Case Study: Remote Team Sets Up Telepractice Services for Child With Autism
Work Setting: Schools
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Summary
A team of educational professionals worked together to set up speech-language pathology telepractice services for a 6-year-old child diagnosed with autism spectrum disorder (ASD) who had recently moved to a rural school district. By coordinating with an educational assistant working in the classroom, the speech-language pathologist (SLP) was able to observe and provide services remotely. The team worked with the boy to help him increase his communicative intents.
Background
Marco is a 6-year-old boy with a diagnosis of ASD. Marco recently started to gesture to objects and say words during sensory play. While reading books with an adult, Marco showed positive affect and rising intonation with single words while pointing to pictures. Marco also used pointing and some words to ask for things.
After starting kindergarten, Marco moved to a rural school within the same state. Despite the move, Marco’s family wanted him to continue with the multidisciplinary communication intervention that he had started in preschool. Marco’s new classroom consisted of six students with ASD from grades K–2. Four of the students, including Marco, were nonverbal or minimally verbal. Classroom instruction was based on an Applied Behavior Analysis approach. The school used the Picture Exchange Communication System (PECS) for all nonverbal and minimally verbal students.
Meet the Team
The interprofessional practice (IPP) team included the following members:
How They Collaborated
During the initial meeting, the team decided that the SLP, special education teacher, and OT would work together to develop classroom goals and objectives. They also discussed the logistics of setting up telepractice services in Marco’s new school. Because the SLP’s home was a 4-hour drive away, the special education director and OT assessed whether the school had the resources needed for telepractice. This included high-speed Internet for video conferencing and access to web cameras, touchscreens, and pointing devices. The team found that the school’s resources were adequate.
Once the assessment was completed, the special education teacher and telepractice SLP worked together to set up telepractice technology in the classroom. When the technology was in place, the SLP would observe Marco remotely while he worked on short activities with the classroom-based educational assistant. The SLP would then provide direction to the assistant.
The school psychologist’s role was to reach out to Marco’s parents and orient them to their child’s new school. The psychologist reported that Marco’s parents were pleased with their son’s classroom placement and the warm welcome that he received. However, Marco’s mother was apprehensive about whether Marco would benefit from telepractice therapy. The interprofessional practice (IPP) team arranged for the telepractice SLP to address her concerns.
The team met to discuss their findings and identified two main goals for Marco. These goals included (1) increasing the number and variety of communicative intents and (2) initiating use of vocalizations paired with gestures.
The team decided that the telepractice SLP would give instructional strategies and directions to the educational assistant twice a week. The special education teacher and the educational assistant would incorporate these strategies into Marco’s day-to-day classroom routine and would update the telepractice SLP at each treatment session.
Outcome
Marco’s use of communicative intents continued to grow during the academic year. At the end of the year, Marco demonstrated the ability to initiate vocalizations with gestures at least seven times during each 5-minute interaction.
Ongoing Collaboration
Marco’s IPP team agreed that they would meet at least every 6 months to monitor Marco’s progress. The team facilitator suggested that the team reflect on the frequency of future meetings, acknowledging scheduling difficulties. The special education teacher and the SLP committed to posting Marco’s session data online biweekly.
