Setting Up Teletherapy for the New School Year: A School SLP's Checklist

Wired beats wireless and a headset beats a laptop microphone, on both ends. If you can influence only one piece of equipment across your caseload, push for wired headsets for the students. Bluetooth adds latency and its own processing, which is why a child can sound clear in the hallway and mushy on the call.

In your platform audio settings, look for original sound, high fidelity, or music mode. Enabling it turns down the noise gate and echo cancellation that chew up quiet fricatives, at the cost of letting background noise through. Check video too: the student needs to see your mouth, so your face should fill a reasonable share of the frame and be lit from the front, never backlit by a window.

Before the first session, confirm three things in writing with your district: that teletherapy is documented as the service delivery model in each student's IEP where required, that your district's consent or notice form has been sent and returned, and that your platform is the one approved for student data. Requirements vary by state and district, and licensure rules differ again if a student is located in another state. Ask your special education administrator rather than assuming. This is an administrative process question, not legal advice.

Scheduling online is a different problem. You lose walking time but gain login time, so build a five-minute buffer between sessions rather than stacking them. Send teachers the schedule with the link, the exact minutes, and a one-line description of what they need to do, because a link buried in an August email thread will not be findable in October.

Give every session a permanent link where your platform allows it. Rotating links are the most common reason a session starts eight minutes late. Family-facing versions of this communication are in the parent letter templates for school SLPs.

The largest single predictor of whether a session works is the adult on the other end. In school telepractice this person is often called an e-helper or facilitator, and may be a paraprofessional, an aide, or at home a caregiver. Decide who it is before the year starts and tell them what you need in plain, non-clinical terms.

The environment needs four things: a quiet space, a hard surface at the right height, headphones, and the student close enough to the camera that you can see their face and mouth. A child on a beanbag holding a tablet at arm's length gives you no usable placement information, and you will spend the session redirecting the device.

Write the helper a half-page instruction sheet in advance, covering what they should do rather than why. Most helpers over-help, prompting and answering for the child, and a written note that their job is to stay quiet unless asked works better than saying it once in session one.

When a parent is the adult in the room, the first session is partly a coaching session. Teach two skills: how to wait, and how to model. Waiting means giving the child five full seconds before helping. Modeling means saying the word correctly once, without demanding a third and fourth repetition.

Do not teach placement cues to a parent in the first weeks. Placement is what goes wrong when it is copied off a screen, and a parent coaching tongue position incorrectly can entrench an error. Give them repetition and encouragement, and keep the shaping for yourself.

Send home a short, specific task each week rather than a general request to practice. One page at the level the child is actually working on gets used, where a thirty-page packet does not. The guide to home practice packets covers sizing these, and the word lists by sound give you printable stimuli.

Short online sessions run best on a fixed routine with variable content. Use the same four-part shape every week so no minutes go to explaining what happens next, and swap the activity inside each part. Plan a transition every five to seven minutes, meaning a change in what the child is doing: from repeating to choosing, choosing to drawing, drawing to reading.

Keep materials in three forms so a technology failure is not a lost session: something to share on screen, something on paper at the child's desk, and something needing no materials at all. The teletherapy game collection is built for this constraint, with activities that work through a shared screen and give feedback on each attempt.

Your hands are on the keyboard and your eyes are on the screen, so a paper tally sheet will not get filled in. Move data collection onto the same screen: a spreadsheet or note window docked beside the video, one row per student, beats a clipboard here.

Sample rather than counting everything. Ten to twenty scored trials from the middle of the session is more honest than a full count you abandon at minute six. Mark the level and the cueing next to the number, since the same figure means very different things with and without a model.

Two things are harder online. You will miss quiet errors, so ask the child to repeat any production you are unsure about rather than scoring a guess. And you cannot see the whole mouth, so for placement-sensitive targets ask the child to move closer to the camera for a few deliberate trials. Reviewing the relevant sound guide beforehand tells you what to look for.

Teletherapy works when the setup happens in August. Test audio on the real network with real fricatives, get the consent and platform questions answered in writing, name the on-site helper and give them a written half-page, and build one folder of materials and one data template before the first login. Almost every mid-year frustration traces back to one of those four being skipped. For the rest of the start-of-year list, see the back-to-school checklist for school SLPs.

For the activity half of the session, the teletherapy games on SpeechTherapyMagic score each attempt in real time and show whether the target sound was correct, useful online precisely because your ear is working through a compressed channel. Treat that as a second opinion supporting your clinical judgment, not a replacement.