March 2020 brought a million changes no one could have ever expected. For most Speech-Language Pathologists, the biggest of those changes was likely a sudden halt in face-to-face therapy. Many SLPs were able to pivot by learning to provide telepractice, literally overnight in some cases.
For schools, initial plans of a 2-week closure turned into more than a year of distance learning in some cases. And not just school-based SLPs were impacted. SLPs across all settings (clinics, private practice, home health, etc.) were impacted by the COVID-19 pandemic.
And now, 16 months later, professionals may be back to in-person teletherapy, still providing teletherapy, or a combination of both. Today, I am sharing the thoughts of a few SLPs (who graciously responded to my Instagram story one random day) on their experiences with telepractice during and after the pandemic. Below, I have grouped portions of their complete responses in order to provide multiple perspectives for each question.
Initially, How did you feel about beginning teletherapy?
Taylor Herrera, SLP-A: "I was thrown into teletherapy by the pandemic and honestly it never crossed my mind prior to that point. I am an SLP-A in Texas and about to graduate with my masters, so I was not eligible to practice teletherapy prior to the pandemic. At first, I was very hesitant because the only viewpoint I had was face to face interaction with my students, and I wasn’t sure how that would translate on screen."
Randi Meier, MS, CCC-SLP (NY): "I found being thrown into teletherapy to be a very exciting experience at first. This was a method of service delivery I had always wondered about and yet was never quite in the position to take on previously."
Jennifer, SLP: "At first, I hated teletherapy. We were thrown into the deep end with no life preserver. I had no materials to use for teletherapy. In the beginning, I spent hours creating activities for my students."
What have you learned about teletherapy? What has surprised you about this service delivery model?
Randi Meier, MS, CCC-SLP (NY): "I think the one thing that has surprised me the most is how much progress the students made using teletherapy who had committed family members. I have learned that teletherapy is what you make it, just as in person therapy is. If you have lame activities your child won’t make many gains, but with some creativity and knowledge students can thrive."
Jennifer, SLP: "I enjoyed getting to see into my students' home lives. I met brand new baby siblings. I saw ofrendas during Day of the Dead celebrations. It was a new perspective on my student's lives. I also learned that not all online platforms are created equally. So often you had to ask how do I do this in XYZ platform. Teletherapy may not be for all students but it was a great way to work with some of them."
S.D., Brooklyn, NY: "I have learned that teletherapy is a very successful practice and that students can learn a lot from teletherapy. I have been surprised by how many resources are out there for teletherapy and how many activities there are for students to use. I have realized that teletherapy can be an effective method for speech language therapy. I have a more positive perspective and outlook towards teletherapy."
What did you like, or not like, about teletherapy?
Taylor Herrera, SLP-A: "I ended up LOVING teletherapy for the time I was at home, and working, however when we made the transition back to school in august, teletherapy became much more difficult. We were then working in hybrid groups with little ones, and it just really threw me for a loop. I figured out quickly that I needed to find more board game like activities for my teletherapy students. All in all it was a great experience! What I think I enjoyed most was being able to have the parent more involved. Working as a school based SLP-A, I see the parent once a year and speak via email, but being able to have them take a front row seat in every session was great! Obviously, that was different, but they were asking more questions, wanting to know why we were doing certain things, and asking for more home practice! It was great!"
S.D., Brooklyn, NY: "I like that teletherapy allows for a flexible schedule and for people to work from different locations. I was able to work with students from different areas."
What were some helpful sources of information for learning about teletherapy?
Taylor Herrera, SLP-A: "I researched and found videos and tutorials on teletherapy, things people thought were great and things that were must haves. I kind of just jumped in and went with it!"
Randi Meier, MS, CCC-SLP (NY): "In trying to learn how to navigate teletherapy service delivery I listened to courses discussing teletherapy ethics and practices. What I was surprised to find was that there was a great deal of practical procedures that have changed post-Covid and those courses developed prior to Covid do not have the most up to date or accurate procedural information. Basically, Covid turned the world upside down and it did so with the rules surrounding teletherapy as well. Also, I attribute to my teletherapy success to the wide variety of materials that were available through Teachers Pay Teachers and Boom Learning. Without those resources my therapy would have been a lot less stimulating and I would have enjoyed teletherapy less as a clinician."
Jennifer, SLP: "I think the online SLP community has been amazing during all of this! That is where I learned how to make this work, where to get materials, tricks to make using online platforms easier, and made connections during a really isolating time."
S.D., Brooklyn, NY: "I actually found your blog, professional developments and boom cards very helpful and useful to do teletherapy."
How has this experience changed your perspective and influenced your practice of speech language pathology moving forward in the future?
Taylor Herrera, SLP-A: "Ultimately, that [increased parent involvement in therapy sessions] made me realize how much I really liked the more intense parent interaction, which led to my decision to change settings and jump into the home health field. The initial blast of teletherapy helped me grow as a clinician, and really think outside the box which I loved! It was a challenge that was welcomed in a time where nothing was certain. I am very thankful for the opportunity to practice teletherapy, and I am a much better clinician for it!!"
Randi Meier, MS, CCC-SLP (NY): "While at first I was so intimidated by teletherapy, I was able to develop a system that worked for my students (parent coaching for nonverbal students and direct teaching for verbal ones). This experience influences my practice as I have seen the enormous benefits of walking parents through strategies in real time and not just explaining it to them via phone. Teletherapy has allowed clinicians to work with families in a more practical and applicable manner. Overall, the outcome of being pushed into teletherapy by the pandemic has caused my perspective to shift. I am no longer intimidated by digital service delivery and have confidence of its effectiveness with a variety of children."
Jennifer, SLP: "I will continue to use Boom Cards and Google Slides. They are lots of engaging materials on both of those platforms and then you can share with parents as homework. Great ways to have easy activities for carryover."
S.D., Brooklyn, NY: "This experience will allow me to use more technology based interventions into my in person sessions. I would also consider doing teletherapy as well in the future."
SLPs across the globe will look back at 2020-2021 as a whirlwind of shifting to teletherapy to provide services to their students and clients. There have been so many obstacles to overcome– the learning curve of becoming a teletherapist, the disruption of services for those without internet or computer access, and a long list of other hardships that many have faced due to the pandemic.
However, it's clear that there have been some silver linings in the world of speech therapy. to name a few– Parents have been able to play a more critical in their child's therapy. Students have expanded upon their tech skills. Speech-language pathologists have been pushed out of their comfort zone to navigate a new world of remote service delivery and digital speech therapy activities. If you're an SLP, hopefully you have been able to reflect on your resilience, dedication, and growth during this pandemic!
