When I started my first telepractice position over 10 years ago, I was taking a huge leap of faith. I lived in a rural area at the time, and speech-language pathologist jobs were not easy to come by.

In fact, I had been commuting over 45 minutes to my FIRST school and traveling to multiple school sites throughout the day. But I decided to leave the stability of a full-time position with benefits and put all of my eggs in the telepractice “basket.” The company hired me as an employee, but they were very clear that the position was only part-time. Fortunately, less than six months after starting with the company, I was offered a full-time position as a telepractice SLP that matched the salary at my previous brick-and-mortar job. This came complete with full benefits (e.g., health insurance, 401k plan, tuition reimbursement, etc.), paid time off, and to top it all off…NO COMMUTE!

So who wouldn’t want this type of job, you may ask? Based on ASHA’s 2016 Telepractice Survey, over 50% of SLPs working in telepractice positions served clients in elementary schools. This refers to children who are enrolled in a brick-and-mortar or online school. This does not include homeschooled students or those who are of school age but paying for private speech therapy. I wanted to make this distinction because I will be sharing the pros of telepractice from a school clinician’s perspective. There are definitely opportunities to provide services via telepractice to individuals of all ages, which is what I do in my private practice. But in the lists below, I aim to compare apples to apples.

One of the most common questions from SLPs who are considering telepractice is, “What are the pros and cons?” That’s because telepractice is still fairly new in our field, and people want to know what they are getting themselves into before jumping in feet first. They want to know, Why should I do this? What impact is it going to have on my life, my family, my finances? And most importantly, Why shouldn’t I do this? In other words, Will this be a huge mistake?

So without further ado, here are the pros and cons of telepractice from the perspective of a school-based clinician.

Ten Pros of Telepractice

1. No commute. If all you do is telepractice, you literally have zero commute! School-based SLPs in a brick-and-mortar setting commute from their home to the school(s) to which they are assigned. For me, this was four schools.
2. No “voluntary” school duties. This means no lunch room duty, bus duty, or any other duties that come along with working in a brick and mortar school.
3. More client engagement. Technology is such a HUGE part of everyday life and is becoming an even larger component of education. Kids love playing “computer” games, watching videos, and using mobile apps- all of which can be utilized via telepractice.
4. Fewer behavior problems. Because technology is so motivating for many children, the amount of negative behaviors is decreased in telepractice.
5. Smaller caseloads. Some states have caseload caps but then write in exceptions if there are SLPAs at the school. Due to the nationwide shortage of Speech-Language Pathologists, the number of students on a school-based SLP’s caseload can easily creep close to 100.
6. One-on-one therapy or smaller groups (if any). Most telepractice SLPs only have individual sessions. If they do see students in groups, groups are much smaller than the 5-6 students that you might try to cram into a group session at a brick-and-mortar school.
7. Endless possibilities when it comes to intervention materials. Because of the world wide web, the world is your oyster when it comes to the possibilities of materials that you can use in telepractice. If you need ideas, check out my online course, Materials in Telepractice.
8. Fewer sick days. When I worked in brick-and-mortar schools, I would get sick AT LEAST once per year. Since I’ve been in telepractice, I’ve taken off more days for professional development than for being sick (YAY!)
9. Flexible schedule. This varies, depending on the type of position you have (full-time versus part-time, employee versus independent contractor, etc.). Because you can complete indirect duties on your own time and work across different time zones, there is much more flexibility in telepractice than if you physically have to go into a school building (e.g., everyone must stay until 3:30pm).
10. More family involvement (if you work with online schools). If you are working with students who are at home during the school day instead of at a school building, they usually have a family member present (e.g., mom, dad, grandma, or some other responsible adult). This means that you’re getting to speak to mom/dad EVERY WEEK, maybe even twice per week. Talk about carryover! Parents can actually SEE what you do, instead of just hearing about it or reading about it in their child’s “speech homework folder.”

I’ve spent a lot of time sharing the pros of telepractice because there are so many! If you have more to add, feel free to comment below. Now for all of the skeptics, there have to be some cons, right? People are actually shocked that I “love my job.” What’s not to love? As I mentioned earlier, I’ve been doing telepractice for over 10 years, and I absolutely love it! So if you ask my opinion based on personal experience, I’d say there are no cons to telepractice. But that’s not realistic. I’ve hired, trained, and/or managed over a hundred telepractice SLPs, so I know that telepractice is not for everyone. Just as telepractice is not appropriate for every client, is not appropriate for every clinician. And I’m okay with that. So I’ve taken an objective approach to the list of cons.

Five Cons of Telepractice

1. Technology. As great as technology is, it is also unreliable. Murphy’s Law states that “what can go wrong, will go wrong.” The key is knowing what to do when something goes wrong. If you are properly trained and prepared for the “what if’s,” then you will handle technology hiccups like the pro that you are!
2. No human touch. When it comes to working with kids, I’ve always been more of a high-fiver than a hugger, so this is not a huge con for me. However, I know that many SLPs miss that human contact that you can have in-person. What if you need to deliver tactile cues? Never fear, your e-helper is near!
3. Isolation. Even if it’s not human touch that you crave, some people just enjoy the physical presence of other humans throughout the day. If you are the type of person who needs to be around other people during the day, then telepractice is not for you (unless of course, you meet up with friends during your lunch break). However, many telepractice companies provide a lot of support in the form of supervision, team meetings, and discussion forums.
4. More sedentary work day. I can’t ignore the elephant in the room. If you are providing services on the computer, you are going to need to sit (or stand) still long enough during your sessions so your students can actually see you in the view of the webcam. This is not the case in brick-and-mortar schools where you’re always on the go. If you are a full-time telepractice SLP, there are definitely ways to fight the urge to sit at your computer for eight hours straight with no break.
5. Less pay (maybe). Pay is usually a pretty hot topic when it comes to telepractice, so I will keep this brief. If you want to compare a traditional school-based SLP position at a brick-and-mortar school to a telepractice SLP position where you work for someone other than the school entity directly (either through an employee or contractor relationship), the difference is the cost of the middle-man. This is a trade-off that many SLPs are willing to accept, given the amount of training and support that you will receive from a company if you are just getting started in telepractice. If you decide that you do want to go at it alone, consider an online course, such as my Ultimate Telepractice Training for Beginners.

As I mentioned before, telepractice is not for everyone. However, I hope this list of pros and cons will help you make an informed decision about whether telepractice is right for you. If you haven’t seen my list of Top 10 Skills of a Telepractice SLP, CLICK HERE to download it for FREE. If I can be of any assistance, please email me or view my full course offerings HERE.

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