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FAQS
FAQS
Questions about online speech therapy
This will vary by therapist and your location. Most private clinicians see children at an office, but some travel to homes. If you are not within driving distance, online service (telepractice) is the way to go. The directory listings can be sorted to find SLPs licensed in your state.
Yes. Speech-language pathologists must be licensed to practice in their state of residence and in the location where services are provided. The directory listings can be sorted to find SLPs licensed in your state.
Yes. According to the American Speech-Language-Hearing Association (ASHA), “Use of telepractice must be equivalent to the quality of services provided in person and consistent with adherence to the Code of Ethics (ASHA, 2016a), Scope of Practice in Audiology (ASHA, 2004b), Scope of Practice in Speech-Language Pathology (ASHA, 2016b), state and federal laws (e.g., licensure, Health Insurance Portability and Accountability Act [HIPAA; U.S. Department of Health and Human Services, n.d.-c]), and ASHA policy.”
Read more at ASHA’s brochure on telepractice.(https://www.asha.org/siteassets/uploadedFiles/ASHA/Practice_Portal/Professional_Issues/Telepractice/Telepractice-for-Speech-and-Hearing-Services-Brochure.pdf)
Telepractice is growing in use across the U.S. and around the world. Insurance coverage varies between insurers, plan coverage and location. Your therapist may be knowledgeable about programs in your area, but you will need to check directly with your insurer to be certain.
You need a high-speed internet connection and a device with an internet browser (computer, tablet, smart phone). Your SLP will recommend a platform or app that connects you in a video conference and meets requirements for confidentiality.
No. We provide the directory as a service to connect parents with service providers. It is up to the parent to interview and select an SLP. It is up to the SLPs to operate their private practice including teletherapy equipment, an online platform and materials.
Don't believe anyone who guarantees outcomes for treatment. We screen the SLPs in the directory to determine they are certified and abide by the code of ethics of their national professional organization. As you would when contracting with any service provider, we encourage you to ask for and verify the credentials of any service provider before they work with you and your child.
SLPs must be licensed by your state/province/country licensing board and in their location of residence. Most SLPs also belong to a professional association that sets standards for training, certifies therapists have met those standards, and sets and enforces rules for ethical practice. SLPs may also hold one or more certificates to demonstrate they have completed additional training in a research-based methodology, for example a Naturalistic Developmental Behavioral Intervention (NDBI).
CCC-SLP stands for Certificate of Clinical Competence in Speech-Language Pathology. This is the national certification for SLPs in the United States, by the American Speech-Language-Hearing Association. The CCC-SLP demonstrates that your therapist has completed a Master’s degree or higher, passed a national certification examination, and completed a supervised Clinical Fellowship Year. SLPs must complete additional training to renew this certification every five years.
Certification in some other English-speaking countries include:
• CPSP from Speech Pathology Australia
• S-LP(C) from Speech-Language & Audiology Canada (SAC)
• MIASLT from Irish Association of Speech and Language Therapists (IASLT)
• MNZSTA from New Zealand Speech-Language Therapists Association (NZSTA)
• SALT from the United Kingdom’s Royal College of Speech & Language Therapists (RCSLT) are certified by the Health and Care Professions Council
Questions about speech-language delay
We use this as an umbrella term for any child who is not using gestures, sounds, words, sentences or social communication at the level expected for his or her age.
There are many factors that can result in a speech, language or communication delay. Unclear speech sounds may be related to malformations of the mouth, poor hearing, muscle weakness, poor coordination between the brain and muscles, or a difference in the way a child’s brain processes information. One or more of these factors also can affect how a child uses gestures, learns words, makes sentences and communicates in social situations.
While scientists are learning more about the factors that lead to speech-language delay, in most cases we do not have a good understanding of why a specific child develops the factor that leads to their specific delay. When a factor (e.g., autism, apraxia, developmental delay) is identified, the information can help point to specific treatment methods.
When we get to the stage of diagnosing a speech-language-communication disorder, we make a distinction between a delay versus a disorder. Delay means communication is following the usual sequence we see in typically developing children, but at a slower rate. Disorder means we’ve identified one or more factors that are interfering with the child’s typical communication development. Neither term means something “worse” than the other; both terms can range from mild to severe.
Many specialists (e.g., pediatricians, early childhood developmental specialists) are trained to screen and identify speech-language skills expected at each age. They refer children to a speech-language pathologist (SLP) for an in-depth examination and diagnosis. The SLP can develop a detailed description of the child’s overall communication development and a plan for the best course of treatment based on this information.
Yes. You don’t have to wait for a diagnosis to begin using methods that support communication development; however, a diagnosis provides details on how to individualize treatment for your child’s specific needs. Funding sources (e.g., insurance companies, service agencies) require a diagnosis to qualify for their support. Early intervention (EI) and school-based services require a diagnosis before they enroll a child in special services--they provide their own evaluations. Families that disagree with the EI or school evaluation results may obtain an evaluation from a private speech-language pathologist to help document the child’s needs.
Questions about Naturalistic Developmental Behavioral Intervention (NDBI)
• NDBI is any of several communication intervention programs for young children that combine methods from the fields of developmental and applied behavioral sciences.
