By: Marva Mount, MA, CCC-SLP, Vice President for Professional Services

School districts across the U.S. are facing an unprecedented shortage of speech-language pathologists (SLPs). According to the American Speech-Language-Hearing Association (ASHA), many districts continue to report unfilled SLP positions while demand for services continues to rise due to increasing student needs and federal special education requirements. As a result, current speech-language pathologists working in the schools report overwhelming caseloads, workloads, and significant burnout that causes highly efficient and caring therapists to leave their public school jobs. This vicious cycle then continues with no additional support for district-hired staff.

As districts struggle to recruit and retain qualified clinicians, speech teletherapy has emerged as an evidence-based solution that helps schools maintain compliance, ensure continuity of services, and improve access to specialized expertise. Far from being a temporary substitute, research demonstrates that teletherapy is an effective service-delivery model capable of producing outcomes comparable to traditional in-person speech-language therapy. This article will dive into this current situation by examining the aspects of teletherapy that can support in-person speech-language pathologists and students with communication challenges.

Understanding the SLP Workforce Crisis
The shortage of qualified SLPs is a nationwide challenge. School districts compete with healthcare systems, private practices, and staffing agencies for a limited pool of licensed clinicians. Rural districts, geographically isolated communities, and hard-to-staff regions frequently experience the greatest difficulty filling vacancies.

When SLP positions remain vacant, districts experience:

• Missed or delayed Individualized Education Programs (IEP) service minutes
• Increased caseloads for existing staff
• Delayed evaluations and reevaluations
• Difficulty conducting eligibility meetings
• Compensatory education obligations
• Increased risk of due process complaints

Federal law requires districts to provide services outlined in students' IEPs. Failure to deliver these services can create significant compliance risks and financial liabilities.

What Is Speech Teletherapy?
Speech teletherapy, also referred to as telepractice, is the provision of speech-language pathology services through secure videoconferencing technology. Teletherapy allows licensed SLPs to evaluate, diagnose, consult, and provide direct intervention remotely while maintaining the same professional standards required for in-person services. ASHA recognizes telepractice as an appropriate model of service delivery when provided by qualified clinicians for a school or district.

Services delivered through teletherapy may include:

• Speech and language therapy
• Comprehensive evaluations
• Reevaluations
• Augmentative and alternative communication (AAC) assessments and support
• Progress monitoring
• IEP development and participation
• Consultation with teachers and families
• Multi-Tiered System of Supports (MTSS)/Response to Intervention (RTI) support
• Supervision of speech-language pathology assistants
• Coverage/support for self-contained classrooms

Research Demonstrates Comparable Outcomes
One of the most common questions districts ask is whether students achieve the same outcomes through teletherapy as they do through traditional face-to-face therapy.

The answer from current research is encouraging.

A systematic review of school-based telehealth services found that telepractice outcomes for speech sound disorders were equivalent to, and in some cases slightly better than, traditional in-person treatment outcomes.

Research conducted by Grogan-Johnson et al. (2013) comparing speech sound interventions delivered via telepractice and face-to-face models found no significant differences in student performance outcomes. Similar findings were reported in pilot studies comparing teletherapy and conventional on-site speech-language services.

More recently, a 2025 systematic review and meta-analysis examining randomized controlled trials comparing telehealth with in-person speech-language pathology services found no significant differences in outcomes across multiple communication disorders. Researchers concluded that telehealth-based speech-language services are a viable alternative to face-to-face treatment (Scott et al., 2025).

ASHA's evidence-based review similarly reports that telepractice services are feasible, efficient, and effective for a wide range of communication disorders and populations.

Are all students good candidates for teletherapy? The short answer is no. The best answer is possibly, as long as collaboration, communication, and student needs are at the forefront of every decision made. Teletherapy should not be ruled out until thoughtful consideration is given to each individual student and what needs they bring into the therapy situation.

Benefits for School Districts

1. Expanded Access to Qualified Clinicians
Teletherapy removes geographic barriers that often limit recruitment efforts. Districts gain access to clinicians from across the state or country rather than relying solely on local candidates. This significantly expands the available talent pool.

