I am extraordinarily busy running my existing SLP program. How else can Presence TeleCare help me?

Presence TeleCare is not just another Non-Public Agency.  We want to be your partner in building an exceptional SLP program for your students. We encourage you to think broadly about how telepractice might play a role in your program. With our technology and top-notch SLPs, there are many ways we can help you succeed, such as:

• Filling hard-to-fill vacancies
• Reduction of existing SLPs’ caseload, cutting down on burnout and resulting turnover and recruiting expense
• Serve students at remote sites without excessive travel time and expense
• Backup in the event of unexpected attrition to ensure continuity of service
• Service to students from non-public schools and students who are transitioning off IEPs

How are clients, particularly younger children, supervised?

In-room supervision is critical to the success of a school-based telepractice program. Presence TeleCare requires that schools have a paraprofessional present in the room with all students.

The paraprofessional has traditionally had the following responsibilities:

• Transporting the student to/from the telepractice session
• Assisting the student with technology set-up (e.g., attaching the headset to the computer)
• Ensuring that the conferencing connection with remote SLP is functioning. Contacting the SLP via phone if necessary
• Remaining in the sessions to ensure that any technology glitches are reported and fixed
• Providing cues, prompts, and models for the student upon SLP direction
• Helping relay information between the school staff and the SLP related to scheduling, absences, or school functions

Paraprofessionals are typically identified by and hired through each individual school district.

Paraprofessionals are trained in a short, live or on-line training session. Issues covered in this training session include basic technology troubleshooting strategies, roles and responsibilities, and guidelines for maintaining confidentiality.

Does telepractice meet IDEA and ASHA standards?

Yes. ASHA issued a position statement recognizing telepractice as an appropriate method of service delivery in 2005. IDEA does not dictate specific service delivery methods, so telepractice meets IDEA standards as an appropriate way to fulfill IEP obligations. All robust, peer-reviewed academic research on this topic to date indicates that telepractice meets IDEA requirements.

We strongly believe that the quality of services delivered via telepractice must be consistent with the quality of services delivered face-to-face. This is why we rigorously monitor progress and outcomes and are committed to providing SLPs with superb mentorship and supervion.

Are there confidentiality issues with telepractice?

If the telepractice session is encrypted with SSL (a.k.a. TLS) encryption technology, federal standards of confidentiality are met. All communications on Presence TeleCare’s platform are encrypted using this technology.

The relevant federal laws regarding confidentiality are the Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act (HIPAA). FERPA requires that schools have a student’s consent prior to the disclosure of education records. HIPAA requires that health records be kept secure. HIPAA only applies to schools under certain circumstances.

Both of these laws are careful not to specify certain technological standards for encryption. Based on common practice by numerous health and educational institutions under these laws, SSL encryption technology is universally considered adequately secure.

What is the initial cost of the hardware/software?

Hardware and software costs associated with the Presence TeleCare platform are minimal. Typically, the only hardware needed for each station is webcams and headsets, at a cost of $90-120 per station.

We recommend specific equipment models that we believe represent the best value and quality for delivering telepractice. However, schools are welcome to purchase other models if they prefer. The web cams that are built into many laptops are also perfectly adequate. Presence TeleCare also recommends that schools have a phone, fax, and printer near the room where the telepractice session is conducted.

Beyond this, our platform requires only a broadband connection and a computer with Internet Explorer, Safari, or FireFox installed.

Are there ongoing costs?

Presence TeleCare provides schools with a complete program for all their tele-SLP needs. We recruit talented SLPs, train them on the clinical nuances of telepractice, and provide support, supervision, and quality assurance as the program continues. We manage a network of tele-SLPs, which allows school districts to have one point of contact for their tele-SLP programs.  With our deep SLP team, we help schools continue to provide services in the event of unexpected absences and attrition.

Because we are a comprehensive service, the cost for our program is based on the amount of time during which schools use Presence TeleCare SLPs. Our rates are competitive with current market rates and are highly cost-effective, especially when savings in recruiting, transportation, training, retention, and supervisory costs are factored in.

Can specialist SLPs provide services via telepractice?

Trained specialists can greatly accelerate a student’s progress. For example, bilingual SLPs can provide highly effective intervention and assessment for English language learners or Board Recognized Specialists in Fluency will a large arsenal of techniques that will be helpful for children who stutter. Many school districts are unable to access SLPs with specialty certifications, leaving children with special or low-incidence needs to wait for months for specialized services.

Among Presence TeleCare’s roster of talented SLPs are Board Recognized Specialists (a certification granted to SLPs who have advanced knowledge, skills, and experience beyond the Certificate of Clinical Competence) in fluency and child language. Our roster also includes SLPs with specialized knowledge in bilingualism. These SLPs are ready to provide services to children immediately without wait time for services.

What about the more “hands-on” aspects of SLP intervention?

While direct manipulation of the articulators is not possible, SLPs can easily model placement in the telepractice setting.

