October 24, 2018
Kira Wright, CCC-SLP
Every session is a challenge as a new clinician. I remember the crazy amount of time I spent preparing for each treatment session in graduate school. Luckily, as I gained knowledge and experience, I became more efficient and comfortable. This was the case when I started using telepractice, too. Ten years later, I’ve gained knowledge and experience that make me a much better clinician, on video or not! And still, cases arise that make me sit up straight and put my thinking cap on. You know the ones I’m talking about -- “How are you going to serve this student over telepractice?!” “We’ve never done it this way…” “I don’t know if this is going to work…” When telepractice is the only option for a student to receive services, due to geography, economics, timing, or some other factor, we can find ourselves faced with the need for some creative problem-solving and specialized accommodations.
My favorite tool to guide teams through these tough conversations is our Accommodation Checklist for Telepractice. We designed the form so that teams would be able to look at Physical, Cognitive, Behavioral, and Communication considerations, and then decide what sort of accommodations need to be made to remove the barriers to accessing services via telepractice. It also has a section to guide the discussion about what sort of Support Resources the student might need, as well as an area to delegate roles and responsibilities and to decide appropriateness. Read on to learn how it works, then download it for free below!
Physical considerations and accommodations for telepractice
Physical considerations for telepractice include factors related to how a student physically accesses the technology involved. This section asks the team to think about what the student needs to maintain their physical orientation to the screen, to see and track tasks on screen, to carry out fine and gross motor tasks such as typing, mousing, and pointing, and to hear the clinician and themselves during therapy. If the team determines that the student needs additional support in this area, the checklist offers a list of possible accommodations such as adjustments to lighting or screen contrast, alternative placements for the computer, and the use of assistive technology such as switches and joysticks.
Cognitive and behavioral considerations and accommodations for telepractice
Cognitive and behavioral considerations for telepractice include factors related to a student's attention and behavior support needs. Can the student independently attend to the computer screen for the duration of a therapy session? Can they independently manage their own behavior? What about asking for help when they need it? Possible accommodations in this area include visual supports, minimized distractions, consult with on-site staff regarding the day's emotional state, and modification of tasks and duration of sessions.
Communication considerations and accommodations for telepractice
Students who are receiving speech-language services have special communication needs by definition. This section asks teams to dive a little more deeply, however, and consider the nature of those needs and how they specifically relate to telepractice. If the student is not yet communicating verbally, for example, it will be essential that their primary mode of communication be integrated into the sessions. Likewise, accommodations will need to be made if the student and clinician are not proficient in the same language.
Support resources considerations
This section asks a team to think about the technology itself (e.g. computer, webcam, internet connection) as well as the support personnel who are available for the purpose of telepractice.
Determination
Once the team has completed all of the above sections, the Accommodations Checklist for Telepractice provides space for a list of the necessary accommodations and notes regarding the plan's implementation. This is a crucial step for the team, as it allows for an assessment of what can realistically be provided to the student and by whom, and allows for a clear delineation of roles and responsibilities. Finally, the tool asks the team to consider everything they've discussed thus far and decide whether telepractice is an appropriate service model for the student at this time.
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I love this accommodations checklist because it takes the focus off the telepractice model. It turns the conversation toward the student’s skills and needs, and the capabilities of all the people on the team. By looking at the time, space, knowledge, and supports that are available, an IEP team can decide how to spend them in a way that is sustainable and agreeable to the whole team. It’s been used by teams serving just about every type of student you can think of -- preschoolers, AAC users, students with limited vision or mobility, students with challenging behaviors -- and on teams that are facing their own internal challenges as well. Give it a try with your easiest and your toughest cases, and let us know what you think!
This post was last updated 10/13/22
