Adding Structure to Your Speech Teletherapy Sessions

I remember preparing for my first ever teletherapy session. It may as well have been my first speech therapy session EVER– I was that nervous.

My main hesitation was that I had no idea how to apply my SLP knowledge to a virtual setting. I had no clue what a telepractice session actually looks like.

In 2014, the learning curve was steep and there were very few resources about teletherapy for SLPs to access. But as I got more experience under my belt, I came to realize that the virtual setting doesn't necessarily change the framework of sessions.

Teletherapy just alters the way the actual activities are ordered and presented– I can keep my speech therapy structure 🙌 As SLPs know, this is often beneficial for many reasons, including...

• Keeping sessions on track

• Building routine and consistency

• Reducing unknowns for students

Once I came to understand that the structure of virtual speech therapy can parallel that of in-person sessions, I built a toolbox of digital activities to make it work. I was relieved to know that I could organize sessions in a way that was familiar.

Structuring a Teletherapy Session

This is how I generally structure my teletherapy sessions, although it does vary from student to student and day to day. Of course, this is not the only or right way to do it, but it's what works for me.

1. Check in with students, warm up, and discuss homework.

When a student (or group of students) logs in to the teletherapy session, I greet them and engage in some chit chat about what's going on in their world. Because of the virtual setting, this might also include some initial technology fixes such as moving the webcam or adjusting the microphone.

At the beginning of the session, I also like to incorporate a brief warm-up. These activities may not be directly related to students' exact goals. The purpose is to engage students, make them feel comfortable, encourage participation, and possibly get them them thinking about their speech therapy goals.

If the student had speech therapy homework, I ask how the assignment went. This may include general questions, such as checking in on a student's use of articulation carryover or fluency strategies. For those with a paper or digital assignment, we may go over some of the specific items.

This digital circle time resource covers most of what I want to do early in the session. It helps me welcome students, elicit language (through familiar routines and prompts), review homework, and display a schedule of the session activities. As a Google Slides resource, the movable images and fillable text boxes make it completely customizable.

There are also many ways to warm up with older students. Some ideas include...

• Asking a high-interest poll question

• Sharing a thought-provoking photograph (such as "What's Going On in This Picture?" from The New York Times)

• Displaying a brain-teaser, such as these word plexer puzzles (get them here on Boom)

• Role playing a conversation

• Playing a quick game (such as trivia, Kahoot!, Baamboozle)

2. Collect some data... or not!

While I don't collect data on every goal in every session, I often like to get it out of the way early. Doing so before I jump into teaching, providing cues, and giving feedback ensures the student's responses are not impacted by me. Instead, the data is a truer representation of their abilities.

This part is quick. I take just a few minutes to get quality data on one or more objectives. Read about the free tool I created for data collection in speech therapy (virtual or in-person).

3. Provide teaching, review concepts, or give reminders.

Next up– the heart of the therapeutic intervention where we use our knowledge, experience, expertise to provide a skilled service. What this looks like in any given session varies based on what the student is working on and their level of proficiency for a particular goal.

Just like in face-to-face speech therapy, this could be working to elicit a new articulation sound, explaining a grammatical structure, modeling language on an AAC device, or teaching different elements of body language. In teletherapy, you just find teletherapy platform-friendly ways to do it!

If you've done explicit teaching of the goal in previous sessions, you may just need to review or remind the student. For example, maybe the student is working on overall intelligibility. If you've already presented and discussed a set of clear speech strategies, you may just need to show and review them briefly.

For those SLPs that love to use themes in teletherapy, this is a time to introduce or discuss the theme of the week (or month). This might include revealing a new theme, inquiring about a student's experience with a topic, or pre-teaching relevant vocabulary.

4. Provide practice opportunities.

After the teaching component, it's time for the student to practice, practice, practice! This can be done through drill, a digital book or video, a game, or any other digital activity.

Because Boom Cards are digital and highly interactive, they're pretty constant for practicing skills in my teletherapy sessions. Many of the practice decks I've created (check them out here on Boom) also have a teaching element built right into the deck, so I may use one deck for both components.

Teletherapy Reinforcement Options

If you're looking for some teletherapy activities to break up drill work, provide a quick break, utilize visuals, elicit language, or reward hard work, here are a few digital reinforcement options:

1. Quick turn games (such as these from Toy Theater)

2. Digital stickers

3. Visual manipulatives (such as the Marble Jar and Abacus from Toy Theater)

4. Building activities (such as these Make-a-Games from ABC Ya)

5. 50 or 100 trials sheets (using movable or clickable pictures or digital annotation)

6. A digital choice board, such as this PDF with clickable buttons and check boxes.

5. Wrap up and explain homework.

Finally, you can wrap up your teletherapy sessions by discussing homework practice for the next week, giving scheduling reminders, and saying goodbye.

The switch to teletherapy doesn’t mean you have to completely abandon the structure you know, love, and are comfortable with in speech therapy sessions. Here's your reminder that you already know what to do. The addition of a few digital tools can help you use a similar therapy format to what has previously worked for you.

📌 Got a speech therapy board on Pinterest? SAVE the love ❤️