October 9, 2012 Columns

School Matters: Getting to Know Telepractice

The start of any new year brings promise, excitement, energy, and creativity. You may be eager to try something different this year in your school, or find ways to manage your workload more effectively. Among the several new trends in schools affecting the way speech-language pathologists provide services is telepractice.

Two Formats

There are two ways to provide telepractice services—"real-time" (synchronous) two-way communication, or "offline" (asynchronous), such as recording sessions for practice. Telepractice technologies have included telephone service, videoconferencing, computer-based programs, document and high-definition cameras, calibrated microphones and headsets, DVD recorders, whiteboards, and new technologies, such as virtual environments. The technology should be easy to use, functional, and appropriate for capturing and transmitting the needed information remotely.

Telepractice has been used mostly in rural or remote areas where it may be difficult to recruit or retain qualified SLPs. But with rapid changes in technology, it may be used to deliver services to students regardless of location. As with any service-delivery method, SLPs need to use their clinical judgment to determine whether the student is a good candidate for this service delivery option.

Is Telepractice Appropriate?

Before you approach your teachers, families, and administrators about using telepractice, consider the following:

  • Professional issues—Are facilitators available? Do they need training to assist the SLP during a session?
  • Reimbursement may be limited—Each state administers its own Medicaid program and sets its own regulations. There is a significant difference in eligibility of services and reimbursement rates among states; contracting with a local education agency may be an alternative.
  • Evidence-based research—Research in the pediatric population is somewhat limited; more cost-benefit research is needed.
  • Available technology and facilities—You need technology that can provide quality services that are equivalent to face-to-face services. Reliable technical support, adequate Internet connectivity, and sufficient bandwidth are all essential. A quiet, well-lit space in the school is preferable.
  • State and federal laws—State licensure laws for telepractice differ in each state; 16 states and the District of Columbia have licensure provisions in statute, regulations, or policy for telepractice. Providers also must follow privacy laws under the Health Insurance Portability and Accountability Act (HIPAA) and Family Education Right to Privacy Act (FERPA).

Despite these requirements, successful telepractice programs are under way in many states, and many school districts are interested in piloting this approach (see p. 10 for pointers on piloting). Oklahoma, Ohio, and Virginia are some of the states successfully using telepractice for speech and language screenings and assessment, individualized education program documentation, and meetings.

Use this checklist to get started:

  • Check with your state education department for possible grants to pilot a program.
  • Check with your state's licensure board and education department for licensure laws, regulations, and policies.
  • Review the HIPAA and FERPA rules and ASHA's Code of Ethics.
  • Review the ASHA policy documents on telepractice.
  • Outline technology needs and the costs.
  • Establish a training program for SLPs, facilitators, school professionals, and families.
  • Collect data or collaborate with university faculty to conduct research on your program.
  • Talk to other SLPs who have successful programs.

See if telepractice can help you—it may help serve more students and keep your workload under control.

Susan Karr, MS, CCC-SLP, associate director of school-based speech-language pathology services, can be reached at skarr@asha.org.

cite as: Karr, S. (2012, October 09). School Matters: Getting to Know Telepractice. The ASHA Leader.

Online Telepractice Resources for School-Based Clinicians

ASHA Policy Documents

American Speech-Language-Hearing Association. (2010). Code of ethics [Ethics].

American Speech-Language-Hearing Association. (2007). Scope of practice in speech-language pathology [Scope of Practice].

Other Resources


Special Interest Group 18, Telepractice

American Telemedicine Association

State-by-state licensing and other information

Campbell, Michael (2012). How to develop a school-based telespeech program. Presentation at the ASHA Schools 2012 conference.


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