As schools and clinics begin to shut down around the world, we’re starting to get questions from our members such as,
How Can I Continue to Support My Clients if my School/Clinic Gets Shut Down?
Can Our Students Still Get their IEP Minutes if the School Goes to Online Learning?
How Can I Help Prevent Regression in Communication Skills?
Unfortunately, there are no easy answers to these questions but this article will pull together some resources and ideas that will help you make the best decisions for your clients/students as we navigate this life-altering situation.
What to do if your School/Clinic is Considering Closing Down
This is where most of us find ourselves currently, at least in the United States. Our administrators are working frantically to find alternatives that will meet the needs of their clients/students without causing major regressions in their learning. Many schools are considering online learning or virtual learning options. But is this right for our students with communication disorders? Here are some factors to consider and bring up with your administration so they are seeing the big picture. They’re trying to think about the school as a whole so they may not see how this will affect the children on your caseload as clearly as you do.
Consider the Modifications and Accommodations on Your Clients’ IEPs:
Many children on your caseload likely have modifications and accommodations written into their Individualized Education Plans (IEPs) that specify what the school is required to provide to accommodate for their disability. When your school is considering virtual learning scenarios, think through those modifications and decide if the online learning systems will be able to provide those. If not, your school is obligated to provide those. For example, if a client’s IEP states that he requires a teacher to obtain his attention before giving directions, this will be difficult to do if lessons are sent via video.
What You Could Do: Explain the issues you foresee to your administration so they understand what to consider when choosing whether or not to do online learning
Decide if Services Can Be Provided Virtually:
Your administration should understand that if schools are cancelled entirely, then IEP services are not required to be served. However, if school is being held virtually, the school is still responsible for providing the services listed in the child’s IEP. As these discussions are happening (on whether or not to do virtual learning), talk with your administration about your concerns for any children that you DON’T think would benefit from receiving their services virtually. Many children can be served quite well through teletherapy and some others could be served through doing parent training virtually. But others may not be appropriate for receiving their services that way so their minutes will need to be made up using compensatory minutes later.
What You Could Do: Bring any concerns to your administration about children that would not be appropriate for virtual services.
Talk to Your Clients/Students about Coronavirus:
There is a lot of panic right now about this virus. But the children on your caseload see you for a reason: they have communication problems. So there’s a pretty good chance that they don’t really understand what’s going on around them, even if someone has tried to explain in. However, I can guarantee that even those children who don’t understand are feeling the anxiety and tension in their community. You can help lessen their own anxiety about the situation by finding ways to talk about the virus with your clients in ways they can understand. You don’t need to share every gory detail but you can still help them understand that some people are getting sick so it’s important to wash our hands and stay home if the school decided that everyone needs to stay home. If you have clients who would be very upset by a change in their routine, you may want to create a simple social story about what would happen if the school had to close for a time.
What You Could Do: Consider the possibility of providing services and education online and talk with your administrator about your concerns. Talk to clients ahead of time that you think may need some help understanding what’s happening.
What to Do if Your School/Clinic DOES Shut Down:
What if you’re beyond talking and now it’s actually happening? What if your school or clinic shuts down? Not to worry, we have suggestions for that, too. First and foremost, keep yourself and your family safe. You can’t help others if you are not taking care of yourself. Follow all of the guidelines for how to protect yourself and if you have been advised to stay home, then stay home! Don’t power through sessions just for the sake of getting your clients minutes in. They need to be free from illness more than they need their speech services. However, there are things you can do to make sure they continue to be supported throughout this event.
Start By Checking In with Your Caseload:
Here’s the first step: Start with a check-in. Don’t jump right in with sending home kits or starting teletherapy services. Every family on your caseload is going to be in a different situation with different needs. Some families will be wondering how they can help their child keep up his communication skills but others will just be wondering how to get enough food or how to stay sane while dealing with their child’s meltdowns as a result of this upset. You don’t know where they are until you ask.
Ask them how they’re doing and what their biggest challenge or fear is right now. Then, help them get what they need. That’s not to say that you’re responsible for bringing them food or watching their kids. But you probably know more about what resources are available than they do so connect your families with whatever resource will help them the most. Give them the number to the local health department or connect them with your school social worker. Call up the behavior specialist at your school and ask her to give the family a call. Help that family in whatever way they need because it’s very possible that no on else has called them to offer support and they may not know where to turn.
