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Teletherapy solutions have made headway in addressing persistent special education staffing shortages--states should consider what might be possible with permanent legislation

COVID-era teletherapy authorizations are expiring, but the problem persists

Teletherapy solutions have made headway in addressing persistent special education staffing shortages--states should consider what might be possible with permanent legislation

COVID-19 safety guidance has been relaxed and schools have returned to in-person learning, but it’s not yet time to breathe a sigh of relief. Many schools continue to encounter challenges in effectively serving their students, faced with special education staff shortages, backlogs of evaluations, and a youth mental health crisis.

Before the pandemic, a complex web of restrictions limited the ability of schools to leverage online services. From professional associations to state licensure boards, virtual therapy and evaluation services were discouraged or prohibited. In some cases, new graduates were prevented from obtaining their necessary practice hours through remote work. Many states imposed extensive barriers to allowing a licensed therapist to serve students across a state border, slowing down the ability to serve students through teletherapy.

These boards and associations then moved quickly to lift restrictions and clarify guidance to prioritize serving children in need. But as often happens in times that call for rapid action, these changes were made with a short-term mentality. Most of the removal of barriers to teleservices was done through temporary waivers and allowances, rather than taking action to permanently include remote and online services as a solution to serving the growing number of students with special education or mental health needs. These decision makers did not imagine the long-lasting impact of the pandemic, and they did not anticipate the evolution of educational services to a more technology-forward model.

Today, more than two years after most of these waivers and temporary orders were activated, many are in limbo, and some have expired. Without permanent policy, schools are finding themselves right back where they started, with staffing shortages that limit them from providing all of the services their students need, and the inability to turn to online services to help relieve the pressure.

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Schools and educators have higher levels of comfort with virtual learning solutions than ever before. With a return to the “new normal,” now is the time to revisit temporary guidelines in favor of long-term solutions to ongoing challenges.

One specific challenge is the growing shortage of speech-language pathologists serving school special education programs. The majority of school-based speech therapists report unfilled clinical job openings in their districts, and tens of thousands of additional therapists will be needed to fill the growing need over the next decade.

To combat staff shortages, states like Arizona and Oregon have enabled remote, online supervision of on-site speech-language pathology assistants (“SLPAs”), something long supported by the American Speech-Language-Hearing Association.

Supervision of SLPAs via telepractice benefits districts, therapists, and students. Compared with advanced-degree SLP professionals, SLPAs are more affordable to hire and are a more racially diverse workforce. SLPAs working in schools can take on administrative tasks from existing on-site therapists so they can focus on delivering high-quality therapy. Data shows that when supported by assistants, therapists have more time to focus on complex caseloads, and experience reductions in their workloads and in clerical duties – one of their biggest challenges.

“Remote supervision has allowed us to more than double our in-person speech services compared to previous years when assistants were supervised on site,“ said Matt Kaste, Director of Exceptional Student Services in Yuma Elementary School District One. “This increased coverage means we can provide in-person services for some of our students who need it the most.”

When supervising therapists are offered a more flexible schedule and are able to work from home, they remain in the profession longer. Cheryl Glus, an SLP and assistant technology professional, gave her perspective. “There are several advantages for the supervising clinician. Because I don’t have to commute, I can be more present for the assistant, more easily accommodate schedule changes while still completing our required hours, and I can use my time more productively. I can also oversee assistants all over the country, seeing therapy through a different set of eyes and continuing my own education.”

Supervision via telepractice may also offer longer-term benefits to clinicians and staff in schools. Glus added: “Remote supervision increases the assistant’s confidence and independence. They aren’t physically in a room with their supervisor, looking to them for full support. This, in turn, helps them better prepare to enter the workforce.”

In states such as California, waivers enabling telesupervision have expired. As lawmakers work to create more permanent solutions, thousands of children go without their required speech services. Unless schools are able to use remote therapists to conduct the required supervision hours remotely, they cannot turn to assistants as a solution to address their students’ needs.

We’ve seen virtual solutions make headway in addressing special education staffing shortages that have persisted for years. Instead of reverting to old ways, now is the time for every state to consider what might be possible with permanent legislation.

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