5 Myths About Teletherapy

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By Elise Mitchell, M.S. CCC-SLP

Let’s talk about teletherapy, shall we?! As teletherapy gets more and more popular, it sparks a lot of questions and many misconceptions.  I want to take this time to talk to you honestly, and I want you to feel like you know what teletherapy is and what it isn’t.  You may be a parent looking for speech therapy for your child, an adult with a busy 9-5 work schedule, a school administrator questioning speech therapy for your district, a speech therapist wondering about employment, etc.  Whatever reason you’ve come across this blog, I want you to leave the blog with a better understanding about teletherapy. So, I’m going to address the concerns that the team at DotCom Therapy hears the most. 

Misconception 1: Teletherapy is not as personal as in-person therapy.

    So, the other day was my birthday (yay for aging), and I happened to be working that day. This group of older boys that I’ve been working with this year immediately came to the computer and sang "Happy Birthday” to me. Why did they do that?  Because I’m one of their teachers, and we have built an amazing teacher-student rapport. I can share so many stories of tearing up over students’ successes, hurting with the student who just lost a grandparent, giving a "computer high-five” to a student doing well...I could really fill up so many blogs with these stories. The relationship with the teletherapist is just as personal as the relationship with the therapist. Am I getting the flu when they get the flu?  No.  Am I establishing a meaningful relationship with the patient or student?  Yes. Technology does not alter the personal attention that each patient/student is given.

Misconception 2: I won’t be a part of the school team.

    The communication that is done between teletherapist and other school district staff is more virtual in nature.  No, I’m not sitting there with the teachers on my lunch breaks talking about my day (instead I’m rotating laundry and making the beds that I forgot to make that morning).  However, I am always emailing teachers/staff and preparing for IEPs or checking in on students.   The facilitators that are in person with the students are constantly communicating with the therapist, as well.  I feel like I’m exposed to even more teamwork because location isn’t a barrier, so I am a part of several school teams. Also, with this, I feel like the therapist gets what they put out there. Upon hire, I emailed the staff/teachers that I would be working with and let them know a little about myself. That sparked conversation about my children, my specialties, etc. 

Misconception 3: I need to be in person to see the articulators.

    I have given a good amount of Oral Mechanism Exams during my time as a teletherapy SLP.  Technology has evolved and the camera can see a lot.  If you can’t see something, you simply give instructions for the patient/student to move to where you can see it. An adult patient can be asked to look up so you can really get a good look at the soft palate.  A student can be asked to "open wide” so you can get a good look at the uvula. Everything that can be seen in person, can be seen on a camera.  

Misconception 4: I have to be "in person” for my materials to be relevant and to prompt.

    Let’s start with materials: the internet and apps are great materials.  I have access to internet games, online coloring, speech therapy apps, etc. I make PowerPoints with images targeting certain sounds or "wh questions”.  I can scan in my speech worksheets that I have and use those. I can read the books I have at my desk. The facilitator can get the kids a puzzle to do as reinforcement for sounds.  I actually think I spend a lot less time and money on materials as a teletherapist. 

For cueing: there is never a moment where I have said, "Oh, I wish I was in person to teach this person how to say this sound.”  Never once, and I have worked with some pretty severe cases. If anything, I like describing to the student, for example, where to put the tongue depressor, so he/she can make the sound /k/. I like describing the tactile cues.  This allows for generalization outside of the classroom and parents love this. 

Misconception 5:  Teletherapy cannot treat severe populations or individuals with behaviors.

    Once again: the therapy isn’t different, the mode of delivery is. The thought that students or patients with complex co-morbidities, e.g. Parkinson's disease and post stroke, have to go to a "brick-and-mortar” type setting is just not true.  If anything, we want to encourage teletherapy more for these individuals because often their immune system is compromised, and there are risks with going to an outside setting. 

    I hear this a lot when it comes to caseloads in the schools, as well, and it simply isn’t true. The teletherapy school model isn’t just for students with a speech impairment. Here are some examples of some other populations that could benefit from teletherapy services: an individual with autism that communicates via picture exchange, an individual with cerebral palsy who is NPO (nothing by mouth) with the exception of speech therapy feeding trials, individuals who are deaf/hard of hearing and use sign language, an individual with Down syndrome who is learning how to use an AAC device, and individuals with severe behaviors.  In fact, often times I’ve seen an increase in performance in speech therapy and decrease in behaviors, e.g. meltdowns, when using the web-based therapy platform. 

I hope that this answered any questions you may have.  Always remember that teletherapy isn’t a different type of therapy...it’s a different mode. With DotCom Therapy, rural and underserved school districts, individuals with compromised immune systems, working professional, kids of busy parents and many more are able to have speech therapy. This modality makes it to where speech therapy is available to everyone, everywhere. How exciting is that?!