What You Could Do: Call each family on your caseload and ask them:
- How are you doing?
- What is your biggest challenge at home right now?
Help Teachers Figure Out How to Modify Virtual Learning Platforms:
If you are at a school that has decided to use virtual learning, or if you work with a private client whose school has gone to this, you may want to help with modifying the virtual learning platform for your clients. How will your clients who are deaf or hard of hearing access virtual lectures? How will assignments be modified for a child with attention problems? What additional visual supports can be added for your clients who have receptive language impairments and are not auditory learners? Talk to the teachers and the administration about these issues. It is not your job to solve all of the problems that an online learning environment presents, but you can still advocate for your clients that you feel may fall farther behind if learning is moved to a system like this.
What You Could Do: Work with parents and teachers to make sure that your clients have the best possible chance of being able to benefit from online learning that is being put into place for all students.
How to Provide Teletherapy Services to Your Speech/Language Therapy Clients:
Now let’s talk about how you can actually continue to serve your clients virtually if you and your school/clinic decide to do so. There are many aspects and factors that you will want to consider.
What Teletherapy Platform Will You Use?
It is imperative that you maintain client privacy as per HIPAA (or your country’s requirements) during this time. Not all video conferencing platforms are secure enough to be used for telepractice. Talk with your administrator about the importance of using HIPAA-compliant methods for communicating with your clients and conducting sessions. Your administrators may want to invest in a service like VSee that provides a HIPAA-compliant platform for conducting video calls with clients. You’ll also want to make sure that you have access to a secure email or text message system to be able to communicate with parents in writing throughout this process. Check with your school’s/clinic’s current setup for communicating with families. Also, keep in mind that you will need to make sure that teletherapy is OK through your employer, whoever is paying for services (such as insurance or medicaid), as well as your state/country licensing board. In some areas, there are very specific rules for conducting telepractice/teletherapy.
What You Could Do: Find a secure platform like VSee to run your video sessions. Check with your employer, payer, and state licensing board before beginning any telepractice services.
Determine What Will Count as Minutes and Document:
Talk with your administration about what will count toward a client’s IEP minutes. Do phone calls with the parent count? Or do you need to see the client directly? Or will nothing count if you’re not in the same room? Find out what will count toward the client’s minutes and document everything! Chances are, you’ll still have compensatory minutes to make up when this is all said and done, but the more you can do now to count toward those minutes, the less overwhelming it will be for everyone when schools and clinics re-open.
What You Could Do: Talk to administrators about what counts toward a client’s IEP minutes and document every contact minute you conduct.
How to Run Your Teletherapy Speech Therapy Sessions:
Unless your school/clinic has an online scheduling system, you’ll probably need to contact families directly to schedule services. Make sure they have access to internet and a device with a camera that is compatible with whichever telepractice platform you choose. Then, you’ll just send them a link to connect with you at the scheduled time (that will come from your telepractice platform). Advise the parents to make sure that one caretaker can be present during the session (unless you’re working with an older, independent client).
Here’s one idea for how to run your sessions, though you can modify this to suit the needs of your caseload: Schedule your sessions for 30 minutes each. Start each session by talking with the parent/caregiver about how things are going. Ask about all of family life, not just speech therapy. Keep in mind that this is a quickly-changing situation so you never know when a family’s situation or health may change. Be ready to provide emotional support or connect them to resources as appropriate. Next, turn on screen share and pull up a worksheet with the client’s speech targets or a specific activity. In another tab, pull up something that the client would find fun. That could be an online game or video clips of something the child enjoys. Have the parent bring the child over to work on the skill for as long as the child can focus. In between reps, switch to the reinforcer activity (game, videos, etc.). The client won’t be able to use his/her computer to work the game or the videos, but that’s even better because then the child will have to communicate with you about what to click on and what to do. Keep practicing the skill until the child is unable to focus anymore. For some clients, this may only be a few minutes and that’s OK! Spend the rest of the time doing parent training to help the caregiver learn how to carry-over this skill at home.
What You Could Do: Schedule with parents for 30-minute blocks. Start with a check-in, then screen share a worksheet and practice the skill. If the child is unable to work with you the whole time, switch to parent training for the rest of the session.