Districts also can access specialized expertise such as:

• Bilingual speech-language pathologists
• AAC specialists
• Autism specialists
• Clinicians experienced with complex communication needs

2. Improved Compliance with IDEA Requirements
Teletherapy helps districts maintain legally required service delivery and document compliance with IEP mandates. Many providers offer robust reporting systems that track direct and indirect services, therapy minutes, progress monitoring, evaluations, and case management activities.

By ensuring students receive required services, districts reduce the risk of:

• Due process hearings
• State complaints
• Compensatory service obligations
• Litigation costs

3. Continuity of Services for Students
When vacancies occur, teletherapy allows districts to continue services without interruption. Students maintain access to therapy, progress monitoring, and related supports even when local staffing challenges arise. It is important to be curious and ask questions of possible teletherapy providers to get a more accurate idea of how they sustain continuity of staff.

Consistency is particularly important for students working on communication goals that require regular intervention and ongoing collaboration among educational team members. Having multiple service providers marching in and out of therapy for students does not yield the best results, particularly where teletherapy is involved.

4. Increased Student Engagement
Today's students are digital natives who are comfortable learning through technology. Teletherapy platforms often incorporate interactive activities, visual supports, digital games, and multimedia resources that increase participation and motivation.

Research cited by ASHA has found strong student satisfaction, high levels of engagement, and favorable participation rates in telepractice settings.

5. Enhanced Access in Rural and Underserved Areas
For rural districts, teletherapy may be the only practical solution for providing timely access to specialized speech-language services. Rather than leaving positions vacant for months, districts can quickly connect students with qualified clinicians regardless of physical location.

6. Full-Service Special Education Support
Many teletherapy providers do more than direct treatment. Experienced school-based teletherapists often participate in:

• IEP meetings
• Eligibility determinations
• Evaluations and reevaluations
• Teacher collaboration
• Parent consultations
• Progress reporting
• Medicaid documentation

This comprehensive support reduces administrative burdens on district staff and helps maintain continuity across special education processes. Teletherapists should be a dependable and consistent extension of district staff who are collaborative and communicative.

How Teletherapy Reduces Administrative Burden for School Districts
One of the most overlooked benefits of speech teletherapy is its ability to reduce the operational and administrative workload placed on special education directors, coordinators, principals, and campus staff. Many teletherapy providers offer comprehensive support that extends well beyond direct therapy services.

1. Reduces Recruitment and Hiring Challenges
Recruiting qualified SLPs has become increasingly difficult nationwide. When districts rely solely on local hiring, administrators often spend months posting positions, screening applicants, conducting interviews, negotiating contracts, and managing vacancies. Teletherapy expands access to a larger pool of licensed clinicians, reducing the time and effort required to fill open positions.

2. Eliminates Coverage Gaps During Staff Turnover
When an SLP resigns, retires, takes maternity leave, or accepts another position, districts often scramble to find replacement coverage. Teletherapy providers can frequently supply qualified clinicians more quickly than traditional hiring processes, helping prevent service interruptions and reducing the administrative work associated with emergency staffing solutions.

3. Supports Case Management Responsibilities
Many teletherapy providers offer services beyond direct treatment, including:

• IEP participation
• Progress monitoring
• Evaluation reports
• Consultation with teachers and families
• Documentation
• Medicaid-related documentation when applicable

By assuming these responsibilities, teletherapists reduce the workload placed on campus staff and special education administrators.

4. Improves Documentation and Compliance Tracking
Teletherapy programs often provide structured documentation systems and reporting tools that track:

• Therapy minutes delivered
• Student attendance
• Progress toward goals
• Direct and indirect services
• Evaluation timelines

This documentation helps districts maintain compliance and reduces the amount of time administrators spend monitoring service delivery and preparing for audits or compliance reviews.

5. Reduces Time Spent Managing Missed Minutes
When vacancies exist, administrators often spend considerable time:

• Tracking missed services
• Developing make-up plans
• Coordinating compensatory services
• Communicating with families

By maintaining consistent service delivery, teletherapy helps reduce the occurrence of missed minutes and the administrative burden associated with remediation efforts.