• Naturalistic means therapy methods are used in natural settings (like home or daycare/school) during typical, daily interactions.
• Developmental means therapy uses activities that are meaningful for the child’s level of development. The therapist shares the child’s interests and balances control of the activity with the child.
• Behavioral means therapy uses contingencies and other principles of learning to increase or decrease behaviors (actions, speech, language) in planned and consistent ways, and without the use of medications.
• Intervention means a treatment approach. NDBI programs emphasize helping parents learn and apply the intervention methods during interactions with their child throughout the day. The parent and therapist work in partnership to increase the child’s communication development.
Some NDBI programs have been used for decades. Some programs are still in development or refinement, based on ongoing research. However, the term NDBI is new. It was coined in 2015 by researchers from around the U.S. who wanted a consistent term to describe the approach they were using. This new term helps with communication about the programs; facilitates communication between researchers, clinicians and parents; helps insurers understand the treatment approach; and helps funding agencies know what type of research they are funding.
Rather than work on isolated skills without meaningful contexts, NDBIs work on communication skills embedded in the context of a child’s development in social, play, motor movement, and thinking skills. That means we teach words that are naturally used during the activity we are sharing with children. We show them how to use their communication skills for reasons that make sense during that activity. Embedding communication into these daily routines is the most efficient way to encourage children to use the skills whenever the opportunity arises. Also, taking the child’s interests into account increases their attention and motivation for learning.
Some of the programs with the most research are: Early Achievements, Early Start Denver Model (ESDM), Enhanced Milieu Teaching, Incidental Teaching (IT), Joint Attention Symbolic Play Engagement and Regulation (JASPER), Pivotal Response Training (PRT), Project ImPACT and Social Communication/Emotional Regulation/Transactional Support (SCERTS).
The Hanen Center uses NDBI methods and produces a number of widely-used books, workshops and other resources.
You can read more about NDBIs in our blog, starting with What Is NDBI? and Four Advantages of Naturalistic Intervention.
Questions about Telepractice in Schools
Telepractice provides speech-language services from an off-site location using 2-way interactive video over a high-speed internet connection. The American Speech-Language-Hearing Association sets guidelines for speech-language pathologists (SLPs) in telepractice, and state licensing boards regulate telepractice in each state.
Most school districts turn to telepractice when they have been unable to fill a full- or part-time position vacancy for a speech-language pathologist to be on site.
Check this list from the American Speech-Language-Hearing Association for regulations that apply to U.S. states and territories. Check this site to find SLP organizations in other countries.
Agencies save you time in recruitment, and are able to draw from a wide pool of qualified SLPs. They contract with and train the SLPs, and provide any technical assistance you may need for setting up your program.
Districts report improved recruitment and retention with individual contracts because SLPs are paid the full contract amount without an agency fee. Both parties usually report better communication and coordination when a staff member in the district, rather than an agency supervisor, holds responsibility for oversight of the contract and services.
Your union may have concerns about contracting for a service that could be provided by a certified staff member. You may want to share information with representatives before you contract with a telepractitioner, and provide them with documentation of your unsuccessful attempts to hire a person. Many districts repost the open position annually prior to renewing a telepractice contract.
Telepractice may cost more than a direct hire, depending upon where potential hires fall on your salary schedule. Expect to pay a telepractitioner at least the equivalent of salary and benefits you would pay an in-person SLP, with full credit for experience and education. In addition, you will need to hire or reassign a paraprofessional “telehelper” to be present during the times the SLP sees students.
Yes, for the duties specific to SLPs and special education. Telepractitioners provide direct therapy, perform evaluations, write reports and IEPs, attend IEP team meetings, and consult with staff or parents as needed. Most telepractitioners participate in Child Study Teams and other collaboration with teachers, and some inservices. Use your district's position description for SLPs to define the expectations in your telepractice SLP contract.
It may surprise you to learn that age is not a factor with telepractice. Early intervention (birth to age three) is ideal for telepractitioners who use the widely recommended model for this age group, parent coaching. Preschoolers benefit from improved carryover of skills if they attend with their parent (which gives added flexibility in scheduling) or with a classroom para or teacher.
School-age students of all ages, disability types and severity levels have been successfully served via telepractice. Some students may be best served with co-treatment or consultation between the SLP and another special educator. In rare instances, a student may be unable to use a computer because of severe behavioral or cognitive challenges.
School districts have the sole right and responsibility to assign staff to perform the duties prescribed in IEPs. Even though staff assignments are not part of the IEP process, it can be helpful to proactively inform parents and staff of the process you are using for finding an SLP.
Provide parents with information such as this description of telepractice by the American Speech-Language-Hearing Association. Your state education agency's consultant for speech-language may have additional information regarding other schools using telepractice. Invite parents to a demonstration before sessions begin, or invite them to observe a session with their child. Let them know what system has been set up for them to communicate with the SLP and receive information updates.
More information for parents is available at our blog post My child's school hired a telepractice speech-language patholoigst. What is that?
I have worked with Joyce in a school environment. She has amazing ideas and she implements them in the most seamless way. She has been essential in helping students grow in their communication and develop essential social skills in a way that is child centered and honors their learning style.
- PAM BERRY TEBEAU, MIT, NBCT
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