for first-hand experiential perspective.


  1. How does it work without an SLP on-site?  


While the on-site speech therapist model meets traditional expectations, innovation in service delivery provides that this is no longer the only relevant presentation style for skilled therapy.  DotCom Therapists receive extensive support and training in how to utilize on-site facilitators when needed. Tactile cueing, play-based approaches and push-in therapy can all be done via the virtual platform when lead by effective communication. While facilitators can oftentimes serve a passive role of general supervision, they can also be involved extensively in manipulating materials, providing reinforcement and managing behaviors. The level of support required is based on student needs, not a one-size fits all approach.


2. What about students with severe disabilities?


Because we truly see provision of services through the virtual platform in the same light as on-site therapy, we meet the students where they are and provide the most relevant therapy possible. This includes augmentative and alternative communication therapy when needed! DotCom Therapists are able to target goals such as eye gaze communication and picture-based exchange via our platform.  Individuals with multiple or severe needs typically have support personnel throughout their day that can be utilized to facilitate the sessions with an experienced and specialized therapist.  Not only does this give the SLP an individual on-site to act as their hands when needed, this gives the support staff an opportunity to see how communication goals are being targeted. It allows for further generalization of goals outside of the therapy context.  The support personnel will then be able to communicate to teachers functional implementation of goals in the classroom setting, prompts and even structured reinforcement.


3. What about younger students?


Regardless of age, students love technology! Many of the students we work with under the age of five engage with the therapist in play-based intervention and effective functional therapy through the platform. Again, DotCom Therapists are highly supported by experienced teletherapy leaders and best practice advocates for implementing these seemingly non-traditional types of teletherapy in classroom environments. By utilizing this approach, we are transparently serving students in the least restrictive environment. Implementation of therapy through the technology is engaging and motivating for students. In addition, satisfaction reports with the use of telepractice with this age group have been positive (McCullough, 2001).


4. Does my school need to hire another person to facilitate the speech therapy sessions?


No.  We do our best to work with the staff you already employ. As mentioned previously, the majority of facilitators are passive in nature. Meaning, they are in line-of-sight should the student need in-person support but they are not necessarily actively spending their day sitting at a therapy session if unwarranted.  In the event that an active facilitator is needed, e.g. assisting the therapist with manipulation of on-site materials, play-based intervention or behavioral modification, the therapist will work with the active facilitator to schedule and perform a push-in classroom approach or strategic session setup. This ensures the service delivery is stress-free and meets the needs of the student and school.


5. Is this just for schools that have a hard time finding an SLP?


Well, we certainly help with that! However, teletherapy is not a last resort™ but rather a documented, viable service delivery option (Grogan-Johnson, Alvares, Rowan, & Creaghead, 2010; Grogan-Johnson et. al., 2011; McCullough, 2001; Waite et al., 2006).  Telepractice not only addresses the SLP shortage but it targets needs specific to a district.  By removing location as a barrier, students receive services from the most qualified professionals.  We are able to tailor the assigned therapist to student need and shape our services based on who is the right fit for the job, not just a professional with credentials.  For example, removing location as a barrier makes a bilingual therapist just a click away.


6. Is this essentially just getting on FaceTime or Skype and performing therapy?


No.  Teletherapists have legal obligations to adhere to strict privacy, security and licensure laws.  DotCom Therapy has an entire team focused on fidelity to ever-changing regulations and ethical delivery of effective services. Our leaders and therapists alike are advocates for industry best practice standards in this ever-evolving service delivery model.


7. Can you complete assessments through telepractice?


Yes.  Once again we reference the importance of therapist training and comprehensive support provided as a value within our organization. Assessments completed through telepractice are possible and effective (Crutchley, S., Dudley, W., & Campbell, M, 2001; Waite et.al, 2006; Waite et.al, 2010).  Because our services are not bound by location, schools have access to an experienced therapist or diagnostic team that is well-versed in the Individuals with Disabilities Education Act (IDEA), state-specific timelines, special education eligibility criteria and using a standards-based approach when writing goals.  


In summary, teletherapy is an effective delivery model for schools mandated to provide skilled speech therapy to students.  It is being used to address the therapist shortage and provide effective therapy to meet the needs of students in a stress-free, efficient manner.




References:


Crutchley, S., Dudley, W., & Campbell, M. (2010). Articulation assessment through videoconferencing: A pilot study. Communications of Global Information Technology, 2, 12-23


Grogan-Johnson, S., Alvares, R., Rowan, L., & Creaghead, N. (2010). A pilot study comparing the effectiveness of speech language therapy provided by telemedicine with conventional on-site therapy. Journal of Telemedicine and Telecare, 16, 134-139.


Grogan-Johnson, S., Gabel, R., Taylor, J., Rowan, L., Alvares, R., & Schenker, J. (2011). A pilot exploration of speech sound disorder intervention delivered by telehealth to school-age children. International Journal of Telerehabilitation,3, 31-42.


McCullough, A. (2001). Viability and effectiveness of teletherapy for pre-school children with special needs. International Journal of Language and Communication Disorders, 36(Suppl. 1), 321-326.


Waite, M., Cahill, L., Theodoros, D., Busuttin, S., & Russell, T. (2006). A pilot study of online assessment of childhood speech disorders. Journal of Telemedicine and Telecare, 12(Suppl. 3), S3:92-94.


Waite, M., Theodoros, D., Russell, T., & Cahill, L. (2010). Internet-based telehealth assessment of language using the CELF-4. Language, Speech, and Hearing Services in Schools, 41, 445-448


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