6. Streamlines Vendor and Staff Management
Some districts contract with multiple agencies to fill speech positions. Teletherapy providers can often supply all speech-language pathology services from a single organization, simplifying:

• Contract management
• Billing
• Scheduling
• Communication
• Staff support

This creates a more centralized and efficient management structure for district leaders

7. Reduces Scheduling and Travel Logistics
Because teletherapists provide services remotely, districts avoid many logistical challenges associated with itinerant staff, including:

• Travel between campuses
• Mileage reimbursement
• Scheduling conflicts
• Lost service time due to travel

This can lead to more efficient use of clinician time and less administrative coordination.

8. Strengthens Compliance Management
Districts remain legally responsible for delivering speech-language services identified in a student's IEP. Teletherapy helps ensure that evaluations, therapy sessions, progress reports, and IEP participation continue even during staffing shortages, reducing the administrative efforts associated with compliance monitoring and risk mitigation.

Bottom Line
Teletherapy reduces administrative burden by helping districts maintain staffing, streamline documentation, support case management activities, simplify compliance tracking, reduce recruitment demands, and minimize service disruptions. Rather than requiring administrators to continually manage vacancies and missed services, teletherapy allows district leaders to focus more time on student outcomes and program improvement.

Teletherapy is not just a staffing solution; it is an operational strategy that can reduce workload across Human Resources, Special Education, Compliance, and Campus Administration while ensuring students continue to receive the services they need.

Looking Ahead
The SLP shortage is unlikely to disappear. Demand for speech-language services continues to increase while workforce growth struggles to keep pace. However, districts no longer need to view staffing shortages as barriers to serving students effectively.

Research consistently demonstrates that speech teletherapy can deliver outcomes comparable to traditional face-to-face services when implemented appropriately by qualified clinicians. Teletherapy expands access to specialized expertise, supports IDEA compliance, protects student progress, and provides districts with a scalable solution to ongoing workforce challenges.

For many districts, teletherapy is not simply an emergency staffing strategy. It is a sustainable, evidence-based service delivery model that helps ensure every student receives the communication support necessary for educational success. If done well, students thrive and demonstrate progress with communication skills that support educational success, all without the logistical complications often found in school districts.

TSHA has an incredible Teletherapy Committee led by innovative and experienced teletherapists who volunteer their time to advance the understanding and use of successful teletherapy in a variety of settings. Check out the valuable resources they have shared and volunteer if you feel led to do so.

Teletherapy should no longer have the reputation of COVID-19 times. Since 2020, many changes have been made to platforms, materials, and evaluation instruments that have increased efficiency, student engagement, and acceptance of this valuable service delivery model. When teletherapy is done correctly, students thrive, districts are able to support students and maintain compliance, and in-person SLPs are not burdened with huge caseloads that drive them from the school systems.

We hope you, as a speech-language pathologist, will investigate and research the use of teletherapy further and share your findings with district special education administrators struggling to staff their schools. It will assist you. It will assist families. It will ensure students receive their federally mandated IEP minutes. When used effectively, it is a win for many.

Key References

• American Speech-Language-Hearing Association (2024). The Value of Telepractice in Speech-Language Pathology. Retrieved from https://www.asha.org/research/ebp/demonstrating-your-value/value-of-slp-telepractice-services/.
• Canadian Agency for Drugs and Technologies in Health. Telehealth for Speech and Language Pathology: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines. 7 April 2015. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK304803/.
• Grogan-Johnson, S., et al. (2013). A Comparison of Speech Sound Intervention Delivered by Telepractice and Side-by-Side Service Delivery Models. Communication Disorders Quarterly Vol 34, Issue 4. Pp 210-220. Aug 2013.
• Sanchez, D., Reiner, J.F., et al. (2019). Systematic Review of School Telehealth Evaluations. The Journal of School Nursing. 2019;35(1):61-76. 
• Scott AM, Clark J, Cardona M, et al. (2025). Telehealth versus face-to-face delivery of speech language pathology services: A systematic review and meta-analysis. Journal of Telemedicine and Telecare.2025;31(9):1203-1215.