Making Pediatric Teletherapy Work for Your Program
Telehealth services in general, and teletherapy in particular, have become widely accepted during the COVID-19 pandemic. News outlets and anecdotal evidence say this growth is one of the pandemic’s “silver linings.”
But, because you must make sure students with special needs get the related services they need, you may not be so convinced! When schools are closed, having to use pediatric teletherapy to deliver these services is challenging.
So much of what your therapy staff does is hands-on. Some of it involves special equipment. Plus, when therapy sessions happen via video conferencing, it’s harder to unobtrusively observe what’s going on and feel confident your program’s working as it should.
At Pediatric Therapeutic Services (PTS), we agree teletherapy can’t fully replace in-person therapy. But we’re also enthusiastic about our clinicians’ ability to use it to make a positive impact on students and help them stay on target with their goals.
Seven Issues in Remote Therapy Needing Your Attention Now
While planning and implementing pediatric teletherapy raises a multitude of issues, here are seven we think deserve special attention:
- Be Clear on Your Responsibility.
According to Department of Education guidance, special education and related services aren’t required if regular education services have discontinued because of school closures. But, if your school or local education agency continues providing regular educational services for all students during closures, your program must provide special education and related services to give those students equal access to their free appropriate public education (FAPE).
- Consult with Individualized Education Program (IEP) and Section 504 Teams.
Don’t use a one-size-fits-all model of teletherapy during school closures. Provide the services and supports identified in students’ IEP or 504 plans to the fullest extent possible. Input from the student’s IEP or 504 team is critical in shaping the teletherapy experience. In addition, when schools reopen, the team should determine what compensatory services, if any, are due.
- Choose Simple and Secure Technology.
Ideally, your teletherapy platform will use technology that is ubiquitous, intuitive, and capable of streaming video and audio in real-time—securely encrypted end-to-end. Nicholas Slamon and Jay Greenspan put forth these criteria for pediatricians implementing telemedicine in 2016, but they are also relevant for related service programs during this pandemic.
- Comply with HIPAA and FERPA.
The Department of Health and Human Services (HHS) won’t penalize providers who, in good faith, use audio-video technologies for telehealth that don’t fully comply with federal laws governing personally identifiable information and protected health information. But, HHS’ temporary exercise of discretion doesn’t mean Zoom and Skype are automatically your best options for pediatric teletherapy. Adopting a fully compliant platform now may spare you ethical worries and legal headaches later on.
- Double-Check Your Providers’ State Licensures.
What if a student who normally resides within your district’s bounds is sheltering in place across state lines? What if your program is in a regional private school attracting students from several states? What if a service provider is working from home in another state? Check to see whether your state has eased or changed licensure requirements in light of the pandemic.
- Provide Prior Written Notice of a Plan for Continuity of Education
Districts should issue a Notice of Recommended Educational Placement (NOREP) to the parents, guardians, or other caregivers of students with current Individualized Education Programs (IEPs). The NOREP details the school’s plan for addressing the student’s IEP services during the closure. It should document any remote therapy the school will provide. Consult with your professional legal counsel before distributing the NOREP.
- Involve Parents and Other Family Members in Teletherapy Sessions.
Encourage your therapists to draw on students’ families as resources. From helping set up the remote therapy space optimally to participating in sessions as helpers, parents and other caregivers can do so much to make pediatric teletherapy a success. At PTS, we’ve found parents overwhelmingly appreciate greater involvement in their students’ related services. But, don’t forget they’re facing their own stress during the pandemic. Ensure your staff has plans to provide them with extra support.
This list of issues is no substitute for your knowledge of your own program, nor is it legal advice—always confer with professional legal counsel. We do hope, however, that it helps you start thinking through the many factors at play, and ways to address each one.
PTS Can Help Your Program Make the Most of Remote Therapy
Last spring, the Council of Administrators for Special Education encouraged administrators to make good faith efforts, thoroughly documented, to provide accessible and accommodated services.
Several months into the pandemic, we think this advice still holds.
- Trust your best clinical reasoning and ethical judgment to determine what therapy services you can and will provide to which students.
- Document what actions you take, and why.
- Maintain communication with students’ families, so they know you’re doing all you can to help students make progress.
If you want or need a partner in providing pediatric teletherapy, contact PTS.
Our clinicians can use your in-place, secure remote-learning platform to deliver a wide range of related services. And, our Clinical Directors can help you accurately assess and measurably improve your program’s performance.
Together, we’ll make it through, doing as much good for as many students as possible.
And who knows? You may end up agreeing teletherapy’s growth in 2020 is a “silver lining” after all!