|TO:||District Administrators, CESA Administrators, CCDEB Administrators, Directors of Special Education and Pupil Services, and Other Interested Parties|
|FROM:||Carolyn Stanford Taylor, Assistant Superintendent
Division for Learning Support
|SUBJECT:||The Use of Telespeech as a Service Delivery Method for Speech and Language Services
A number of questions have been raised concerning the use of telespeech as a service delivery method in Wisconsin public schools. As a result, we are providing this Information Update Bulletin to address these questions. If you have further questions about this topic, please contact the Special Education Team at (608) 266-1781.
1. What is telespeech?
Telespeech is the term used to describe a remote service delivery model that involves the use of technology as the medium for the provision of speech/language services. Although there are many terms used to describe remote service delivery across various disciplines, for the purpose of this bulletin the term telespeech will be used.
2. What technology is used to deliver services through telespeech?
Two different kinds of technology make up most of the telespeech applications in use today. The first, called store and forward (asynchronous), is used for transferring digital images from one location to another. A digital image is taken or recorded using a digital camera, (stored) and then sent (forwarded) to another location. This asynchronous application has often been used as an adjunctive mode to supplement services delivered in person, consultation, or to review and validate information observed and recorded during a live-interactive telespeech session.
The other widely used technology is live-interactive (synchronous) video conferencing. This is used when face-to-face service is required. Video conferencing involves the transmission of real-time digitized video images and voice between remote locations. There are several technology options for video conferencing. Some of these include Voice over Internet Protocol (VoIP) services, mobile videoconferencing systems, Plain Old Telephone Service (POTS) videoconferencing, and high definition television (HDTV) technologies. These are described below.
- VoIP service uses a computer, special VoIP phone, or traditional phone with adapter to convert voice into a digital signal that travels over the internet. Integrated with video software, VoIP provides a mechanism for internet-based videoconferencing. Some examples of VoIP technologies include Skype, iChat, Google Voice, and Video Chat
- Mobile videoconferencing uses a cell phone with videoconferencing capabilities to transmit audio and video over a Wi-Fi or cellular network.
- POTS videoconferencing primarily uses an analog telephone line or landline to support audio and video transmission through a videophone or specialized equipment connected to a television or computer.
- HDTV videoconferencing requires a high definition television, console, HD camera, remote control, and high speed broadband connection at both locations.
- There are also telespeech networks with commercial videoconferencing systems that utilize high-end videoconferencing technologies (e.g., Polycom) and fiber optic telephone lines (e.g., T1 lines) or high-speed internet to connect sites.
3. What is the responsibility of the Local Education Agency (LEA)?
LEAs must ensure the quality of the audio and video signal is appropriate. The selection of videoconferencing equipment should include consideration of camera capabilities (e.g., pan-tilt-zoom and resolution), display monitor capabilities (e.g., size, resolution, and dual display), and microphone and speaker quality. Network connection speed will impact the overall quality of video and audio clarity. Bandwidth is a measure of the information-carrying capacity of a communications channel. Conventional telephone connections provide the narrowest bandwidth. Broader bandwidth permits greater speed of transmission, resulting in sharper, faster, and larger video images. However, broader bandwidth is associated with higher cost and reduced availability in some areas. Network availability and reliability are also important factors, as are equipment maintenance, training, and upgrades. Secure transmission of information may be obtained through the use of encryption, the use of hardware and software firewalls, and through a virtual private network (VPN). VPN uses a public telecommunications infrastructure, such as the internet, to provide remote offices or individual users with secure access to a private organization's network.
It’s not unusual to see the use of store-and-forward, interactive, audio, and video still images in a variety of combinations and applications. The use of the Web to transfer information and data is also becoming more prevalent. The hardware, software, and peripheral devices used in telespeech will continue to change as technology continues to advance.
4. How are services to students delivered through telespeech?
When service is provided through the use of telespeech, information is transmitted across a telecommunications connection between the participants who are at different locations. Generally this consists of real-time audio and visual connections between the student and the speech/language pathologist (SLP). See question number 2.