Where to Find Materials for Teletherapy:
Any worksheet that you have a digital copy of (downloaded from the internet) works great for this because you can simply pull up the document on your computer and share your screen. It gets a little trickier if you only have hard copies of materials because you’ll need to hold them up to the camera for the client to see them. Teletherapy platforms will allow the client to see you (for cues) and see your worksheet as well. Plus, you’ll be able to see the client in their camera so you can provide feedback. Below is an example of what that might look like:
If you need more digital materials for use with telepractice, there are hundreds of great worksheets inside The SLP Solution Membership. We’re building out a full curriculum of homework-friendly no-prep kits that are perfect for use with teletherapy/telepractice. Click the button below to become a member.
What You Could Do: Find digital materials that you can pull up during a screen share with your client.
Other Ways to Prevent Regression While Schools/Clinics are Closed:
Even if you are not going to be conducting full teletherapy services virtually, you may still be interested in knowing how you can support your clients and their families through this event and help prevent regression. Here are some other ideas you can try outside of virtual therapy:
- Weekly Phone Check-Ins: Check in with families on a weekly basis. Ask them about their biggest challenges right now. Remember that not all of them will be in a place where they’re able to focus on speech/language therapy. Some may need connection to other resources or ideas for just getting through the day. Provide communication support where you can and connect them with others who can help them in other areas.
- Weekly Newsletter: If you have access to your client’s email addresses, you can send secure messages with weekly newsletters. Include practical strategies that parents can use at home to reduce communication frustrations and build their skills. Include some fun activities that will boost their communication skills for those parents who are looking for things to do with the children to keep them occupied and learning.
- Email Worksheets/Activities to Families: For those families who are interested, send home worksheets and activities that they can work through at their own pace. Make sure not to send anything too difficult for the client because you don’t want them to practice something the wrong way. But start with skills that the child has recently mastered (for reinforcement) and then ask the parents during your weekly check-in how it is going. If the child seems ready for a new skill, send another worksheet home but instruct the parents to stop if the child is struggling too much. If you need homework pages to send home, keep in mind the no-prep kits in the Curriculum that we’re currently building have homework instructions on every page: Click Here to View our Curriculum
- Send Videos to Families: If you are working with a child on a skill and you think he may be ready for the next level of it, send a quick video to families with instructions or demonstrations of how to do it. You can also do this with parenting strategies that you think may be useful for our families during this time as they relate to communication challenges. If you have a secure messaging system that you can use, encourage families to send videos back their child practicing the skill so you can provide feedback.
Other Ways You Can Use this Time to Your Advantage:
You may be feeling stressed out and overwhelmed by all of this and that’s OK! Prioritize your own mental health first and take care of your family. However, if you find yourself stuck at home for long periods of time with nothing to do, you may want to consider how you can use this time off to your advantage so that you are better able to help your clients when all of this is finally over and we’re able to get back into regular services. Here are a few ideas that may help:
- Get Caught Up on Paperwork: Have some reports that need to be written? Want to get a jump start on year-end progress reports? Now is a great time to start on those. Chances are, once schools are back in session, there will be a lot of chaos and scrambling to get caught up so the more you can do now, the better.
- Get Organized: Do you ever feel like you have too much to do and not enough time to do it in? Well, you may not be able to access your office during all of this to organize your physical space, but you can certainly organize how you run your practice/do your job. We’re holding a webinar later this month for helping you learn how to set up your therapy process so that you can plan for a whole month of therapy at once, saving you time and energy. Consider joining our webinar or going through your own therapy process and finding ways to streamline and save yourself time.
- Brush Up on Topics of Interest: We often hear from our SLPs that they don’t have enough time to complete their continuing education hours or go learn more about topics that they are interested in or that they need extra help in. With in-person events and conferences being cancelled, online learning is the way to go! Consider tools like our online membership program that provide training videos and continuing education so that you’ll be ready to hit the ground running once regular sessions resume.
We're Stronger Together:
At the end of the day, the most important thing here is that you stay safe and support your clients as best as you can. At The SLP Solution, we’re monitoring this situation closely and we will continue to offer support and guidance where we can. We’d love to have you join our SLP Solution membership program as we navigate this situation together. We house the largest international community of speech-language professionals and we’re all working together to make sure we take care of each other and our clients. For only $25 per month, you can join our community, access our curriculum, and get support from our staff and your peers around the world.