SLPs can also engage students in typical activities to facilitate production of specific phonemes such as blowing through a straw, touching a finger or popsicle stick to the roof of the mouth, and moving two articulators together (e.g., “Put your teeth on your top lip and gently bite down. Watch me! See where my teeth are? Now, blow some air through your teeth”).

If the child is unable to accomplish the activity through visual cues and verbal instructions, the paraprofessional aide, at the request of the SLP, can facilitate the placement activity.

Is telepractice appropriate for all conditions?

In over 10 years of research, telepractice has been consistently found to be clinically effective for a wide range of communication disorders.

SLPs must exercise their professional judgment in evaluating whether an individual is appropriate for telepractice. As ASHA has noted, factors include hearing/visual ability, level of cognitive functioning, sitting tolerance, and ability to maintain attention.

At Presence TeleCare, our SLPs are trained and carefully supervised in evaluating a individual’s appropriateness for telepractice. In our assessments, we analyze the physical, sensory, cognitive, and behavioral characteristics that may impact an individual’s ability to benefit from telepractice.
Furthermore, data-driven progress monitoring is an essential part of our service and allows for continued re-evaluation of the appropriateness of telepractice as the mode of service delivery. We closely track our clients’ progress against national standards and make adjustments as needed.

What are the qualifications of Presence TeleCare SLPs?

Many SLPs are drawn to the Presence TeleCare network because of the clear benefits of telepractice and our leadership in providing this mode of delivery.  This allows us to be highly selective in our SLP recruitment. All of our SLPs possess the appropriate state licenses in addition to their ASHA Certificate of Clinical Competence.

We choose our SLPs through a rigorous selection process that includes extensive interviews, detailed reviews of their clinical experience, and validation of their state license and certificate of clinical competency.

Our standards have enabled us to assemble an experienced and talented corps of SLPs who are passionate about telepractice.  We are very proud of our role in setting the highest standards for this service delivery medium.

Will Presence TeleCare SLPs provide consistent service?

We believe consistency of service is paramount.  Every new client of Presence TeleCare is assigned to an specific SLP. The SLP has responsibility for the individual’s case, including knowing the child’s history, interpreting previous assessments, conducting new assessments if required, collaborating in program planning and/or IEP development, and implementing the intervention program.  The SLP manages ongoing documentation and data collection, ensuring that he or she knows the child’s needs intimately.

How do Presence TeleCare SLPs communicate with parents and teachers? Do Presence TeleCare SLPs participate in IEP meetings?

Close collaboration with teachers, school administrators, and parents is one of our core values. Our technology platform is intended to enhance collaboration among the relevant stakeholders. For example, parents and teachers can closely monitor a child’s progress by viewing recorded video reports from the SLP, together with online data.

Presence TeleCare SLPs participate in all meetings of the IEP team via video-conference. In some circumstances, our SLPs may be present in person.

Does Presence TeleCare integrate its services with a child’s classroom curriculum?

Yes. We believe strongly in the collaborative-consultative model, and our platform is designed to promote active collaboration between SLP and classroom teacher. Our web-based platform allows for video communication between any two individuals with a headset and a broadband internet connection. Effective collaboration with a child’s teachers is a key performance metric for our SLPs.

Can Presence TeleCare provide services for children in groups?

Yes. Multi-point video-conferencing is one of the most exciting features of our web platform, allowing SLPs to provide live, simultaneous intervention to children with similar conditions across geographic distances.

How does Presence TeleCare monitor and document progress?

Our platform makes data collection/progress monitoring dramatically easier for SLPs. In contrast to painstaking pen-and-paper recordkeeping processes, SLPs can input data live during a session with the click of a mouse. The data is automatically stored in a individuals’s file and can be easily viewed in graphic form. Qualitative records can also be easily recorded and stored online.  Presence TeleCare SLPs review these records with our supervisors, school administrators, parents, and teachers.

How are assessments handled?

Valid assessments are essential to effective clinical intervention, and Presence TeleCare makes sure a client has been rigorously assessed before moving to the intervention phase.  Our SLPs choose thoughtfully from the full array of assessments available to SLPs. For new clients, Presence TeleCare SLPs, in consultation with our supervisors, use their training and judgment to assess whether in-person assessment is necessary. If so, Presence TeleCare makes arrangements for in-person assessment. Such arrangements may include assessment by a school-based SLP and/or remote supervision of the assessment using our video-conferencing platform.

What type of remediation materials or curriculum does Presence TeleCare use?

Our web platform makes telepractice fun for kids and easy for SLPs. We provide SLPs with a full arsenal of intervention stimuli, including flashcards, games, stories, and a whiteboard. The stimuli are organized in ways that make sense for clinical SLPs. SLPs can easily swap out stimuli during a session, allowing them to easily adapt to a child’s changing needs. Future tools will include scheduling, progress tracking, IEP integration and the ability of SLPs to upload their own materials.

And of course, the platform employs the latest web-based video conferencing technology, ensuring reliable, high-quality video and audio.