5. May telespeech be used as a service delivery method in Wisconsin public schools?
Yes. LEAs are required to provide a free appropriate public education (FAPE) in the least restrictive environment (LRE) to all students enrolled in special education in the district. As part of FAPE, the individual education program (IEP) team may consider a number of service delivery options to meet each individual student’s needs. If the IEP team determines the use of telespeech provides FAPE to the student, it may be used as a method of service delivery.
6. What are the licensing requirements for SLPs who provide service to students in Wisconsin public schools using telespeech?
An individual must be properly licensed to provide services in a Wisconsin public school. The provision of service in a Wisconsin public school, including through telespeech, requires the SLP to hold a WDPI 820 speech and language pathology teaching license.
7. May pre-service university students use telespeech as part of a practicum or student teaching experience in Wisconsin public schools?
No. PI.34 requires pre-service students to be onsite at the school district during the experience. A WDPI-licensed SLP must also be onsite at the school district and immediately available for direction and supervision during the pre-service student’s interaction with students at the school district.
8. May a school, college, or university engaged in the preparation of professional school personnel use telecommunications as means of supervision?
9. Should the use of telespeech be written in the student’s IEP?
Yes. The IEP must include a description of the special education and related service location which clearly indicates when and where the student will be in a particular environment. The IEP team will need to address any questions or concerns the parents have regarding the use of telespeech.
10. What do IEP teams need to consider when determining if telespeech is an acceptable method of service delivery for a student?
Service delivered through telespeech must be designed to meet each student’s individual needs. Because services are based on the unique needs of each individual student, telespeech may not be appropriate in all circumstances or for all students. Determining candidacy for telespeech is based on information about the student's behavioral, physical, sensory, and cognitive abilities to participate in services provided from a distance. This information must be addressed prior to the implementation of any services delivered through the use of telespeech. The following student factors, while not exhaustive, should be discussed by IEP teams when considering the use of telespeech as a service delivery model.
- Attention (e.g., ability to sit in front of a monitor and attend to the therapist)
- Auditory comprehension (e.g., ability to follow directions)
- Necessity of support personnel, such as a paraprofessional, to assist the child onsite
- Cognitive ability
- Hearing ability
- Visual ability (e.g., ability to see material on a computer monitor)
- Behavior (e.g., ability to sit in front of a camera and minimize extraneous movements to avoid compromising the image resolution)
- Physical endurance (e.g., sitting tolerance)
- Manual dexterity (e.g., ability to operate a keyboard or mouse if needed)
- Comfort level with technology
- Cultural/linguistic considerations (e.g., availability of interpreter)
- Access to and availability of resources, especially a telecommunications network
Students who are not appropriate candidates for the delivery of services though telespeech will require direct in-person services from the SLP.
11. May an LEA bill Medicaid School Based Services (MA-SBS) for the service provided by a SLP to a student through telespeech?
No. MA-SBS reimburses only direct in-person time spent with a student for any covered service.
12. May an LEA use IDEA grant funds to pay for services provided by a SLP through telespeech?
Yes. LEAs may use IDEA grant funds for private contracting of speech and language services provided via telespeech if the SLP providing the service is WDPI licensed.
American Speech-Language-Hearing Association. (2010). Professional issues in telepractice for speech-language pathologists (professional issues statement). Available from www.asha.org/policy
American Speech-Language-Hearing Association. (2005). Speech-Language Pathologists Providing Clinical Services via Telepractice: Technical Report [Technical Report]. Available from www.asha.org/policy
American Telemedicine Association. (2010). A Blueprint for Telerehabilitation Guidelines. Available from http://www.northeasttrc.org/docs/Specialty/A%20Blueprint%20for%20Telerehabilitation%20Guidelines.pdf
American Telemedicine Association. (2012). Telemedicine/Telehealth Terminology. Retrieved from http://www.americantelemed.org/files/public/standards/glossaryofterms.pdf July 23, 2012.
Brown, N. (2002). Introduction to Telehealth. Association of Telehealth Service Professionals. Available at http://www.atsp.org/introduction-to-telehealth
Cason, J. (2011). Telerehabilitation: An adjunct service delivery model for early intervention services. International Journal of Telerehabilitation, 3(1), 19-28. Available at http://telerehab.pitt.edu/ojs/index.php/Telerehab/article/view/6071
Wakeford, L. (2002, Nov. 25). Using telehealth technology to provide services to children with special needs. OT Practice, 7(21), 12–16.