Education continues to look different for most students — and that especially includes those pupils with disabilities who receive support services like speech therapy through their schools.

In most cases, in-person services have been replaced by virtual therapy appointments, which have been an adjustment for families and the speech language pathologists who work with them. Families whose children previously received services in school are now trying to juggle telehealth visits with varying levels of success.

As students head back to school — mostly online — families are trying to work out the educational hurdles, which include making sure their students are receiving the support they are entitled to in a virtual setting.

“What used to fit in our box in a school setting might not be realistic right now,” said Liz Lucas, a speech language pathologist (SLP) and clinical instructor in the University of Delaware’s Department of Communication Sciences and Disorders who also works in the UD Speech-Language-Hearing Clinic. “We need to recognize that we have to be flexible that way.”

Lucas and Amanda Owen Van Horne, associate professor and director of the Tell Lab, offer the following tips for parents of children with language and speech issues.

Tip 1: Accept that speech services will look different, at least to start the year

During a typical school year, there’s a transition time as SLPs get cases assigned to them and they work through the scheduling puzzle to meet with each child needing their services, Lucas said. The coronavirus (COVID-19) pandemic exacerbated this already challenging scenario, upending treatment plans, delaying assessments and creating a backlog of meetings for schools and parents.

As your children start back to school, understand that services will be different, Van Horne said. Many families are already used to telehealth speech services, but the length and presentation of those could change, depending on the child’s needs and what they can handle. For example, speech services may be shorter than before or transitioned to one-on-one meetings to keep students engaged.

“It might be sensory overload to have three other people looking at them. They might not have the stamina for that 30 minutes,” Lucas said. “Flexibility, creativity and balance are all keys right now.”

It’s important for parents to remember that COVID-19 hasn't stripped them of their children’s federal rights to special education, Van Horne said. Identified students are still entitled to services, but it may take longer for schools to clear the backlog of assessments that need to be completed. Some assessments may be prioritized over others to allow students to continue getting their provided services.

“It's very difficult to be in compliance with last year’s IEPs under the current setting, so have some patience as your IEP is being revised,” Van Horne said. “But also recognize that if you feel like you've asked and waited, asked and waited, you have the right to a meeting.”

Tip 2: Communication matters — on both sides

Speech language pathologists spend time working with students, but also they need to take the consideration of the family’s situation during this time. Some parents are juggling home and work responsibilities at the same time. Other parents are working out of the home and depending on others to help their children with their schoolwork.

In either situation, Lucas said, there needs to be open communication between the family and clinicians. There may be more leeway for scheduling virtual therapy sessions at non-traditional hours to accommodate parents’ working schedules. Therapists also may spend more time working on coaching tips with parents, recognizing that not all kids are going to be able to fully engage with the computer visits.

Most importantly, if the intervention being used by the SLP doesn’t seem to be helping, parents need to speak up. At the same time, speech pathologists need to ask about potential issues that can affect a child’s educational experience.

“The SLP should ask the family, ‘Where do you see communication breaking down in your home right now?’ Lucas said. “”If you as a parent perceive that something is working well, it's also good for your SLP to hear that. I would want the parent to feel like they're a partner in that process.”

To help families, UD’s Communications Sciences and Disorders department has created Partners Advocating for Communication in Kids, or PACK, an online group intended to help those who are caring for children with communication disorders. UD graduate students are joining families and master clinicians to provide caregivers with support in understanding their children’s communication needs. The group meets the second Monday of each month at 10:30 a.m. via Zoom. Email supportkids@udel.edu for the link.

Tip 3: Teletherapy is a chance for families to see what goes on during speech services 

A public school SLP is charged with providing academic support to students in specific areas, Van Horne said. That’s the way IEP plans are written and the lens by which success is measured.

But a silver lining to working virtually with families is the chance for parents to see about the interventions that are being used. Zoom therapy sessions give parents an opportunity to see what their child is working on in the moment, rather than having to wait for the annual IEP meeting, Lucas said.

“Instead of it being something where activities are happening in the clinic and then we talk to you about them at the end of the session, and we hope that you carry over at home, we're actually in your home,” Van Horne said. “I'm watching you interact with your child in your actual home environment. We're using your cool toys. And so, those kinds of things mean that we all are being more effective at functional support for the families.”

Tip 4: The home environment matters for virtual therapy

After six months of virtual therapy, SLPs have learned a few tricks to increase their odds of success with young clients, Van Horne said. SLPs know certain headsets work better with kids than others. Macs and PCs offer more options for interacting with students than Chromebooks. Tablets are portable enough so that a parent can place it next to where a child is playing to allow the SLP to offer parent coaching in real time.

And chairs. Chairs can make a lot of difference.

“My kids love this chair because it does this,” Van Horne said, demonstrating as she rocked back and forth in her seat. “And you can imagine if you're doing speech therapy and the kid’s chair is like that.”

Keep in mind that the noise should be at a minimum during the speech therapy visit. That includes background noise and lighting. “Now is not the moment to listen to the radio, watch your favorite TV program on high volume, wash the dishes or play with the dogs,” Van Horne said.

Lucas said she also tells parents to hide the self-view feature on their device once the televisit starts. It’s another distraction kids — and adults — don’t need.

Tip 5: Expectations are critical

However speech services are delivered, Lucas said, it’s most important for families and therapists to manage their expectations early.

Parents should know that students are not expected to sit quietly for the duration of the visit. They may stand, jump up and down and even yell at the screen.

“In a normal setting, there would be hands-on activities and games and you can move around,” Lucas said. “So, again, it's about your expectations being realistic and not expecting the appointment to be a certain way. This is not the time to worry about perfection.”